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Repigmentation of pretibial vitiligo with calcineurin inhibitors under occlusion
Author(s) -
Hartmann Anke,
Bröcker EvaBettina,
Hamm Henning
Publication year - 2008
Publication title -
jddg: journal der deutschen dermatologischen gesellschaft
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.463
H-Index - 60
eISSN - 1610-0387
pISSN - 1610-0379
DOI - 10.1111/j.1610-0387.2007.06455.x
Subject(s) - pimecrolimus , tacrolimus , vitiligo , calcineurin , medicine , dermatology , occlusion , topical steroid , surgery , transplantation
Summary 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.