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| Tacrolimus Ointment Effectiveness and Safety of Tacrolimus in Vitiligo Children |
Padmaleela, Dr.P.Venkatesh, Dr.D.Hepcykalarini, Dr.R.Premad
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Abstract:
Thus far, several small studies and case reports on the use of topical immunomodulators in vitiligo have been published. We undertook a comprehensive literature review, searching for studies evaluating clinical response to tacrolimus topical therapy for vitiligo. Our inclusion criteria were: Use of tacrolimus ointment as monotherapy to treat vitiligo. We found 29 studies from 2002 to 2014. Overall, 709 patients were treated in 29 studies. Pooling the lesions, 50% repigmentation of vitiligo patches was never achieved before 2 months of treatment, with a peak after 6 months of therapy. The best results were obtained on lesions of the cephalic region, especially the face, with tacrolimus 0.1% ointment two times daily. The percentage of non-responsive patients ranged from 0% to 14%. The lack of melanin pigment makes the lesional skin more sensitive to sunburn. Vitiligo can be cosmetically disfiguring and is a stigmatizing condition, leading to serious psychological problems in daily life. It occurs worldwide in about 1% of the population, mostly between the ages of 10-30 years, and as often in males as in females. The cause is unknown, but might involve genetic factors, autoimmunity, toxic metabolites, and/or a higher vulnerability of melanocytes. Some new treatments for this condition include corticosteroid + UVA treatment, UVB narrow wave band (311nm) irradiation, and transplantation of autologous pigment cells. In widespread Vitiligo, residual pigment can be removed by depigmentation agents. Sunscreens, camouflage products and good guidance may help the patient to better cope with this disease.
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