Saleh Ramadan, Ahmed Aml Abd-Elaziz, M Abd-Elmagid Wafaa
Department of Dermatology, Venereology and Andrology, Faculty of Medicine, Sohag University, Sohag, Egypt.
Department of Dermatology, Farshot Central Hospital, Qena, Egypt.
J Cosmet Dermatol. 2021 Dec;20(12):3943-3952. doi: 10.1111/jocd.14041. Epub 2021 Apr 17.
Topical tacrolimus is increasingly used nowadays in the treatment of vitiligo.
We evaluated therapeutic outcomes of tacrolimus 0.03% in non-segmental vitiligo (NSV).
Sixty-three patients with NSV were divided into groups A and B. Group A received 0.03% tacrolimus ointment (n = 31) and group B received 1% hydrocortisone acetate ointment (n = 32) for 24 weeks. Vitiligo area and severity index (VASI) and repigmentation rates were determined at baseline and 4-week intervals.
In group A, 24-week VASI [0.5 (0.3, 1.95)] was significantly lower than baseline VASI [0.75 (0.5, 2.1); p = 0.030]. In group B, 24-week VASI [0.75 (0.4, 2.3)] was not significantly different from baseline VASI [0.73 (0.4, 2.1); p = 0.111]. Repigmentation was observed in 14/31 (45.2%) of patients in group A versus 0/32 (0.0%) in group B (p < 0.001). Repigmentation was graded as poor in 6/31 (19.4%), fair in 4/31 (12.9%), good in 1/31 (3.2%), and excellent in 3/31 (9.7%).
Repigmentation was achieved in 45% of patients with NSV following treatment with tacrolimus 0.03% monotherapy for 24 weeks. Tacrolimus-induced repigmentation is more likely in patients with vitiligo vulgaris, head and neck lesions, skin phototype III, and young age.
外用他克莫司目前在白癜风治疗中的应用日益广泛。
我们评估了0.03%他克莫司治疗非节段型白癜风（NSV）的疗效。
63例NSV患者分为A组和B组。A组31例患者外用0.03%他克莫司软膏，B组32例患者外用1%醋酸氢化可的松软膏，疗程24周。在基线及每4周时测定白癜风面积和严重程度指数（VASI）及色素恢复率。
A组24周时VASI[0.5（0.3，1.95）]显著低于基线VASI[0.75（0.5，2.1）；p = 0.030]。B组24周时VASI[0.75（0.4，2.3）]与基线VASI[0.73（0.4，2.1）]无显著差异（p = 0.111）。A组14/31（45.2%）患者出现色素恢复，B组为0/32（0.0%）（p < 0.001）。色素恢复情况分级为差6/31（19.4%）、中等4/31（12.9%）、良好1/31（3.2%）、优秀3/31（9.7%）。
0.03%他克莫司单药治疗24周后，45%的NSV患者实现色素恢复。寻常型白癜风、头颈部皮损、皮肤光型III及年轻患者更易出现他克莫司诱导的色素恢复。
