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The Best of the Best
Dec 2012

Top-Accessed Article: Successful Treatment of Vitiligo With 0.1% Tacrolimus Ointment

Author Affiliations

Author Affiliations: Department of Dermatology, Howard University College of Medicine, Washington, DC.

Arch Dermatol. 2012;148(12):1432. doi:10.1001/archdermatol.2012.2385

Travis LB, Weinberg JM, Silverberg NB. Successful treatment of vitiligo with 0.1% tacrolimus ointment. Arch Dermatol. 2003;139(5):571-574.

In this article, Travis and colleagues report 3 cases of vitiligo that were successfully treated with tacrolimus ointment. Although the number of cases is small, this report is notable because it describes patients with disease that was refractory to treatment with both topical corticosteroids and phototherapy, mainstays of therapy for vitiligo. Tacrolimus ointment was well tolerated in these patients, with no local adverse effects. It is an excellent alternative to topical corticosteroid therapy for vitiligo, especially in the face and intertriginous areas, where the risk of steroid atrophy is of major concern, and can also be used in areas that are not easily accessible to phototherapy. It is well tolerated in both children and adults.

Since the publication of this article, topical calcineurin inhibitors (tacrolimus ointment and pimecrolimus cream) are now commonly used in the treatment of vitiligo. In 2005, the Food and Drug Administration issued “black box” warnings for tacrolimus ointment and pimecrolimus cream because of potential safety risks, including lymphomas and skin cancers. Although, to our knowledge, there is currently no scientific evidence of increased risk of malignancy, care should still be taken when these medications are being prescribed for prolonged periods or for use on large body surface areas of vitiligo.

From October 2010 to August 2011, this article was accessed 2014 times on the Archives of Dermatology website.

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Article Information

Contact Dr Halder at the Department of Dermatology, Howard University College of Medicine, 2041 Georgia Ave NW, Washington, DC 20060 (rhalder@howard.edu).

Conflict of Interest Disclosures: Dr Halder has served as a consultant to Combe Corp, L’Oreal USA, and Momelan Technologies and has received royalties from Informa.