title: Occlusive treatment enhances efficacy of tacrolimus 0.1% ointment in adult patients with vitiligo: results of a placebo-controlled 12-month prospective study.
abstract: Topical tacrolimus was recently introduced as a novel therapeutic option in vitiligo. Excellent results were seen mainly on the face and neck areas. We treated 30 adult vitiligo patients with tacrolimus 0.1% ointment twice daily, and compared the results with those of placebo ointment. In 20 patients, defined areas on the right arm or leg were occluded overnight with 3 different dressings. Repigmentation was evaluated quantitatively and qualitatively. Quality of life changes were assessed with the Dermatology Life Quality Index. After 6 months, treatment was stopped in 7 of 30 patients as they did not show any repigmentation, 5 of them had no occlusive therapy. After 12 months, 17 of 21 patients (81%) with facial involvement showed repigmentation of the face. Although no or minimal repigmentation occurred on the extremities when using tacrolimus ointment alone, 80% of the patients showed repigmentation on the arms when using additional occlusive, especially hydrocolloid dressings. Hands, feet and lower legs were unresponsive. The best results were obtained in patients with long-standing vitiligo. Only minimal side-effects were noted. There was no significant elevation in tacrolimus blood levels, taking into account that occlusion was performed only on limited parts of the body. In conclusion, tacrolimus 0.1% ointment proved an effective and safe treatment option for adult patients with vitiligo. Beyond the face and neck areas, repigmentation could be achieved only by additional occlusion.
authors.affiliation: Department of Dermatology, University of Erlangen, Erlangen, Germany. anke.hartmann@uk-erlangen.de
authors.forename: Anke
authors.initials: A
authors.lastname: Hartmann
authors.forename: Eva-Bettina
authors.initials: EB
authors.lastname: Bröcker
authors.forename: Henning
authors.initials: H
authors.lastname: Hamm
mesh_terms: D000328:Adult; D000906:Antibodies / Q000097:blood; D000974:Antibodies, Antinuclear / Q000097:blood; D005260:Female; D006801:Humans; D007073:Immunoglobulin E / Q000097:blood; D007166:Immunosuppressive Agents / Q000097:blood / Q000627:therapeutic use*; D008297:Male; D009779:Occlusive Dressings; D009824:Ointments; D011446:Prospective Studies; D011788:Quality of Life; D012720:Severity of Illness Index; D016559:Tacrolimus / Q000097:blood / Q000627:therapeutic use*; D013961:Thyroid Gland / Q000276:immunology; D013974:Thyroxine / Q000097:blood; D014820:Vitiligo / Q000188:drug therapy* / Q000523:psychology
chemical_list: D000906:Antibodies; D000974:Antibodies, Antinuclear; D007166:Immunosuppressive Agents; D009824:Ointments; D007073:Immunoglobulin E; D013974:Thyroxine; D016559:Tacrolimus