Efficacy of topical tacrolimus 0.03% monotherapy in the treatment of non‐segmental vitiligo: a randomized, controlled trial

Abstract

Several hypotheses have been suggested for the pathogenesis of vitiligo including biochemical, neural, and autoimmune theories. 1 Topical corticosteroids (TCSs) and topical calcineurin inhibitors (TCIs) are frequently used as first-line treatment of vitiligo based on their immnuesuppressive and immunemodulatory actions. 2 Despite excellent repigmenation rates provided by TCSs, their long-term use is often complicated with skin atrophy, striae, and telangiectasia. 3 Topical calcineurin inhibitors have been considered as alternatives to TCSs for vitiligo therapy given their reasonable efficacy and better short-term safety. 4 Tacrolimus is a member of the TCIs' family that acts through inhibition of T-helper (Th) cells, thus reducing synthesis and release of pro-inflammatory cytokines. 5 Cytokine transcription blockage leads to decrease in Th 1 -and Th 2 -dependent release of interleukins 2, 3, 4, and 5, interferonγ, and tumor necrosis factorα. 6 Oral tacrolimus has been approved by the Food and Drug Administration (FDA) for prophylaxis against rejection in kidney and liver transplant