Corticosteroids as effective as newer topicals in childhood vitiligo
MedWire News: A clinical trial comparing two ointments for vitiligo in children has found that the corticosteroid clobetasol propionate and newer topically applied drug tacrolimus are equally effective at treating pigmentation patches.
In both treatment groups, over half of the patients showed a good response in terms of facial patches while non-facial patches responded less well, report the authors of the study, led by Nhung Ho of the University of Toronto in Ontario, Canada.
Vitiligo is a condition that results in a loss of pigment in patches of skin around the face and elsewhere. It occurs when melanocytes, the cells responsible for skin pigmentation, die or are unable to function.
Topical corticosteroids (including clobetasol propionate) are the most commonly used treatment in childhood vitiligo, but their long-term use is a concern due to perceived side-effects. Newer topical calcineurin inhibitors, including tacrolimus may be "promising safe alternatives," according to Ho and team.
To test this, the researchers conducted a randomized trial comparing clobetasol propionate ointment (at 0.05% concentration) and tacrolimus ointment (at 0.1%).
A total of 100 children were randomly assigned to receive one or other of these two treatments, or a placebo ointment, for a total of 6 months.
Photographs were taken at the start of the study and at 2, 4, and 6 months -thereafter; a successful response was defined as repigmentation of more than 50%.
In the facial group, 58% of the clobetasol propionate group responded successfully, as did 58% of the tacrolimus group.
In the nonfacial group, 39% of the clobetasol propionate group responded, compared with 23% of the tacrolimus group - a statistically similar proportion.
"Both clobetasol propionate 0.05% and tacrolimus 0.1% ointments offer similar benefit in pediatric vitiligo, both facial and nonfacial," the team concludes.
The research is published in the British Journal of Dermatology.
MedWire (www.medwire-news.md) is an independent clinical news service provided by Springer Healthcare Limited. © Springer Healthcare Ltd; 2011
By Andrew Czyzewski