Pazyar Nader, Hatami Mohammad, Yaghoobi Reza, Parvar Seyedeh Yasamin, Radmanesh Mohammad, Hadibarhaghtalab Maryam
Department of Dermatology, School of Medicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.
Molecular Dermatology Research Center, Dermatology Department, Shiraz University of Medical Sciences, Shiraz, Iran.
J Cosmet Dermatol. 2023 May;22(5):1513-1520. doi: 10.1111/jocd.15616. Epub 2023 Jan 31.
Vitiligo is an autoimmune skin disorder characterized by circumscribed depigmented macules and patches caused by the loss of functional melanocytes. Although there is no definitive treatment for vitiligo, several treatment options have been associated with relative satisfactory outcomes. The purpose of this study was to compare the efficacy of micro-needling in conjunction with topical 5-fluorouracil (5-FU) versus topical tacrolimus ointment in treating vitiligo patches.
This study included nineteen participants, each of whom received both treatments on two randomly selected vitiligo patches of approximately the same size and location. On one patch, a combination of weekly micro-needling and topical application of 5-FU solution was used every other day, while on the other, 0.1% tacrolimus topical ointment was applied twice daily. The G-score was used to compare treatment outcomes after 3 months.
The median duration of the disease in our population was 7 years. Six patients (32%) in the micro-needling plus topical 5-FU treated group showed a moderate to excellent response, indicating a significant improvement between both treatments (p-value = 0.019). In contrast, all other patches treated with topical tacrolimus showed poor improvement. Lower extremity and trunk responded more to treatment with micro-needling plus topical 5-FU than upper extremity and acral areas. Moreover, none of those who have had the disease for more than ten years have responded to treatment. Mild erythema, pinpoint bleeding, and irritation were detected only in the micro-needling treated group.
The current study showed that using micro-needling in conjunction with 5-FU could treat vitiligo patients more efficiently than tacrolimus monotherapy. Despite showing moderate to excellent improvement in patches treated with micro-needling and 5-FU, this well-tolerated office-based modality still requires additional research.
白癜风是一种自身免疫性皮肤病，其特征为功能性黑素细胞丧失导致的局限性色素脱失斑和斑块。尽管白癜风尚无确切的治疗方法，但几种治疗方案已取得相对满意的效果。本研究的目的是比较微针联合外用5-氟尿嘧啶（5-FU）与外用他克莫司软膏治疗白癜风斑块的疗效。
本研究纳入了19名参与者，每个人在两个随机选择的大小和位置大致相同的白癜风斑块上接受两种治疗。在一个斑块上，每周进行微针治疗，并每隔一天外用5-FU溶液，而在另一个斑块上，每天外用两次0.1%他克莫司软膏。使用G评分比较3个月后的治疗效果。
我们研究人群中疾病的中位病程为7年。微针联合外用5-FU治疗组有6名患者（32%）显示出中度至极佳的反应，表明两种治疗之间有显著改善（p值=0.019）。相比之下，所有其他外用他克莫司治疗的斑块改善情况较差。下肢和躯干对微针联合外用5-FU治疗的反应比上肢和肢端部位更明显。此外，病程超过十年的患者均对治疗无反应。仅在微针治疗组检测到轻度轻度红斑、点状出血和刺激反应。
本研究表明，微针联合5-FU治疗白癜风患者比他克莫司单药治疗更有效。尽管微针和5-FU治疗的斑块显示出中度至极佳的改善，但这种耐受性良好的门诊治疗方式仍需要更多研究。
