Repigmentation of pretibial vitiligo with calcineurin inhibitors under occlusion.

Abstract

Treatment of vitiligo is a challenge, especially in children. Recently, topical calcineurin inhibitors have been introduced in the management of vitiligo, but significant repigmentation is not achieved except on the face. Large pretibial lesions of a 15-year-old female with progressive vitiligo were treated twice daily over six months with 0.1% tacrolimus ointment on the right and 1% pimecrolimus cream on the left side without effect. Additional overnight occlusion with polyurethane and hydrocolloid foils during the following 18 months led to substantial repigmentation on both sides (tacrolimus-treated side, 88% repigmented area; pimecrolimus-treated side, 73%). Tacrolimus serum levels measured at four different time points did not exceed 1.8 ng/ml. This case report on a direct comparison of topical tacrolimus and pimecrolimus in vitiligo shows that on the shins considerable improvement could be induced with both agents only by additional long-term occlusion and that tacrolimus was somewhat more effective than pimecrolimus.

• Authors: Anke Hartmann, Eva-Bettina Bröcker, Henning Hamm
• Journal: Journal der Deutschen Dermatologischen Gesellschaft = Journal of the German Society of Dermatology : JDDG (J Dtsch Dermatol Ges) Vol. 6 Issue 5 Pg. 383-5 (May 2008) ISSN: 1610-0387 [Electronic] Germany
• PMID: 18042249 (Publication Type: Case Reports, Journal Article)

Chemical References

• Calcineurin Inhibitors
• Dermatologic Agents
• Immunosuppressive Agents
• pimecrolimus
• Tacrolimus

Topics

• Administration, Topical
• Adolescent
• Calcineurin Inhibitors
• Dermatologic Agents (administration & dosage)
• Female
• Humans
• Immunosuppressive Agents (administration & dosage)
• Leg Dermatoses (drug therapy, pathology)
• Occlusive Dressings
• Remission Induction
• Skin Pigmentation (drug effects)
• Tacrolimus (administration & dosage, analogs & derivatives)
• Tibia (pathology)
• Treatment Outcome
• Vitiligo (drug therapy, pathology)