Laser therapy and tacrolimus ointment best for vitiligo

Patients with vitiligo, a skin disorder characterized by patches of white, or de-pigmented skin, had better repigmentation of these patches when they were treated with a combination of laser therapy and tacrolimus ointment than patients treated with laser therapy alone, according to an article in the September issue of The Archives of Dermatology, one of the JAMA/Archives journals.

According to the article, vitiligo is a skin pigmentation disorder that affects one percent to two percent of people worldwide. Patients with vitiligo develop white patches on their skin, referred to as "lesions." Recently, the 308-nm (nanometer) excimer laser has been used to treat lesions associated with vitiligo with good results. Additionally, a new topical ointment called tacrolimus has shown promise in treating vitiligo.

Thierry Passeron, M.D., of Hopital de l'Archet, Nice, France, and colleagues investigated the effects of the 308-nm excimer laser in combination with tacrolimus on 14 patients with vitiligo aged 12 to 63 years.

For each patient, four to ten lesions were chosen and treated twice a week with the 308-nm excimer laser for a total of 24 sessions. Topical 0.1 percent tacrolimus ointment was applied twice daily to target lesions for patients in group A (excimer laser plus tacrolimus). Patients in group B received only the laser treatments. Treated lesions were compared with control lesions (that received no treatment) on the opposite side of the body. Forty-three lesions were treated (23 in group A and 20 in group B).

The researchers observed repigmentation in all group A lesions (100 percent) and in 17 (85 percent) of the 20 group B lesions. Repigmentation was not observed in the control lesions.

"A repigmentation rate of 75 percent or more was obtained in 16 (70 percent) of the 23 group A lesions and in 4 (20 percent) of the 20 group B lesions," the authors write. The average number of sessions needed to see an improvement in repigmentation was 10 for group A and 12 for group B.

"The combination of 0.1 percent tacrolimus ointment applied twice daily and 308-nm excimer laser therapy performed twice a week gives excellent results on UV-sensitive and UV-resistant areas. The treatment was well tolerated, and the patients were satisfied," the researchers conclude.