Role of topical calcineurin inhibitors in treating vitiligo

Wong and Lin (2013) stated that topical calcineurin inhibitors (e.g., pimecrolimus and tacrolimus) are indicated for the treatment of atopic dermatitis, but they have been studied in many off-label uses.  These investigators reviewed the English language literature to define their roles in treatment of vitiligo.  Double-blind studies showed that tacrolimus 0.1 % ointment combined with excimer laser is superior to placebo, especially for UV-resistant areas, such as bony prominences of the extremities.  When used alone, tacrolimus 0.1 % ointment is almost as effective as clobetasol propionate 0.05 % ointment.  Other studies suggested it can also be effective for facial lesions.  Double-blind studies showed that pimecrolimus 1 % cream combined with narrow band UVB is superior to placebo, especially for facial lesions.  Moreover, the authors concluded that additional studies would further clarify the role of topical calcineurin inhibitors in vitiligo.