Safety and Efficacy of the Combination of 308-nm Monochromatic Excimer Light and Topical 0.1% Tacrolimus Ointment in Segmental Vitiligo: An Open-label Study.

Vitiligo is an acquired disorder characterized by depigmented macules or patches on the skin due to the loss of functional melanocytes. Segmental vitiligo (SV) is a subtype of vitiligo refractory to treatment. We studied safety and efficacy of 308-nm monochromatic excimer light (MEL) in combination with 0.1% tacrolimus ointment for the treatment of SV. Fifty patients with SV were enrolled. MEL was given on alternate dates in combination with topical tacrolimus. Clinical photographs were taken once a month. Two independent dermatologists analyzed and graded the results. Five patients were lost to follow-up. Concerning overall treatment success, 77.8 percent of patients demonstrated at least 75-percent repigmentation. More specifically, 35.6 percent of patients showed complete (100%) repigmentation (Grade 5), whereas 42.2 percent of patients showed more than 75-percent repigmentation (Grade 4). Combination therapy with topical 0.1% tacrolimus and a 308-nm excimer lamp appears to be efficacious with a good safety profile. The duration of disease was a statistically significant factor inversely correlated with treatment success rate. The site of vitiligo also plays a significant part in the outcome, as facial lesions responded best to the treatment.