Treatment of Localized Vitiligo with 1% Pimecrolimus Cream versus 0.05% Clobetasol Propionate Cream—Single, Blinded, Comparative Therapeutic Trial ()
Affiliation(s)
1Scientific Council of Dermatology and Venereologyl, Iraqi and Arab Board for Medical Specializations, Department of Dermatology, Collage of Medicine, University of Baghdad, Baghdad, Iraq.
2Scientific Council of Dermatology and Venereology, Iraqi Board for Medical specializations, Baghdad Teaching Hospital, Medical City, Baghdad, Iraq.
3Department of Dermatology & Venereology, Baghdad Teaching Hospital, Baghdad, Iraq.
ABSTRACT
Background: Calcineurin inhibitors like tacrolimus and
pimecrolimus are new modality of treatment of localized vitiligo. Objective: To
compare the effectiveness and side effects of 1% pimecrolimus cream in
comparison with 0.05% clobetasol propionate cream as a treatment of localized
type of vitiligo. Patients and Methods: Fifty two patients with localized
vitiligo were included in this single, blind, comparative therapeutic trial.
Full history and examination for each patient was done. Wood’s light was used
when needed to confirm the diagnosis. Thirty (57.7%) were females and 22
(42.3%) males, female to male ratio of 1.36:1. Their ages ranged between 3 - 40
(13.15 ± 7.9) years, while disease duration ranged from 6 - 84 (29.62 ± 20.56)
months. Total numbers of lesions were 114 lesions with a mean of 2.2 lesions
per patient. The surface area of the lesions ranged between 1 - 31 (7.15 ±
6.98) cm2. Vitiliginous patches were most commonly located on face 48 (42.1%)
lesions, and lower limbs 35 (30.7%) lesions. Patients were divided in to two
groups according to the type of therapeutic modality. Group A consisted of 25 patients (52 lesions)
receiving 1% pimecrolimus cream and Group B 27
patients (62 lesions) treated with 0.05% clobetasol propionate cream, both used
twice daily. The amount of cream per area was applied according to rule of
fingertip unit. Measuring the surface area of the lesions and calculating the
reduction rate were done every month till the end of the 6th month.
Then patients were asked to stop the use of medication to be re-evaluated again
after 3 months without any treatment and to record any local or systemic side
effects. Results: After 6 months of treatment there was 79.67% reduction in the
surface area of lesions in Group A, while inGroup B there was 82.59% reduction in the
surface area with no statistically significant difference between the two
groups. The reduction rate was early as there was statistically significant
reduction for both groups after one month of treatment (p value < 0.01). The
reduction rates for facial lesions were more than other parts of the body.
There was no significant relapse after 3 months of stopping treatment for both
groups. Side effects were minimal and tolerable. Conclusions: Topical 1%
pimecrolimus is as effective as clobetasol propionate in treatment of localized
vitiligo affecting less than 5% of the body surface area but pimecrolimus was
more preferred as the side effects of topical steroid could be avoided.
Share and Cite:
Sharquie, K. , Al-Hamamy, H. , Noaimi, A. and Ali, K. (2015) Treatment of Localized Vitiligo with 1% Pimecrolimus Cream versus 0.05% Clobetasol Propionate Cream—Single, Blinded, Comparative Therapeutic Trial.
Journal of Cosmetics, Dermatological Sciences and Applications,
5, 107-115. doi:
10.4236/jcdsa.2015.52013.