Evaluation of the Efficacy of Microneedling with Tacrolimus versus Calcipotriol Plus Betamethasone Dipropionate in Vitiligo Treatment

Abstract

Background: Vitiligo is a hypopigmented skin lesion of unknown etiology. Microneedling is a safe and successful approach in vitiligo  treatment. Dermatoscopy plays an essential role with regard to the differentiation between vitiligo from other hypopigmentary disorders. 

Objective: To evaluate the clinical efficacy of microneedling with tacrolimus versus calcipotriol plus betamethasone  dipropionate (Cal/BD) in vitiligo treatment through assessing changes in the degree of repigmentation of the lesions clinically and by  dermoscope.

Patients and Methods: This was a prospective clinical trial carried on forty patients with vitiligo. The studied patient were  divided into two sides; Side A was treated with microneedling and topical calcipotriol (0.05 mg/g) plus betamethasone dipropionate (0.5  mg) ointment. Side B was treated with microneedling and topical tacrolimus (0.03%) ointment. The cases were followed up every month  for 3 months after the termination of therapeutic sessions.

Results: Good response was recognized with right side (A) and left side (B) as  regarding the Vitiligo Extent Tensity Index (VETI) scoring before versus after treatment in each treatment group (P<0.001 for both). The  combination with Cal/BD has a statistically higher outcome compared with the combination with tacrolimus ointment as revealed by dermoscope assessment.

Conclusion: Microneedling combined with Cal/BD ointment or combined with tacrolimus ointment seems to be  safe and effective therapeutic options in vitiligo treatment. Dermoscopically, the combination with Cal/BD has a statistically higher  outcome compared with the combination with tacrolimus ointment.