Mumtaz Hassan, Anis Salwa, Akhtar Ambreen, Rubab Masooma, Zafar Ayesha, Niazi Nayab, Bahadur Hina, Talpur Abdul Subhan, Shafiq Muhammad A, Fatima Tehreem
Urology, Guy's and St Thomas' Hospital, London, GBR.
General Medicine, Surrey Docks Health Center, London, GBR.
Cureus. 2020 Dec 8;12(12):e11985. doi: 10.7759/cureus.11985.
Introduction Vitiligo is an acquired pigmentary disorder of the skin and mucous membranes which is characterized by circumscribed depigmented macules and patches. Vitiligo is a progressive disorder in which some or all of the melanocytes in the affected skin are selectively destroyed. Around 0.5-2% of the world population is affected by vitiligo and the average age of onset is 20 years. The objective of the study was to evaluate the efficacy of tacrolimus versus clobetasol in the treatment of vitiligo. It is an open randomized control trial conducted in the Department of Dermatology, Nishtar Hospital, Multan for six months. Methods One hundred sixty-two patients of vitiligo were included in the study. The disease was diagnosed on basis of clinical features and the Standard Assessment scale proposed by Hossain which was used to monitor and grade the response. Patients were randomly allocated into two groups by lottery method having 81 patients in each group. Group A was given tacrolimus whereas Group B was given clobetasol. Patients were followed up every four weeks. On the 12 week of treatment, effectiveness was assessed by measuring the Assessment scale proposed by Hossain. The results of the two groups were then compared. Results Sixty-three patients (38.9%) were males whereas 99 patients (61.1%) were females. The mean age of the patients included in the study was 29.68 + 8.162 years. The mean weight of the patients was 62.25 + 9.529 Kg. Out of 162, treatment was effective in 89 patients (54.9%) whereas in 73 patients (45.1%) the treatment was ineffective. In Group A (tacrolimus), 42 patients (51.9%) had effective treatment (on the complete resolution of symptoms) whereas 39 patients (48.1 %) had ineffective treatment. In Group B (clobetasol), 47 patients (58%) had effective treatment, and the rest (34, 42%) had ineffective treatment. A Chi-Square test was applied to compare the efficacy of the two groups. There was no statistically significant difference in both the groups in terms of efficacy. Group B was numerically superior in terms of effective treatment (47 versus 42) but not superior statistically. Conclusion Comparison of tacrolimus and clobetasol in patients of vitiligo showed no significant difference in the efficacy of the two groups. It can be concluded that tacrolimus may be considered superior to corticosteroids as its local and systemic adverse effects are less.
引言
白癜风是一种获得性皮肤和黏膜色素沉着紊乱疾病，其特征为局限性色素脱失斑和斑块。白癜风是一种进行性疾病，其中受影响皮肤中的部分或全部黑素细胞被选择性破坏。全球约0.5%-2%的人口受白癜风影响，平均发病年龄为20岁。本研究的目的是评估他克莫司与丙酸氯倍他索治疗白癜风的疗效。这是一项在木尔坦尼什塔尔医院皮肤科进行的为期六个月的开放性随机对照试验。
方法
162例白癜风患者纳入本研究。根据临床特征及Hossain提出的标准评估量表进行疾病诊断，该量表用于监测和评估疗效。患者通过抽签法随机分为两组，每组81例。A组给予他克莫司，B组给予丙酸氯倍他索。每四周对患者进行随访。在治疗第12周时，通过测量Hossain提出的评估量表评估疗效。然后比较两组结果。
结果
63例（38.9%）患者为男性，99例（61.1%）患者为女性。纳入研究患者的平均年龄为29.68±8.162岁。患者的平均体重为62.25±9.529千克。162例患者中，89例（54.9%）治疗有效，73例（45.1%）治疗无效。A组（他克莫司）中，42例（51.9%）治疗有效（症状完全缓解），39例（48.1%）治疗无效。B组（丙酸氯倍他索）中，47例（58%）治疗有效，其余34例（42%）治疗无效。应用卡方检验比较两组疗效。两组在疗效方面无统计学显著差异。B组在有效治疗方面在数值上更优（47例对42例），但无统计学优势。
结论
白癜风患者中他克莫司与丙酸氯倍他索的比较显示两组疗效无显著差异。可以得出结论，他克莫司因其局部和全身不良反应较少，可能优于皮质类固醇。
