Although the treatment of
vitiligo has improved during the last decade,
therapy is still not satisfactory for many patients. Recently topical
calcineurin inhibitors were introduced in the treatment of
atopic dermatitis. Considering the autoimmune hypothesis of
vitiligo pathogenesis, the use of these topical
calcineurin inhibitors seems reasonable. Most clinical
vitiligo trials have been performed with
tacrolimus and show beneficial effects. Concerning the value of
pimecrolimus in the treatment of
vitiligo only few data are available. Therefore we performed an open pilot study in 26 patients to evaluate the efficacy and safety of 1%
pimecrolimus in the treatment of vitiliginous lesions in the head and neck region. In 13 of 26 (50%) evaluated target lesions, repigmentation was noted after a 6 month treatment period with a median percentage of repigmentation of 72.9% (interquartile range: 30.5-98.3%). Duration of
vitiligo and total affected body surface area tended to be inversely correlated with the success rate of treatment. Side effects were mainly limited to a burning sensation at the application site. Despite the promising results of topical
immunomodulators in the treatment of
vitiligo, prudence is in order, as long-term follow up studies are still lacking.