Document Detail

Time-kinetic study of repigmentation in vitiligo patients by tacrolimus or pimecrolimus.
MedLine Citation:
PMID:  19547993     Owner:  NLM     Status:  MEDLINE    
New topical immunomodulators have been reported to cause repigmentation of vitiligo lesions. However, time-kinetics of such repigmentation in different anatomic locations is not well known. We performed a randomized double-blind placebo control study with tacrolimus versus the vehicle and a nonrandomized control study with pimecrolimus to evaluate the time to reach significant pigmentation, its duration and extent in treated areas. Antioxidant status of serum was also assessed. Twenty patients, in the tacrolimus study, had one pair of lesions on different localizations, and 20 on face and/or upper limbs for pimecrolimus. The extent of repigmentation was evaluated by slides and mapmakings at baseline and every 4 weeks during 7 months. Adverse events were recorded. The derivatives of oxygen metabolites, the ferric reducing ability of serum and vitamin E were assessed. Three groups of patients were identified with the tacrolimus study. Eight had no significant change in response characterized by a parallel increase of repigmentation or none in treated and control areas. Nine had a better repigmentation to tacrolimus at fifth month of treatment. Three had a marked repigmentation in control areas at the end of treatment. Repigmentation was significant on the face compared to upper-limbs with pimecrolimus from fourth to seventh month. A significant reduction of oxidative stress and an increase in antioxidant capacity in serum of patients treated with topical tacrolimus was observed, while those treated with pimecrolimus did not show any significant changes but an increase in vitamin E. Our work defines three periods in repigmentation, triggering during the first 4 months, increase in pigmentation with tacrolimus and a plateau or a sustained repigmentation. The continuity of the treatment seems necessary to ensure a prolonged repigmenting effect and even an enhanced one, such as the one we observed on the face with pimecrolimus. The extent of repigmentation was more significant on the face compared to other locations probably due to differences in melanocyte density. Furthermore, we did not find any relationship between repigmentation and the duration of vitiligo. Tacrolimus was able to reduce the systemic oxidative stress independently from its repigmenting capacity. Both drugs were well tolerated.
L J Lubaki; G Ghanem; P Vereecken; E Fouty; L Benammar; J Vadoud-Seyedi; M L Dell'Anna; S Briganti; M Picardo; M Heenen
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Publication Detail:
Type:  Journal Article; Randomized Controlled Trial     Date:  2009-06-23
Journal Detail:
Title:  Archives of dermatological research     Volume:  302     ISSN:  1432-069X     ISO Abbreviation:  Arch. Dermatol. Res.     Publication Date:  2010 Mar 
Date Detail:
Created Date:  2010-01-29     Completed Date:  2010-02-23     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8000462     Medline TA:  Arch Dermatol Res     Country:  Germany    
Other Details:
Languages:  eng     Pagination:  131-7     Citation Subset:  IM    
Department of Dermatology, H?pital Erasme, Universit? Libre de Bruxelles, 808 Route de Lennik, 1070 Brussels, Belgium.
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MeSH Terms
Antioxidants / therapeutic use
Double-Blind Method
Middle Aged
Oxidative Stress / drug effects
Skin Pigmentation / drug effects*
Tacrolimus / adverse effects,  analogs & derivatives*,  therapeutic use*
Vitiligo / drug therapy*,  metabolism
Reg. No./Substance:
0/Antioxidants; 0/pimecrolimus; 109581-93-3/Tacrolimus

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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