Ibrahim Zeinab A, Hassan Ghada F, Elgendy Hoda Y, Al-Shenawy Hanan A
Dermatology and Venereology, Faculty of Medicine, Tanta University, Tanta, Egypt.
Dermatology Department, Tanta University, Tanta, Egypt.
J Cosmet Dermatol. 2019 Apr;18(2):581-588. doi: 10.1111/jocd.12704. Epub 2018 Jul 16.
Vitiligo is a common pigmentary disorder affecting about 1% of the general population. There are numerous medical and surgical treatments. Microneedling is an evolving treatment technique for an expanding number of dermatologic conditions. It is used also to augment transdermal drug delivery through pores created in the stratum corneum.
To evaluate the efficacy of microneedling with tacrolimus versus its efficacy with calcipotriol plus betamethasone in vitiligo treatment.
Twenty-five patients having vitiligo were selected and their symmetrical patches were divided into side A (right side) which received microneedling with dermapen and topical calcipotriol plus betamethasone and side B (left side) which received microneedling and topical tacrolimus. Every patient received a session every 2 weeks for a maximum 6 months (12 sessions) and follow-up for 3 months. Skin biopsies were taken before and after the treatment to evaluate the clinical results.
On side A, 60% of the patients showed excellent improvement while 32% showed excellent response on side B. The mean percentage of improvement was significantly higher on side A than side B (P = 0.017 ). It was effective in the most resistant sites of vitiligo such as: elbows, knees, extremities, and acral area. Histopathological examination showed a significant expression of HMB45 on side A more than side B (P = 0.005 ).
The combination of microneedling with calcipotriol plus betamethasone is more effective than its combination with tacrolimus. They are both effective in resistant sites. Both methods are safe, cheap, and good tolerated office techniques with minimal side effects.
白癜风是一种常见的色素沉着障碍性疾病，影响着约1%的普通人群。有多种医学和外科治疗方法。微针疗法是一种针对越来越多皮肤病不断发展的治疗技术。它还用于通过角质层中形成的孔来增强透皮给药。
评估微针联合他克莫司与微针联合卡泊三醇加倍他米松治疗白癜风的疗效。
选取25例白癜风患者，将其对称的皮损分为A侧（右侧），接受微针联合皮肤滚针及外用卡泊三醇加倍他米松治疗；B侧（左侧），接受微针联合外用他克莫司治疗。每位患者每2周接受一次治疗，最长持续6个月（共12次治疗），并随访3个月。在治疗前后进行皮肤活检以评估临床效果。
在A侧，60%的患者显示出极佳的改善，而在B侧，32%的患者显示出极佳的反应。A侧的平均改善百分比显著高于B侧（P = 0.017）。它在白癜风最顽固的部位如肘部、膝盖、四肢和手足部位有效。组织病理学检查显示，A侧HMB45的表达明显高于B侧（P = 0.005）。
微针联合卡泊三醇加倍他米松比微针联合他克莫司更有效。它们在顽固部位均有效。两种方法都是安全、廉价且耐受性良好的门诊技术，副作用最小。
