Microneedling in Combination with Topical Pimecrolimus 1% versus Topical Pimecrolimus 1% for the Treatment of Refractory Stable Vitiligo: A Randomized Clinical Trial.

Fariba Iraji,Seyed Mohsen Hosseini,Zahra Talebzadeh,Amirhossein Siadat,Mina Saber,Giuseppe Stinco,Fatemeh Mokhtari,Ali Asilian

doi:10.1155/2021/5652140

Fariba Iraji, Seyed Mohsen Hosseini + Show 6 more

Open Access

https://doi.org/10.1155/2021/5652140

Copy DOI

Abstract

Objective Vitiligo is a common, autoimmune disease that results in the destruction of the melanocytes and manifests as depigmented macules on various areas of the skin. Numerous treatment options have been proposed for vitiligo. The purpose of this study was to compare the efficacy of microneedling plus topical pimecrolimus 1% versus the sole use of topical pimecrolimus 1% for the treatment of vitiligo. Methods This clinical trial was conducted on 30 skin lesions on 15 Al-Zahra hospital patients. Each patient had two similar lesions in the limb area, and each lesion was considered a separate treatment group. The left or right side of the patient's lesion was randomly assigned to receive microneedling plus topical pimecrolimus for three months, while the other side received only topical pimecrolimus 1%. As part of the follow-up, digital photography was taken at the baseline and biweekly for three months after treatment and six months' follow-up. The following methods were used to evaluate the results: DLQI questionnaires, patient satisfaction questionnaires, and two independent dermatologists comparing the improvement rate for each group. Results Topical pimecrolimus 1% treatment led to unsatisfactory results, whereas the combination of microneedling and topical pimecrolimus1% treatment produced a more favorable overall outcome (P < 0.001). Conclusion This study established that combination therapy results in more significant patient improvement. Additionally, one patient experienced mild skin irritation as a side effect of topical pimecrolimus.

Highlights

Vitiligo is a common skin disease that affects between 1% and 2% of the world population [1] that occurs in men and women and is most prevalent between the ages of 10 and 30 [2]
Study Design. is study was performed as a randomized clinical trial on 32 lesions from 16 patients who were randomly selected from vitiligo patients who referred to dermatology clinics affiliated with Isfahan University of Medical Sciences between Dec. 2019 and Dec. 2020
We had poor recovery levels after two weeks of treatment and fair repigmentation reached to 40% after two months

Summary

Introduction

Vitiligo is a common skin disease that affects between 1% and 2% of the world population [1] that occurs in men and women and is most prevalent between the ages of 10 and 30 [2]. Various explanations for the mechanism and etiology of vitiligo have been proposed, including genetics, autoimmune mechanisms, psychological factors, biochemical factors, oxidative stress, and viral infections, the exact cause of vitiligo remains unclear [3, 4]. Multiple factors contribute to the mechanism of vitiligo. Physical and mental trauma, and prolonged exposure to UV light are all possible etiologies of vitiligo [5]. Vitiligo is an autoimmune disease frequently associated with other autoimmune conditions, including hypothyroidism, hyperthyroidism, rheumatoid arthritis, and diabetes mellitus [2]. Vitiligo’s basic pathogenesis is currently unknown [9]

Methods

Results

Conclusion