Hartmann Anke, Bröcker Eva-Bettina, Hamm Henning
Clinic and Policlinic for Dermatology, Venerology, and Allergology, University of Würzburg, Germany.
J Dtsch Dermatol Ges. 2008 May;6(5):383-5. doi: 10.1111/j.1610-0387.2007.06455.x. Epub 2007 Nov 26.
Treatment of vitiligo is a challenge, especially in children. Recently, topical calcineurin inhibitors have been introduced in the management of vitiligo, but significant repigmentation is not achieved except on the face. Large pretibial lesions of a 15-year-old female with progressive vitiligo were treated twice daily over six months with 0.1% tacrolimus ointment on the right and 1% pimecrolimus cream on the left side without effect. Additional overnight occlusion with polyurethane and hydrocolloid foils during the following 18 months led to substantial repigmentation on both sides (tacrolimus-treated side, 88% repigmented area; pimecrolimus-treated side, 73%). Tacrolimus serum levels measured at four different time points did not exceed 1.8 ng/ml. This case report on a direct comparison of topical tacrolimus and pimecrolimus in vitiligo shows that on the shins considerable improvement could be induced with both agents only by additional long-term occlusion and that tacrolimus was somewhat more effective than pimecrolimus.
白癜风的治疗是一项挑战，尤其是在儿童中。最近，外用钙调神经磷酸酶抑制剂已被用于白癜风的治疗，但除面部外，无法实现显著的色素再生。一名15岁患有进行性白癜风的女性，其胫前有大片皮损，右侧每天两次外用0.1%他克莫司软膏，左侧每天两次外用1%吡美莫司乳膏，持续六个月，均无效果。在接下来的18个月中，额外使用聚氨酯和水胶体敷料过夜封包，两侧均出现了明显的色素再生（他克莫司治疗侧，色素再生面积为88%；吡美莫司治疗侧，色素再生面积为73%）。在四个不同时间点测量的他克莫司血清水平均未超过1.8 ng/ml。这份关于外用他克莫司和吡美莫司治疗白癜风的直接对比的病例报告表明，在小腿部位，仅通过额外的长期封包，两种药物均可诱导相当程度的改善，且他克莫司比吡美莫司稍有效。
