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Treatment of Childhood Vitiligo Using Tacrolimus Ointment with Narrowband Ultraviolet B Phototherapy
Author(s) -
Dayal Surabhi,
Sahu Priyadarshini,
Gupta Nidhi
Publication year - 2016
Publication title -
pediatric dermatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.542
H-Index - 73
eISSN - 1525-1470
pISSN - 0736-8046
DOI - 10.1111/pde.12991
Subject(s) - vitiligo , medicine , tacrolimus , dermatology , adverse effect , ultraviolet b , combination therapy , cumulative dose , surgery , transplantation
Background/Objectives A combination of narrowband ultraviolet B ( NBUVB ) phototherapy plus topical tacrolimus has been used in adult vitiligo but has not yet been explored in children. We therefore sought to highlight the efficacy of this synergistic combination in childhood vitiligo. The objective was to study the clinical efficacy and safety of a combination of NBUVB with topical tacrolimus ointment 0.03% in childhood vitiligo. Method In this open‐label study, 20 children, 4 to 14 years of age, with symmetrical vitiligo lesions were enrolled for 24 weeks. All were instructed to apply tacrolimus ointment 0.03% on a target patch on the left side of the body twice daily and no topical on a target patch on the right side. The whole body was irradiated with NBUVB three times per week. All patients were examined and the same dermatologist photographed lesions to assess for repigmentation at 4‐week intervals. Response was noted as the percentage of repigmentation (none, 0%; poor, 1–25%; moderate, 26–50%; good, 51–75%; excellent, >75%). Result Our study found a statistically significant difference in the mean percentage of repigmentation at 4 and 6 months between combination therapy and NBUVB monotherapy. The mean cumulative dose and average number of exposures for the first clinically visible response were significantly lower with combination therapy. No serious adverse events were noted during the study period. Conclusion Our preliminary data suggest that a combination of NBUVB phototherapy with topical tacrolimus is a highly effective and promising therapeutic option for vitiligo in children, whose treatment options are very limited, but long‐term studies are needed to evaluate the future risk of malignancy.