Department of Dermatology, Venereology, and Leprology, Post Graduate Institute of Medical Education and Research, Chandigarh, India.
J Eur Acad Dermatol Venereol. 2023 Nov;37(11):2243-2248. doi: 10.1111/jdv.19362. Epub 2023 Aug 7.
Acral vitiligo is a significantly distressing condition and tends to be treatment-resistant. The occurrence of new lesions on acral areas further causes greater psychological trauma. Topical tacrolimus has been widely used in the management of vitiligo and its role in preventing flares in other dermatoses such as atopic dermatitis has been well documented.
To assess the role of topical tacrolimus as preventive therapy in unstable acral vitiligo.
In this single-centre randomized prospective study, 60 patients aged 16-60 years having unstable acral vitiligo with symmetrical lesions were enrolled and randomized (1:1) into two groups. Patients in group A were instructed to apply topical tacrolimus 0.1% ointment on both vitiliginous and normal skin while patients in group B were instructed to apply topical tacrolimus 0.1% ointment only on vitiliginous skin for 6 months. Only the distal hand till the wrist joint was chosen for observation. Vitiliginous patches were assessed monthly for 6 months for a change in the number of lesions and total area involved, extension of preexisting lesions and adverse effects if any.
A reduction in the number of lesions was observed in both groups. The decrease in the number of lesions in group A was 5.6% as compared to 2.3% in group B (p-0.001). The decrease in depigmented area in group A was 10.5% as compared to 4.6% in group B (p-0.048). Treatment failure was seen in 11 out of 60 (18.3%) patients.
Tacrolimus 0.1% ointment application showed effectiveness in preventing the appearance of new lesions in unstable acral vitiligo and hastening the repigmentation when applied on both lesional and perilesional skin in vitiligo.
肢端型白癜风是一种令人深感苦恼的疾病，且往往难以治疗。肢端部位出现新的皮损会带来更大的心理创伤。他克莫司乳膏已广泛用于白癜风的治疗，其在预防特应性皮炎等其他皮肤病发作方面的作用也有充分的文献记载。
评估他克莫司乳膏作为不稳定肢端型白癜风预防性治疗的作用。
这是一项单中心、前瞻性随机研究，共纳入 60 例年龄在 16-60 岁之间、患有对称性不稳定肢端型白癜风的患者，并将其随机（1:1）分为两组。A 组患者被指示在正常皮肤和白癜风皮损上涂抹他克莫司 0.1%软膏，B 组患者仅在白癜风皮损上涂抹他克莫司 0.1%软膏，两组均治疗 6 个月。仅对手远端至腕关节进行观察。在治疗的前 6 个月内，每月评估白癜风皮损的数量和受累总面积、原有皮损的扩展以及任何不良反应。
两组患者的皮损数量均有所减少。A 组皮损数量减少 5.6%，B 组减少 2.3%（p<0.001）。A 组皮损脱色面积减少 10.5%，B 组减少 4.6%（p=0.048）。60 例患者中有 11 例（18.3%）治疗失败。
他克莫司 0.1%软膏应用于不稳定肢端型白癜风，不仅能有效预防新皮损出现，还能加速皮损和周围正常皮肤的复色。
