UV-B Phototherapy Plus Tacrolimus for Childhood Vitiligo
The combination of narrowband ultraviolet B (NBUVB) phototherapy plus topical tacrolimus has been used in adult vitiligo, but has not yet been explored in children. A recent study published in Pediatric Dermatology sought to determine the efficacy of this treatment for children. The combination of NBUVB plus topical tacrolimus ointment 0.03% was used on 20 children aged 4 to 14 with stable vitiligo with at least one pair of symmetrical patches of vitiligo.
Over the 24-week study, patients were instructed to apply a thin layer of topical tacrolimus ointment 0.03% on the target patch on the left side of the body twice daily and no topical treatment on the target patch on the right side of the body. A whole-body NBUVB unit with wavelengths from 310 to 315 nm was administered three times per week on nonconsecutive days. The results showed that there was a significantly higher percentage of repigmentation in the patches treated with combination therapy than in those treated with NBUVB alone at the end of 4 and 6 months of therapy. At the end of 6 months of therapy, 60% of target patches treated with NBUVB plus tacrolimus showed good to excellent response, whereas only 20% of target patches treated with NBUVB alone showed good to excellent response. The authors note that the response to therapy depended on the site being treated. All patches on the face and trunk had good to excellent response while extremities showed a lesser response to treatment.
The authors conclude that the combination therapy is a well-tolerated, effective treatment for childhood vitiligo that enhances the extent of skin repigmentation, decreases the time to repigmentation, and lowers the cumulative doses of NBUVB radiation. They suggest larger long-term prospective studies to determine the recurrence of disease activity and the long-term safety profile of this combination therapy.
Byline: Martha L. Sikes, MS, RPh, PA-C
Posted: January 3, 2017
Source: Wiley Online Library
Adapted from the original article.