Topical tacrolimus for treatment of childhood vitiligo in Asians

Abstract

Childhood vitiligo is a common disorder of pigmentation in India. Considering the lack of uniformly effective and safe treatment modalities for children with vitiligo, search for newer therapeutic agents continues. This study was designed to evaluate the role of topical tacrolimus in the treatment of childhood vitiligo. Twenty-five children with vitiligo were treated with topical 0.03% tacrolimus ointment applied twice daily for 12 weeks. Response was noted as marked to complete (> 75% repigmentation), moderate (50-75% repigmentation) and mild (< 50% repigmentation). Twenty-two children (9 boys and 13 girls) of mean age 7.2 +/- 1.4 years completed the study. Twelve (54.5%) children had vitiligo vulgaris, nine (40.9%) had focal vitiligo and one (4.5%) had segmental vitiligo. The mean duration of disease was 8 +/- 3 months. Nineteen (86.4%) children showed some repigmentation at the end of 3 months and other three had no response. Of these 19 children, repigmentation was marked to complete in 11 (57.9%), moderate in five (26.3%) and mild in three (15.7%) children. Side effects were minimal, such as the pruritus and burning noted in only three patients. Topical tacrolimus is an effective and well-tolerated treatment modality in Asian children with vitiligo.

Effect of Topical Tacrolimus on Vitiligo in Children

“…This corroborates with the study done by Jarallah et al 8 In this study generalized, focal and segmental types of vitiligo were in 46.67%, 43.33%, and 10% cases. These findings correspond with the study done by Kanwar et al 6 where these were 54.5%, 40.9% and 4.5% respectively.…”

“…Majority of the patients suffering from vitiligo were in the age group of 7-12 years (Table I) and majority were females (56.66%); 16.67% of cases had family history of vitiligo. Eighty per cent cases had no history of previous skin lesions (Table I), 6.67% had associated diseases, among them one had thyroid disorder and another had alopecia areata. Generalized vitiligo was the most common (46.67%) presentation followed by focal type (43.33%) ( Table I).…”

Childhood Vitiligo

“…Takrolimus ve pimekrolimus kalsinörin inhibitörleri olup, vitiligo tedavisinde melanositlere karşı sitotoksik T lenfosit reaksiyonlarını baskılayarak etki gösterdikleri varsayılmaktadır [23][24][25] . Yapılan çalışmalarda kalsinörin inhibitörlerinin etkilerinin topikal steroidlere eşdeğer olduğu ve onlar kadar yan etkiler göstermedikleri ortaya konmuştur.…”

Topical Calcineurin Inhibitors in the Treatment of Vitiligo

“…This indicates the involvement of melanoblast in the repigmentation process, namely the proliferation of inactive melanocytes (melanoblasts), which migrate to the nearby epidermis to differentiate and form perifollicular pigment islands. 35,36,37 Topical tacrolimus induces follicular repigmentation better in sun-exposed anatomical sites. Keratinocytes are known to secrete endothelin, a prodifferentiation factor of melanoblasts, after exposure to UVB radiation.…”