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A Randomized Trial to Evaluate the Efficacy and Safety of 1% Pimecrolimus Cream vs. 0.05% Clobetasol Propionate Cream for the Treatment of Childhood Vitiligo

Preeti Sharma, Amit Kumar, Amit Ranjan, Dhiraj Kumar, Bidisha Roy, Vikas Shankar and Ramawtar Singh

Objective: To assess the safety and efficacy of topical 1% Pimecrolimus cream vs. 0.05% clobetasol propionate cream for the treatment of childhood vitiligo.

Place of work: Department of Dermatology, Nalanda Medical College and Hospital, Patna, India.

Participants: In twenty-two children with vitiligo, two symmetrical lesions of about the same size and evolution time were selected. They were devoid of any topical or systemic therapy for two months prior to inclusion.

Interventions: Treatment of focal vitiligo with either topical 1% Pimecrolimus cream or 0.05% clobetasol propionate cream for a 3 month period.

Main outcome measures: The grade of repigmentation was evaluated by photographs at baseline and again at every 2 week visit. Characteristics of pigment, time of response, symptoms, telangiectasias, and atrophy were evaluated every 2 weeks.

Results: Eighteen (81.81%) of the 22 patients experienced some repigmentation. The mean percentage of repigmentation was 35.91% for Pimecrolimus and 40.45% for clobetasol. Lesions in 1 patients using clobetasol presented atrophy, and 2 lesions incurred telangiectasias, Pimecrolimus caused a burning sensation in 2 lesions.

Conclusions: Pimecrolimus 1% proved almost as effective as clobetasol propionate to restore skin color in lesions of vitiligo in children. Because it does not produce atrophy or other adverse effects, pimecrolimus 1% may be very useful for younger patients and for sensitive areas of the skin such as lips, eyelids, glans, and it should be considered in other skin disorders currently treated with topical steroids for prolonged periods.