The efficacy of pimecrolimus 1% cream combined with microdermabrasion in the treatment of nonsegmental childhood vitiligo: a randomized placebo-controlled study.

Recently, topical immunomodulators have been successfully used in monotherapy or in combination with other therapeutic modalities in vitiligo. To determine whether combination pimecrolimus 1% cream and microdermabrasion enhances response time and repigmentation rate in children with vitiligo. Sixty-five children diagnosed with vitiligo enrolled in this randomized placebo-controlled study. Three vitiliginous patches were chosen in each patient. The first lesion was treated by pimecrolimus 1% cream. On the second lesion after doing microdermabrasion on day 1, pimecrolimus 1% cream was applied. On the third lesion placebo was applied. The course of treatment was 10 days. Vitiliginous patches were measured at baseline, day 10, and months 1, 2, and 3. Sixty patients completed the 3-month study period. Clinical response (pigmentation >50%) was observed in 60.4% of the patches treated by combined pimecrolimus plus microdermabrasion at the third month of follow-up, compared with 32.1% and 1.7% for pimecrolimus alone and placebo, respectively (p = 0.000). No significant side effect was observed. Microdermabrasion exerts an additive effect in enhancing the rate and degree of repigmentation by pimecrolimus. This new combined approach appears to be safe and effective in childhood vitiligo.