Does Pimecrolimus Cream Enhance the Effect of Excimer Laser on Eyelid Vitiligo

Abstract

INTRODUCTION: Vitiligo is a cutaneous disorder of pigmentation, for which, there are some proven modalities of treatment. In this study, we evaluated the efficacy of the addition of topical pimecrolimus to 308nm Excimer laser in reducing treatment duration and improving the response rate of eyelid vitiligo, compared with 308nm Excimer laser monotherapy. METHODS: Fifty two symmetrically localized lesions of eyelid vitiligo in 26 patients were observed. Each of vitiliginous patches was treated with 308nm Excimer laser twice a week for a total of 30 sessions. Topical pimecrolimus 1% cream was applied to the patches of right eyelid(group A lesions) and eucerine cream as a placebo to the left side patches(group B lesions)twice daily, throughout the study. Photographs were taken at baseline, 6 and 15 weeks after starting the treatment. RESULTS: Twenty two patients (44 lesions) completed the study. Repigmentation was appeared in all (100%) of groups A and B lesions. A 75% or more repigmentation was achieved in 17(78%) of group A versus 14 (64%) of group B lesions. The average number of sessions needed for the appearance of repigmentation was 8 for group A lesions and 12 for group. The repigmentaion of 50% or more in patients with disease duration of 2 years or less and those with more than 2 years duration ere 100% and 59.2%, respectively. CONCLUSION: Repigmentation rate obtained by the combination therapy of eyelid vitiligo with 308nm Excimer laser and topical Pimecrolimus 1%cream is significantly higher, and obtained in fewer sessions in comparison with 308nm Excimer laser and placebo combination therapy.