Effect of Topical Tacrolimus on Vitiligo in Children

Aqm Serajul Islam,Gazi Asma Sultana,Mansur Alam,Md Abdul Wahab,Mohammed Ziaur Rahman Bhuiyan

doi:10.3329/jemc.v6i1.26380

Abstract

Background: Considering safe treatment modalities for children with vitiligo, search for newer therapeutic agents continues. Hence, new immunomodulatory agents such as calcineurinantagonists, frequently referred to as topical immunomodulators (TIMs) have recently been introduced as new promising tools to treat acquired hypopigmentary disorders. Tacrolimus is safe in treating children due to lack of skin atrophy and less data are available on effect of topical tacrolimus on vitiligo.Objective: To see the effect of topical tacrolimus on vitiligo in children.Materials and Methods: This prospective study was done in outpatient department of Dermatology and Venereology, Chittagong Medical College Hospital (CMCH), Bangladesh. Clinically diagnosed vitiligo patients of up to 12 years age visiting Skin & VD OPD, CMCH during study period were the study population (total 30). The study was carried out from November 2007 to April 2008.Results: A total of 30 patients, 13 (43.33%) males and 17 (56.66%) females with focal, segmental or generalized vitiligo were studied. Seventy percent of study subjects were from 712 years of age. Topical tacrolimus 0.03% ointment was administered twice daily for 12 weeks to each patient. Repigmentation was complete (>75%) in 43.33% cases (13/30), was moderate (5075%) in 33.33% (10/30), mild (<50%) in 13.33% (4/30). Clinical adverse effects were noted in 6.67% (2/30) of cases where pruritus was in 3.33% (1/30) and burning in 3.33% (1/30). None of the reactions was severe, all were mild and well-tolerated and most occurred within the first month of initiation of treatment and resolved with continued use of drug and completely cured after the treatment completed. Nobody had to discontinue the therapy for side effects.Conclusion: In conclusion, tacrolimus ointment may be a rapidly efficacious and safe option for the treatment of vitiligo in children. The ease of topical self-administration with minimal side effects makes this novel immunomodulatory agent a promising addition to the therapeutic armamentarium for vitiligo in children.J Enam Med Col 2016; 6(1): 33-37

Highlights

The word vitiligo is derived from Greek word ‘vitilus’ cutaneous macules and patches devoid of identifiable which means spotted calf.[1]
We evaluate the effects of tacrolimus in children with vitiligo
Patients aged more than 12 years, patients who refused to be included in the study, known cases of tacrolimus sensitivity, patients taking or requiring any steroids, patients with extensive vitiligo, with albinism and hypopigmented nevus were excluded from the study

Summary

Introduction

The word vitiligo is derived from Greek word ‘vitilus’ cutaneous macules and patches devoid of identifiable which means spotted calf.[1]. January 2016 affected by vitiligo have a vast reduction of quality of life caused by the color contrast between healthy pigmented skin and the depigmented vitiliginous patches that give the patients psychological problems.[3] All races are affected. Both sexes are affected ; the female prevalence in some studies can probably be attributed to greater concern and greater willingness to express concern about a cosmetic defect.[2]. The ease of topical self-administration with minimal side effects makes this novel immunomodulatory agent a promising addition to the therapeutic armamentarium for vitiligo in children

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Conclusion