Comparison of the efficacy of microneedling combined with 5-fluorouracil 5% cream versus microneedling combined with tacrolimus 0.1% ointment in the treatment of vitiligo

Abstract

Background and Design: Vitiligo is an acquired depigmenting disorder associated with profound psychological effects. It can manifest as depigmented macules that can be localized or generalized in nature. Various morphological types are seen in patients. Despite existing therapeutic options, none is yet proven to be an ideal method for all patients. Materials and Methods: Sixty lesions in 30 patients with vitiligo were divided into two groups and subjected to microneedling with DermaPen after topical application of 5-fluorouracil (5-FU) cream 5% in one group and tacrolimus ointment 0.1% in another group. This procedure was repeated every 2 weeks for a maximum of 10 sessions. Patients were followed up for 6 months after the last session. Results: The overall repigmentation rate was significantly higher with 5-FU than with tacrolimus. Good-to-excellent response was seen in 76.7% of the lesions with 5-FU and 63.7% of the lesions with tacrolimus. Acral areas showed good-to-excellent response in 50% of the lesions in group A, and in group B, good response was seen in 50% lesions, whereas none attained excellent improvement. Conclusion: Microneedling with 5-FU and tacrolimus appears to be safe and effective therapeutic intervention for stable refractory vitiligo. Both combinations were tolerated well, but 5-FU demonstrated significantly quicker and higher response.

Keywords

• fluorouracil
• tacrolimus
• vitiligo