Microneedling combined with pimecrolimus, 5-fluorouracil, and trichloroacetic acid in the treatment of vitiligo: A comparative study.
5 fluorouracil
Pimecrolimus
TCA
microneedling
vitiligo
Journal
Dermatologic therapy
ISSN: 1529-8019
Titre abrégé: Dermatol Ther
Pays: United States
ID NLM: 9700070
Informations de publication
Date de publication:
03 2022
03 2022
Historique:
revised:
21
12
2021
received:
31
07
2021
accepted:
23
12
2021
pubmed:
30
12
2021
medline:
5
4
2022
entrez:
29
12
2021
Statut:
ppublish
Résumé
Treatment of vitiligo represents a highly therapeutic challenge in spite of the continuous development of new modalities. Combination therapies of vitiligo can help improve treatment response, and reduce recurrence potential. To compare the efficacy and adverse effects of microneedling combined with-fluorouracil, pimecrolimus, and trichloroacetic acid (TCA) in the treatment of localized, stable vitiligo. The study included 75 patients with non-segmental, stable vitiligo who were randomly assigned to three equal groups: group received a combination of microneedling and -FU, group 2 received microneedling and pimecrolimus, and group 3 received microneedling and TCA. The procedure was done every 2 weeks for a maximum of six sessions. Combined microneedling and TCA was associated with the highest + 5-fluorouracil, and lastly combined microneedling + pimecrolimus. The difference between the three groups was statistically significant in favor of the combined microneedling and TCA. Pain, erythema, post-inflammatory hyperpigmentation, infection, and scarring were variably reported adverse effects in the three groups. Combination therapy seems to be a promising modality for the treatment of vitiligo. Combined microneedling and TCA is superior to combined microneedling with either-fluorouracil or pimecrolimus.
Substances chimiques
Trichloroacetic Acid
5V2JDO056X
pimecrolimus
7KYV510875
Fluorouracil
U3P01618RT
Tacrolimus
WM0HAQ4WNM
Types de publication
Journal Article
Randomized Controlled Trial
Langues
eng
Sous-ensembles de citation
IM
Pagination
e15294Informations de copyright
© 2021 Wiley Periodicals LLC.
Références
Spritz RA. The genetics of generalized vitiligo. Curr Dir Autoimmun. 2008;10:244-257.
Hossani-Madani A, Halder R. Treatment of vitiligo: advantages and disadvantages, indications for use and outcomes. G Ital Dermatol Venereol. 2011;146(5):373-395.
Nofal A, Fawzy MM, Alakad R. Trichloroacetic acid in different concentrations: a promising treatment modality for vitiligo. Dermatol Surg. 2021;47(2):e53-e57.
Tharp M. Calcineurin inhibitors. Dermatol Ther. 2009;15:325-332.
Gauthier Y, Anbar T, Lepreux S, et al. Possible mechanisms by which topical 5-fluorouracil and dermabrasion could induce pigment spread in vitiligo skin: an experimental study. ISRN Dermatol. 2013;8:4952.
Mina M, Elgarhy L, Al-Saeid H, Ibrahim Z. Comparison between the efficacy of microneedling combined with 5-fluorouracil vs microneedling with tacrolimus in the treatment of vitiligo. J Cosmet Dermatol. 2018;17(5):744-751.
Puri N, Puri A. A comparative study on 100% TCA versus 88% phenol for the treatment of vitiligo. Our Dermatol. 2012;3:184-186.
Alegre-Sánchez A, Jiménez-Gómez N, Boixeda P. Laser-assisted drug delivery. Actas Dermosifiliogr. 2018;109(10):858-867.
Bhor U, Pande S. Scoring systems in dermatology. Indian J Dermatol Venereol Leprol. 2006;72(4):315-321.
Abd El-Samad Z, Shaaban D. Treatment of localized non-segmental vitiligo with intradermal 5-flurouracil injection combined with narrow-band ultraviolet. J Dermatol Treat. 2012;23:443-448.
Vedamurthy M, Moorthy A, Samuel S. Successful treatment of vitiligo by needling with topical 5 fluorouracil. Pigment Disord. 2016;3:242.
Moore A. Clinical applications for topical 5-fluorouracil in the treatment of dermatological disorders. Review article. J Dermatol Treat. 2009;20:328-335.
Farajzadeh S, Daraei Z, Esfandiarpour I, Hosseini SH. The efficacy of pimecrolimus 1% cream combined with microdermabrasion in the treatment of nonsegmental childhood vitiligo: a randomized placebocontrolled study. Pediatr Dermatol. 2009;26:286-291.
Ebrahim HM, Elkot R, Albalate W. Combined microneedling with tacrolimus vs tacrolimus monotherapy for vitiligo treatment. J Dermatol Treat. 2020;32(8):999-1004. doi:10.1080/09546634.2020.1716930
Guenther L, Lynde C, Poulin Y. Off-label use of topical calcineurin inhibitors in dermatologic disorders. J Cutan Med Surg. 2019;23(Suppl 4):27S-34S.
Kang HY, Choi YM. FK506 increases pigmentation and migration of human melanocytes. Br J Dermatol. 2006;155:1037-1040.
Lan CC, Chen GS, Chiou MH, Wu CS, Chang CH, Yu HS. FK506 promotes melanocyte and melanoblast growth and creates a favourable milieu for cell migration via keratinocytes: possible mechanisms of how tacrolimus ointment induces repigmentation in patients with vitiligo. Br J Dermatol. 2005;153(3):498-505.
Hunter N, Mashaly H, Dorgham D, Ismail S. Trichloroacetic acid peel 15% + NB-UVB versus trichloroacetic acid peel 25% + NB-UVB for stable non-segmental vitiligo. Med J Cairo Univ. 2016;84(1):959-963.
El Mofty M, Esmat S, Hunter N, et al. Effect of different types of therapeutic trauma on vitiligo lesions. Dermatol Ther. 2017;30(2):e12447. https://doi.org/10.1111/dth.12447
Khater M, Nasr M, Salah S, Khattab FM. Clinical evaluation of the efficacy of trichloroacetic acid 70% after microneedling vs intradermal injection of 5-fluorouracil in the treatment of nonsegmental vitiligo. A Prospective Comparative Study Dermatol Ther. 2020;33:e13532.