Bimatoprost, microneedling and tacrolimus versus tacrolimus alone in the treatment of stable nonsegmental vitiligo: A pilot split study

Background: Common depigmenting skin condition vitiligo is defined by the loss of melanocytes, leaving behind characteristic nonscaly, chalky white macules.Two common topical immunomodulators are tacrolimus and pimecrolimus. To avoid T-cell activation, they inhibit calcineurin action. Bimatoprost is a topical medication intended to treat glaucoma and ocular hypertension, although its potential utility in treating vitiligo has recently been investigated, Aim and objectives: to measure the performance of topical Bimatoprost, microneedling, calcinurin inhibitors in the treatment of vitiligo. The desired outcome is improved repigmentation following 12 weeks of therapy contrasted with the current gold standard of care (calcinurin inhibitors), Patients and Methods: The research involved 40 cases diagnosed clinically & verified by Wood's light as vitiligo. Patients were recruited and assessed for eligibility from the outpatient clinic of Dermatology, Hospital of Damietta, Results: There was a greatly statistically significant variance among the studied groups according to increase in improvement at right side when contrasted with left side & decrease in VASI score at right side when compared with left side (p-value < 0.001). There was a statistically significant variance among right and left sides concerning case’s satisfaction (p-value = 0.001), Conclusion: Combination of treatments using bimatoprost, microneedling, and calcinurin inhibitors improves the response to achieve repigmentation in cases with stable, non-segmental, non-facial and non-acral vitiligo with little side effects and significantly high patients’ satisfaction,