Dermatology, Venereology and Andrology Department, Faculty of Medicine, Zagazig University, Zagazig, Egypt.
J Cosmet Dermatol. 2020 Apr;19(4):855-862. doi: 10.1111/jocd.13304. Epub 2020 Feb 6.
Combination therapies have reported to augment the repigmentation in vitiligo. Microneedling (Mn) facilitates drug delivery across the skin barrier.
To evaluate and compare the efficacy and safety of Mn combined with tacrolimus vs Mn alone or tacrolimus 0.1% ointment for treatment of localized and stable vitiligo.
Ninety patients with vitiligo were randomized into three groups: group I received microneedling with tacrolimus, group II microneedling only both at 2 weeks interval for twelve sessions, and group III applied tacrolimus ointment 0.1% twice daily for 6 months. Skin biopsies were taken at baseline and after treatment.
The overall improvement (76.6%) was significantly higher in the combined group compared with other groups. Repigmentation was excellent in 66.6 of group I vs 33.3% in the other two groups (P .03). A highly significant improvement of the extremities was observed in the combined group than in the other groups (P < .001). A fewer number of sessions have reported in the combined group (I) than in the microneedling group (II; P < .001). Immunohistochemical results showed a significantly higher expression of HMB-45 in group I than in other two groups (P .04). Side effects were mild and tolerable in all groups.
The combination group has shown promising results over the other two groups.
联合疗法已被报道可增强白癜风的复色。微针（Mn）促进药物穿过皮肤屏障的递送。
评估和比较 Mn 联合他克莫司与 Mn 单独或他克莫司 0.1%软膏治疗局限性和稳定期白癜风的疗效和安全性。
90 例白癜风患者随机分为三组：组 I 接受 Mn 联合他克莫司治疗，组 II 在 2 周间隔内接受 Mn 单独治疗，共 12 次，组 III 每天两次应用他克莫司软膏 0.1%，共 6 个月。在基线和治疗后采集皮肤活检。
联合组的总体改善率（76.6%）明显高于其他两组。组 I 的复色效果极好，占 66.6%，而其他两组为 33.3%（P<.03）。联合组的四肢改善显著高于其他两组（P<.001）。联合组（I）的治疗次数少于 Mn 组（II；P<.001）。免疫组化结果显示，组 I 的 HMB-45 表达明显高于其他两组（P<.04）。所有组的副作用均轻微且可耐受。
联合组的结果优于其他两组。
