Comparative study of treatment of childhood vitiligo 0.03% tacrolimus versus 0.03% tacrolimus and topical steroids

Rashmi, Sriram (2013) Comparative study of treatment of childhood vitiligo 0.03% tacrolimus versus 0.03% tacrolimus and topical steroids. Masters thesis, Chengalpattu Medical College, Chengalpattu.


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INTRODUCTION: Vitiligo was referred by various names such as ‘Sufaid Dagh’, ‘Phulbahari’, ‘Bars’, ‘Bahak’, ‘Kilas’, ‘Palita’, ‘Kodha’, ‘Sweta Kushta’, ‘Dhawal Kustha’. However origin of the term ‘Vitiligo’ is obscure. Vitiligo is a common skin disorder affecting between 1-2% of world population. In India and different countries across the globe the incidence ranges from 0.1 - 8.8%.The highest incidence has been reported in India followed by Mexico and Japan. It affects 50% of patients before 20 years of age and 25% before 10 years of age, resulting in a significant pediatric problem. It is characterised by completely depigmented milky white macules of varying sizes. This disorder does not cause restriction in capacity to work or expectancy of life. It leads to cosmetic disfigurement causing considerable psychological trauma to patients. AIM OF THE STUDY: The aim of the study is to compare the efficacy of 0.03% tacrolimus alone with 0.03% tacrolimus and mid-potent topical corticosteroids in the treatment of childhood vitiligo. MATERIAL AND METHODS: Study design: 0.03% tacrolimus alone. Versus 0.03% tacrolimus and topical mid-potent corticosteroids (mometasone furoate 0.1%). This was a 2 year, randomized, open, prospective, parallel group, comparative study conducted in vitiligo patients attending the Vitiligo Clinic, Department of Dermatology, Government Chengalpattu medical college, Chengalpattu. This study was conducted from November 2010 to October 2012. (2 years). 50 patients in the age group 2 to 14 years were enrolled in the study. During the initial visit the patients’ demographic details including the name, age, sex, and residential address were noted. Inclusion criteria: 1. Age more than 2 years and less than 14 years. 2. Children free of chronic illness and systemic diseases. 3. All types of vitiligo except vitiligo vulgaris irrespective of site and activity of the disease. Exclusion criteria: 1. Age less than 2 years and more than 14 years. 2. Chronic illness like tuberculosis and lymphoproliferative diseases. 3. Those children previously treated or at present treated with alternate system of medicine. 4. Vitiligo involving more than 20% BSA. CONCLUSION: 0.03 % Tacrolimus alone can be effectively used as topical monotherapy for treating localized stable Vitiligo. • Facial vitiligo responds well to 0.03% tacrolimus alone and no need to add steroids topically as it increases the risk of atrophy. • midpotent topical corticosteroids are combined with tacrolimus there was significant reduction in VASI score at an earlier date, when compared to tacrolimus alone. • The overall efficacy of tacrolimus with steroids is 32.55%, which was only slightly higher than tacrolimus only 31.47%. • Acral vitiligo does not respond to tacrolimus alone or tacrolimus with topical corticosteroids. • When midpotent topical corticosteroids are combined with tacrolimus was most effective in focal and segmental vitiligo. • Vitiligo involving the upper limb and lower limbs showed better response with T+S. • Tacrolimus alone was safe as there were no serious systemic or cutaneous adverse effects apart from transient burning in a few patients unlike steroids which caused atrophy in few patients.

Item Type: Thesis (Masters)
Uncontrolled Keywords: childhood vitiligo 0.03% tacrolimus ; 0.03% tacrolimus ; topical steroids ; Comparative study.
Subjects: MEDICAL > Dermatology Venereology and Leprosy
Depositing User: Punitha K
Date Deposited: 21 Jun 2018 14:23
Last Modified: 26 Mar 2020 14:21

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