A double-blind, randomized, placebo-controlled trial of topical tacrolimus 0·1% vs. clobetasol propionate 0·05% in childhood vitiligo

Ho, New Fei; Pope, Elena; Weinstein, Miriam; Greenberg, SJ; Webster, CJ; Krafchik, Bernice R.

doi:10.1111/j.1365-2133.2011.10351.x

Cited by 77 publications

(64 citation statements)

References 25 publications

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“…In addition, we did not observe skin atrophy or telangiectasia in our subjects. This is similar to a study by Ho et al that none of pediatric patients developed side effects on facial vitiligo treated with 0.05 % clobetasol ointment [29].…”

Section: Discussionsupporting

confidence: 85%

A comparative study of combined treatment with fractional carbon dioxide and targeted ultraviolet B phototherapy for facial vitiligo

et al. 2016

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Facial vitiligo is associated with considerable psychological impact. The management is challenging and requires multidisciplinary treatment. Adding fractional carbon dioxide (CO2) to the conventional treatment has been reported as an effective modality. This study aimed to evaluate the efficacy of combined fractional CO2 laser, targeted ultraviolet B (UVB) phototherapy, and topical steroid on facial vitiligo. A prospective, randomized, split face study was conducted on 14 patients with symmetrical non-segmental facial vitiligo. Ten sessions of fractional CO2 laser was performed on the lesions on one side of face with 2-week interval. Immediately after laser, the lesions on both side of face were treated with 10 sessions of 2-week interval targeted UVB phototherapy and twice daily application of topical 0.05 % clobetasol propionate cream. The patients were followed up for 12 weeks after the last treatment. Clinical improvement was graded by blinded dermatologists and patients using a quartile grading scale. Twelve out of 14 patients completed the study. The degree of improvement was not different between both sides in nine patients. One patient showed more improvement on the combined laser side, and two patients showed inferior results on the combined laser side. Two patients with lesser improvement on the laser-treated side had positive Koebner phenomenon on the non-facial area. The combined treatment with laser, targeted UVB, and topical steroids are not superior to targeted UVB and topical steroids in facial vitiligo. Furthermore, laser may retard the response to the standard treatment in patients with Koebner phenomenon on non-treated areas.

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Section: Discussionsupporting

confidence: 85%

A comparative study of combined treatment with fractional carbon dioxide and targeted ultraviolet B phototherapy for facial vitiligo

et al. 2016

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“…Pre-teens and teens may be at greatest risk of striae. In split face and other studies, high potency topical corticosteroids performed well in pediatric patients with lesions on the head and neck, but not necessary better than tacrolimus [34,35]. Steroid-sparing topical agents should also be considered for long-term use on the body, as topical pimecrolimus has been shown to repigment vitiliginous skin at a comparable rate to clobetasol in split body studies [36].…”

Section: Topical Corticosteroidsmentioning

confidence: 99%

Current Management of Pediatric Vitiligo

Driessche

Silverberg²

2015

Pediatr Drugs

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Vitiligo is a common inflammatory disorder with worldwide prevalence of 0.4-2 % of the population, with half of cases beginning in childhood. The management of childhood vitiligo should be tailored to avoid negative effects on the overall growth and psychological development of the patient. Therapy of vitiligo in childhood is chosen based on the location of the lesions, lesion age, and extent of lesions in the context of the child's age and the developmental status of the child. There are four age categories in childhood vitiligo: [1] infantile and toddler (rare) (ages 0-3 years), [2] ages 4-8 years, [3] ages 9-12 years, and [4] 13+ years of age, based on developmental stage, psychological maturation, and ability to comply or participate in therapy. These categories are also differentiated psychologically by susceptibility to bullying, self-image development, and personal concern with lesion appearance, which increases with time. Intervention is advisable in cases with facial and leg involvement due to prominence of lesions and cosmetic defect. Medical interventions are largely the usage of topical therapies including corticosteroids and calcineurin inhibitors, some vitamin therapy (oral and topical vitamin D), and judicious introduction of phototherapy sources based on age and severity. Screening and appropriate subspecialist referral for co-morbidities (e.g., thyroid disease, celiac disease, psychological distress, and vitamin D deficiency) may enhance overall health. Cosmesis and camouflage are generally safe in childhood and have been noted to improve overall quality of life in this grouping. Genetic transmission of vitiligo is minimal at 5-6 % in first-degree relatives. This article reviews the therapeutics of pediatric vitiligo from the perspective of developmental stages and response to therapy.

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“…), many new studies were done by Lepe et al .,[20] Kanwar et al .,[21] Silverberg et al .,[22] and others[2324] [Table 3] showing its similar efficacy in children. Ho et al .…”

Section: Therapiesmentioning

confidence: 99%

“…Ho et al . [23] undertook a prospective study in children aged 2-16 years with vitiligo, in which he compared tacrolimus with clobetasol propionate and placebo and showed the results were same in both treatment groups and better when compared to the placebo. Studies showing efficacy of pimecrolimus primarily in children are lacking; however, many studies studying a mixed population of children and adults[25–28] are available, which is summarized in Table 4.…”

Section: Therapiesmentioning

confidence: 99%

Childhood vitiligo: Treatment paradigms

Kanwar

Kumaran

2012

Indian J Dermatol

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Childhood vitiligo differs from the adults by showing a higher incidence in females, segmental vitiligo being more common and less frequent association with other systemic autoimmune and endocrine disorders. Childhood vitiligo is often associated with a marked psychosocial and long lasting effect on the self-esteem of the affected children and their parents, hence an adequate treatment is very essential. Treatment of vitiligo is indeed a tough challenge for the dermatologists’ more so in the background of childhood vitiligo. Although multiple therapeutic modalities are available in the therapeutic armamentarium, not all can be used in children. This brief report updates regarding various therapies available in the treatment of childhood vitiligo.

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A double-blind, randomized, placebo-controlled trial of topical tacrolimus 0·1% vs. clobetasol propionate 0·05% in childhood vitiligo

Abstract: Both CP 0·05% and T 0·1% ointments offer similar benefit in paediatric vitiligo, both facial and nonfacial. The facial lesions responded faster than the nonfacial ones.

Cited by 77 publications

References 25 publications

A comparative study of combined treatment with fractional carbon dioxide and targeted ultraviolet B phototherapy for facial vitiligo

A comparative study of combined treatment with fractional carbon dioxide and targeted ultraviolet B phototherapy for facial vitiligo

Current Management of Pediatric Vitiligo

Childhood vitiligo: Treatment paradigms

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