Boone Barbara, Ongenae Katia, Van Geel Nanny, Vernijns Sander, De Keyser Stefanie, Naeyaert Jean-Marie
Department of Dermatology, University Hospital of Ghent, De Pintelaan 185, 9000 Ghent, Belgium.
Eur J Dermatol. 2007 Jan-Feb;17(1):55-61. doi: 10.1684/ejd.2007.0093. Epub 2007 Feb 27.
Although the treatment of vitiligo has improved during the last decade, therapy is still not satisfactory for many patients. Recently topical calcineurin inhibitors were introduced in the treatment of atopic dermatitis. Considering the autoimmune hypothesis of vitiligo pathogenesis, the use of these topical calcineurin inhibitors seems reasonable. Most clinical vitiligo trials have been performed with tacrolimus and show beneficial effects. Concerning the value of pimecrolimus in the treatment of vitiligo only few data are available. Therefore we performed an open pilot study in 26 patients to evaluate the efficacy and safety of 1% pimecrolimus in the treatment of vitiliginous lesions in the head and neck region. In 13 of 26 (50%) evaluated target lesions, repigmentation was noted after a 6 month treatment period with a median percentage of repigmentation of 72.9% (interquartile range: 30.5-98.3%). Duration of vitiligo and total affected body surface area tended to be inversely correlated with the success rate of treatment. Side effects were mainly limited to a burning sensation at the application site. Despite the promising results of topical immunomodulators in the treatment of vitiligo, prudence is in order, as long-term follow up studies are still lacking.
尽管在过去十年中白癜风的治疗有所改善，但对许多患者来说治疗仍不尽人意。最近，局部用钙调神经磷酸酶抑制剂被引入特应性皮炎的治疗中。考虑到白癜风发病机制的自身免疫假说，使用这些局部钙调神经磷酸酶抑制剂似乎是合理的。大多数临床白癜风试验使用他克莫司进行，且显示出有益效果。关于吡美莫司在白癜风治疗中的价值，仅有少量数据。因此，我们对26例患者进行了一项开放性初步研究，以评估1%吡美莫司治疗头颈部白癜风皮损的疗效和安全性。在26例（50%）评估的靶皮损中有13例，经过6个月的治疗期后出现色素再生，色素再生的中位百分比为72.9%（四分位间距：30.5 - 98.3%）。白癜风的病程和全身受累表面积与治疗成功率呈负相关趋势。副作用主要局限于用药部位的烧灼感。尽管局部免疫调节剂在白癜风治疗中取得了令人鼓舞的结果，但由于仍缺乏长期随访研究，仍需谨慎。
