| Title | Combined excimer laser and topical tacrolimus for the treatment of vitiligo: a pilot study. | | Author(s) | Kawalek AZ, Spencer JM, Phelps RG | | Institution | Department of Dermatology Mount Sinai School of Medicine, New York, New York, USA. | | Source | Dermatol Surg 2004 Feb; 30(2 Pt 1):130-5. | | MeSH | Administration, Topical
Adult
Double-Blind Method
Female
Humans
Immunosuppressive Agents
Lasers
Male
Middle Aged
Pilot Projects
Tacrolimus
Treatment Outcome
Vitiligo
| | Abstract | BACKGROUND: Vitiligo is an acquired skin disorder that is characterized by well-defined, often symmetric white patches. Although current therapeutic modalities are directed toward increasing melanocyte melanin production, few treatment modalities address the immunologic nature of the disease.
OBJECTIVE: To determine whether excimer laser, a known therapeutic modality, in combination with tacrolimus, a topical immunomodulator, accelerate response time and/or improve the degree of response in patients with this disorder.
METHODS: Eight subjects diagnosed with vitiligo were recruited to participate in this institutional review board-approved double-blind, placebo-controlled study. Twenty-four symmetric vitiliginous patches (elbows, knees) from eight subjects received excimer laser treatment three times per week for 24 treatments or 10 weeks. Additionally, topical tacrolimus 0.1% ointment (Protopic) and placebo (Aquaphor) were applied to randomized patches (left or right) twice daily throughout the length of the trial. Vitiliginous patches were monitored with photographs at baseline, every 2 weeks, and 6 months after treatment. Biopsies were performed on subjects with significant results.
RESULTS: Twenty vitiliginous patches from six subjects qualified for evaluation. Fifty percent of patches treated with combination excimer laser and tacrolimus achieved a successful response (75% repigmentation) compared with 20% for the placebo group. Subjects who responded successfully repigmented faster (19%) with combination therapy compared with excimer laser alone. Additionally, three subjects experienced transient hyperpigmentation in lesions treated with combination therapy.
CONCLUSION: Combining topical immunomodulators with known phototherapeutic modalities may represent a key advancement in the treatment of disease. | | Language | eng | | Pub Type(s) | Clinical Trial
Journal Article
Randomized Controlled Trial
| | PubMed ID | 14756638 |
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