The Therapeutic Efficacy of Microneedling Combined with Topical Tacrolimus vs. Microneedling Alone in Treatment of Stable Vitiligo. A Comparative Study.

Abstract

Background: Vitiligo is an acquired depigmentary disorder of multifactorial etiology. Several treatment modalities have been attempted with partial success, but the recent focus on surgical treatment like micro-needling. Objective: To compare the safety and ability of micro-needling alone in the induction of pigmentation in stable vitiligo versus combined tacrolimus treatment and micro-needling. Patients and methods: Twenty three patients with stable vitiligo were recruited from the Department of Dermatology and Venereology of Salah Aldeen General Hospital. The patients then subjected to micro-needling of the two vitiliginous patches after that application of topical tacrolimus to the left patch. This procedure was repeated every two weeks for a maximum of 5 months ( 10 sessions). Results: Microneedling with topical tacrolimus showed better but non-significant response than micro-needling alone ( p = 0.519). Moderate improvement occurred in 13% of patches treated with micro-needling alone, while only 9% show moderate improvement in combined treatment. Although 9% show good improvement in combined treatment. Conclusion: Micro-needling induces pigmentation in vitiligo patients, and the addition of topical tacrolimus induces a better response.However, no statistically significant response was observed in any group.