Tassavor Bryan, Chopra Rishi
Osteopathic Medicine, A.T. Still University School of Osteopathic Medicine, Mesa, USA.
Dermatology, UnionDerm Private Practice, New York, USA.
Cureus. 2025 Sep 18;17(9):e92656. doi: 10.7759/cureus.92656. eCollection 2025 Sep.
Topical tacrolimus is an immunomodulator commonly used in the management of vitiligo. We report a case of tacrolimus-associated hyperpigmentation in a nine-year-old girl with non-segmental vitiligo, who presented with depigmented patches on the eyelid and trunk. The depigmented eyelid patch improved with topical tacrolimus but developed localized, paradoxical hyperpigmentation at the treated site. She was managed with alternating topical corticosteroids and tacrolimus alongside photoprotection; after six weeks, the trunk demonstrated full repigmentation, but the eyelid lesion developed marked hyperpigmentation temporally associated with tacrolimus use. Other causes of pigmentation were excluded, and the discoloration resolved completely within six weeks of discontinuing treatment. To further examine this presentation, we reviewed the literature for reports of similar pigmentary changes associated with tacrolimus. This review encompassed both oral and topical use in patients with and without vitiligo.
外用他克莫司是一种常用于治疗白癜风的免疫调节剂。我们报告了一例9岁非节段性白癜风女童外用他克莫司后出现色素沉着的病例，该女童眼睑和躯干有色素脱失斑。眼睑色素脱失斑外用他克莫司后有所改善，但在治疗部位出现了局限性、反常性色素沉着。我们采用外用糖皮质激素和他克莫司交替使用并配合光保护措施对其进行治疗；六周后，躯干完全复色，但眼睑病变出现明显色素沉着，且在时间上与使用他克莫司相关。排除了其他色素沉着原因，停止治疗六周内色素沉着完全消退。为进一步研究此表现，我们查阅了文献中有关他克莫司相关类似色素变化的报道。该综述涵盖了他克莫司在白癜风患者和非白癜风患者中的口服及外用情况。
