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J Cosmet Dermatol. 2018 Oct;17(5):744-751. doi: 10.1111/jocd.12440. Epub 2018 Mar 12.

Comparison between the efficacy of microneedling combined with 5-fluorouracil vs microneedling with tacrolimus in the treatment of vitiligo.

Author information

1
Faculty of Medicine, Department of Dermatology & Venereology, Tanta University, Tanta, Egypt.
2
Faculty of Medicine, Department of pathology, Tanta University, Tanta, Egypt.

Abstract

BACKGROUND:

Several treatment modalities had been used for the treatment of vitiligo, but the optimal treatment has not yet been identified.

OBJECTIVES:

To study the efficacy of microneedling with 5-flurouracil vs its efficacy with tacrolimus in the treatment of vitiligo.

PATIENTS AND METHODS:

Twenty-five patients with vitiligo were subjected to microneedling of 2 patches of vitiligo with dermapen, then application of 5-fluorouracil to 1 patch and tacrolimus on the other patch. This procedure was repeated every 2 weeks for every patient for maximum 6 months (12 sessions). The patients were followed up for 3 months after the last session.

RESULTS:

The overall repigmentation was significantly higher in 5-fluorouracil-treated patches compared with tacrolimus. Excellent improvement occurred in 48% of 5- flurouracil-treated patches while only in 16% of tacrolimus-treated patches. In the acral parts, 40% of the patches treated with 5-fluorouracil achieved excellent improvement (repigmentation >75%), while no patch in the acral parts achieved excellent improvement with tacrolimus. However, there was significant difference between the 2 drugs,regarding inflammation, ulceration, and hyperpigmentation which occurred with 5-fluorouracil.

CONCLUSION:

Microneedling combined with 5-fluorouracil or tacrolimus is safe and effective treatment of vitiligo. However, 5-fluorouracil achieved a greater percentage of repigmentation than tacrolimus particularly in the acral parts.

KEYWORDS:

5-fluorouracil; tacrolimus; vitiligo

PMID:
29532621
DOI:
10.1111/jocd.12440

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