Topical Tacrolimus Is More Effective for Treatment of Vitiligo in Patients of Skin of Color

May 2011 | Volume 10 | Issue 5 | Original Article | 507 | Copyright © May 2011

Jonathan I. Silverberg MD PhD MPH and Nanette B. Silverberg MD

table 2
fisher exact tests. Analysis of interval until >=75 percent clinical improvement was performed using Kaplan-Meier survival analysis over a six month treatment period. Log-rank statistics and corresponding P values were calculated. Data were analyzed with SAS 9.2 Software (SAS Institute Inc., Cary, NC). All tests of significance were two-sided and P values of less than 0.05 were considered significant.


One hundred and one subjects were selected for the study (out of 151 charts that were reviewed); 11 were excluded due to incomplete follow up. Thirty five (38.9%) were male and 37 (42.5%) had a positive family history of autoimmune diseases. Age at initial treatment was 25.6 ± 18.9 years (mean age ± standard deviation). Sixty-six subjects had vitiligo lesions on the body; sixty-five on the face. Of subjects with body lesions, 53 had generalized and 13 segmental or localized disease. Of subjects with head and neck lesions, 55 had generalized and 10 segmental or localized disease.
Of subjects with Fitzpatrick skin types 1 and 2, 32 were Caucasian (94.1%), one Hispanic (2.9%) and one Asian (2.9%). Of types 3 and 4, one was Caucasian (4.2%), 21 Hispanic (87.5%), one Asian (4.2%) and one African American (4.2%). Of types 5 and 6, five were Hispanic (15.6%), eight Indian (25%), four Middle Eastern (12.5%), and 15 African American (46.9%).
Repigmentation with usage of topical tacrolimus was good in all Fitzpatrick skin types on the body (Table 1), as well as the head and neck (Table 2), with greater repigmentation of lesions on the body in individuals of Fitzpatrick skin types 3-4, over types 1-2 and 5-6 (Fisher exact test, P=0.03). More than 75 percent repigmentation of body lesions was noted in 62.5 percent of subjects with Fitzpatrick types 3-4, compared with only 33.3 percent of Fitzpatrick 1-2 and 21.7 percent of Fitzpatrick types 5-6 (Table 1). More than 75 percent repigmentation of head and neck lesions was noted in 69.3 percent, 77.8 percent and 57.2 percent of individuals of Fitzpatrick types 1-2, 3-4 and 5-6, respectively