Narrow-band UVB phototherapy combined with tacrolimus ointment in vitiligo: a review of 110 patients.
BACKGROUND
Narrow-band ultraviolet B (NB-UVB) phototherapy and topical tacrolimus are included among the most innovative approaches to vitiligo.


OBJECTIVE
To evaluate the efficacy and tolerability of combined treatment with NB-UVB and topical tacrolimus in vitiligo.


METHODS
After informed consent, adult patients with chronic (> 1-year duration) stable vitiligo refractory to conventional treatments were enrolled in an open-labelled prospective study. Treatment regimen consists of once-daily application, in the evening, of tacrolimus 0.03% ointment to the lesions of the face, or tacrolimus 0.1% ointment to the vitiligous patches located on other areas. Concomitant NB-UVB phototherapy was performed twice weekly for 16 weeks.


RESULTS
Study population included 110 patients (mean age, 42) with a total of 403 lesions. Within the treatment period, variable repigmentation was evident on more than 70% of lesions. Clinical response (repigmentation more than 50%) was observed in 42% of lesions. Response was strictly dependent on the site, being more frequent for face lesions (73%), followed by limbs (68%) and trunk (53.5%). The therapeutic effect on the extremities and genital areas was quite disappointing. Treatment was well tolerated.


CONCLUSIONS
Our preliminary data suggest that the combination of topical tacrolimus with NB-UVB phototherapy can represent an alternative highly effective approach to refractory vitiligo located on the face, trunk and limbs. Long-term safety data and randomized controlled trials on a large number of patients are required.
Phototherapy Unit, Dermatology Service, AUSL LE2, Gagliano del Capo-Maglie, Via Umberto I 16, 73052 Parabita (LE), Salento, Italy. hello@dariofai.it
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D
Fai
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Cassano
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GA
Vena
D000293:Adolescent; D000328:Adult; D000368:Aged; D003131:Combined Modality Therapy; D005260:Female; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D009824:Ointments; D011446:Prospective Studies; D018709:Statistics, Nonparametric; D016559:Tacrolimus / Q000627:therapeutic use*; D016896:Treatment Outcome; D014467:Ultraviolet Therapy / Q000379:methods*; D014820:Vitiligo / Q000188:drug therapy* / Q000532:radiotherapy*
D007166:Immunosuppressive Agents; D009824:Ointments; D016559:Tacrolimus