Sisti Andrea, Sisti Giovanni, Oranges Carlo Maria
Montecatini Terme, Pistoia, Italy.
Department of Health Sciences, University of Florence, Florence, Italy.
An Bras Dermatol. 2016 Apr;91(2):187-95. doi: 10.1590/abd1806-4841.20164012.
Thus far, several small studies and case reports on the use of topical immunomodulators in vitiligo have been published. We undertook a comprehensive literature review, searching for studies evaluating clinical response to tacrolimus topical therapy for vitiligo. A search was performed on PubMed/Medline using the term "vitiligo", combined with "topical" and "ointment". Our inclusion criteria were: use of tacrolimus ointment as monotherapy to treat vitiligo. We found 29 studies from 2002 to 2014. Overall, 709 patients were treated in 29 studies. Pooling the lesions, 50% repigmentation of vitiligo patches was never achieved before 2 months of treatment, with a peak after 6 months of therapy. The best results were obtained on lesions of the cephalic region, especially the face, with tacrolimus 0.1% ointment two times daily. The percentage of non-responsive patients ranged from 0% to 14%. Treatment was generally well-tolerated; only localized adverse effects were reported. Our objective was to verify the effectiveness and safety of tacrolimus ointment monotherapy. It has good efficacy and tolerability. At present, only small trials and case series are available in the literature. Further, standardized investigations on a larger number of patients are needed.
迄今为止，已经发表了几项关于在白癜风中使用局部免疫调节剂的小型研究和病例报告。我们进行了全面的文献综述，搜索评估他克莫司局部治疗白癜风临床反应的研究。在PubMed/Medline上使用“白癜风”一词，并结合“局部”和“软膏”进行搜索。我们的纳入标准是：使用他克莫司软膏作为单一疗法治疗白癜风。我们找到了2002年至2014年的29项研究。总体而言，29项研究共治疗了709例患者。汇总这些皮损情况，在治疗2个月前从未实现白癜风斑块50%的色素再生，在治疗6个月后达到峰值。使用0.1%他克莫司软膏每日两次治疗，在头部区域尤其是面部的皮损上取得了最佳效果。无反应患者的比例在0%至14%之间。治疗一般耐受性良好；仅报告了局部不良反应。我们的目的是验证他克莫司软膏单一疗法的有效性和安全性。它具有良好的疗效和耐受性。目前，文献中仅有小型试验和病例系列。此外，需要对更多患者进行标准化研究。
