Targeted narrowband UVB phototherapy plus topical tacrolimus and Targeted narrowband UVB monotherapy for the treatment of vitiligo

Siri-on Klahan; Pravit Asawanonda

Authors

Siri-on Klahan DIVISION OF DERMATOLOGY, DEPARTMENT OF MEDICINE, FACULTY OF MEDICINE CHULALONGKORN UNIVERSITY, BANGKOK, THAILAND
Pravit Asawanonda DIVISION OF DERMATOLOGY, DEPARTMENT OF MEDICINE, FACULTY OF MEDICINE CHULALONGKORN UNIVERSITY, BANGKOK, THAILAND

Keywords:

vitiligo, tacrolimus, targeted phototherapy, narrowband UVB, ultraviolet

Abstract

308 nm Excimer laser and targeted narrowband UVB phototherapy have recently been shown to be effective in repigmentation of patient with vitiligo. Previous studies have suggested that the combination of 308 nm excimer laser and tacrolimus is more effective than 308 nm excimer laser monotherapy in the treatment of vitiligo. The aim of this study was to compare the efficacy of targeted narrowband UVB phototherapy plus topical tacrolimus with that of targeted narrowband UVB monotherapy for the treatment of vitiligo. Fifteen patients, received targeted narrowband UVB plus topical tacrolimus or targeted narrowband UVB monotherapy based on random assignment. The treatments were done twice a week for 12 weeks. The mean degree of repigmentation in the combined group and targeted narrowband UVB monotherapy were 1.80 and 1.53 respectively (p=0.103). The data showed the combination of targeted narrowband UVB phototherapy plus topical tacrolimus was more effective than targeted narrowband UVB monotherapy, but was not statistically significantly different at 12^th week.

References

Kostovic K, Pasic A. New treatment modalities for vitiligo: focus on topical immunomodulators. Drugs 2005; 65(4):447-459.

Arca E, Tastan HB, Erbil AH, Sezer E, Koc E, Kurumlu Z. Narrow-band ultraviolet B as monotherapy and in combination with topical calcipotriol in the treatment of vitiligo. J Dermatol 2006; 33(5):338-343.

Seirafi H, Farnaghi F, Firooz A, Vasheghani-Farahani A, Alirezaie NS, Dowlati Y. Pimecrolimus cream in repigmentation of vitiligo. Dermatology 2007; 214(3):253-259.

Coskun B, Saral Y, Turgut D. Topical 0.05% clobetasol propionate versus 1% pimecrolimus ointment in vitiligo. Eur J Dermatol 2005; 15(2):88-91.

Lepe V, Moncada B, Castanedo-Cazares JP, Torres-Alvarez MB, Ortiz CA, Torres-Rubalcava AB. A double-blind randomized trial of 0.1% tacrolimus vs 0.05% clobetasol for the treatment of childhood vitiligo. Arch Dermatol 2003; 139(5):581-585.

Grimes PE, Soriano T, Dytoc MT. Topical tacrolimus for repigmentation of vitiligo. J Am Acad Dermatol 2002; 47(5):789-791.

Asawanonda P, Kijluakiat J, Korkij W, Sindhupak W. Targeted broadband ultraviolet b phototherapy produces similar responses to targeted narrowband ultraviolet B phototherapy for vitiligo: a randomized, double-blind study. Acta Derm Venereol 2008; 88(4):376-381.

Asawanonda P, Charoenlap M, Korkij W. Treatment of localized vitiligo with targeted broadband UVB phototherapy: a pilot study. Photodermatol Photoimmunol Photomed 2006; 22(3):133-136.

Kawalek AZ, Spencer JM, Phelps RG. Combined excimer laser and topical tacrolimus for the treatment of vitiligo: a pilot study. Dermatol Surg 2004; 30(2 Pt 1):130-135.

Lotti T, Buggiani G, Troiano M, Assad GB, Delescluse J, De G, V et al. Targeted and combination treatments for vitiligo. Comparative evaluation of different current modalities in 458 subjects. Dermatol Ther 2008; 21 Suppl 1:S20-S26.

Passeron T, Ostovari N, Zakaria W, Fontas E, Larrouy JC, Lacour JP et al. Topical tacrolimus and the 308-nm excimer laser: a synergistic combination for the treatment of vitiligo. Arch Dermatol 2004; 140(9):1065-1069.

Kang HY, Choi YM. FK506 increases pigmentation and migration of human melanocytes. Br J Dermatol 2006; 155(5):1037-1040.

Lan CC, Chen GS, Chiou MH, Wu CS, Chang CH, Yu HS. FK506 promotes melanocyte and melanoblast growth and creates a favourable milieu for cell migration via keratinocytes: possible mechanisms of how tacrolimus ointment induces repigmentation in patients with vitiligo. Br J Dermatol 2005; 153(3):498-505.

Brazzelli V, Antoninetti M, Palazzini S, Barbagallo T, De Silvestri A, Borroni G. Critical evaluation of the variants influencing the clinical response of vitiligo: study of 60 cases treated with ultraviolet B narrow-band phototherapy. J Eur Acad Dermatol Venereol 2007; 21(10):1369-1374.

Yarosh DB, Pena AV, Nay SL, Canning MT, Brown DA. Calcineurin inhibitors decrease DNA repair and apoptosis in human keratinocytes following ultraviolet B irradiation. J Invest Dermatol 2005; 125(5):1020-1025.

Tran C, Lubbe J, Sorg O, Doelker L, Carraux P, Antille C et al. Topical calcineurin inhibitors decrease the production of UVB-induced thymine dimers from hairless mouse epidermis. Dermatology 2005; 211(4):341-347.