Microdermabrasion and topical tacrolimus: A novel combination therapy of vitiligo.

BACKGROUND: Topical immunomodulators have been successfully used as monotherapy or in combination with other therapeutic modalities in treating vitiligo. To the best of our knowledge, no previous studies have evaluated the combination of tacrolimus 0.03% ointment and microdermabrasion as a therapeutic modality to hasten response time and improve repigmentation rate in vitiligo vulgaris.

AIMS: To explore the efficacy and safety of the combination of MDA and topical tacrolimus (0.03%) as a novel therapeutic approach for stable vitiligo vulgaris.

METHODS: Thirty-five patients with vitiligo were enrolled in this randomized placebo-controlled study. Three vitiligenous patches were chosen in each patient. The first lesion (A) was treated by tacrolimus 0.03% ointment, the second lesion (B) was treated by tacrolimus and microdermabrasion, and the third lesion (C) was treated by petrolatum as a placebo. Treatment course was 3 months, and follow-up was done for three extra months. Vitiligenous patches were assessed at baseline and monthly for 6 months.

RESULTS: Moderate to excellent response was observed in 65.7% of lesions B, compared with 25.8% of lesions A (P = .001). Improvement in VASI score was significantly better in patients treated by the combination therapy (P = .000). Disease duration has a negative impact on therapeutic response. Patients were more satisfied with the combination treatment.

CONCLUSION: Microdermabrasion combined with tacrolimus 0.03% ointment represents a new therapeutic option for the treatment of vitiligo which appears to be an easy, safe, and effective.