Topical Tacrolimus in Vitiligo: Consensus Paper from the Pigmentary Disorders Society

Rashmi Sarkar,1 Sunil Dogra,2 Keshavamurthy Vinay,2 Surabhi Sinha,3 Vignesh R Narayan,4 Muthu Sendhil Kumaran,2 Indrashis Podder,5 Soumya Jagadeesan,6 Mala Bhalla,7 Anupam Das,8 Ridhima Lakhani,9 Richa Sharma,10 Shyamanta Barua,11 Vijay K Somani,12 D M Thappa,13 Venkataram Mysore,14 Bhavesh Swarnkar...

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Main Authors: Sarkar R, Dogra S, Vinay K, Sinha S, Narayan VR, Kumaran MS, Podder I, Jagadeesan S, Bhalla M, Das A, Lakhani R, Sharma R, Barua S, Somani VK, Thappa DM, Mysore V, Swarnkar B
Format: Article
Language:English
Published: Dove Medical Press 2024-12-01
Series:Clinical, Cosmetic and Investigational Dermatology
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Online Access:https://www.dovepress.com/topical-tacrolimus-in-vitiligo-consensus-paper-from-the-pigmentary-dis-peer-reviewed-fulltext-article-CCID
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author Sarkar R
Dogra S
Vinay K
Sinha S
Narayan VR
Kumaran MS
Podder I
Jagadeesan S
Bhalla M
Das A
Lakhani R
Sharma R
Barua S
Somani VK
Thappa DM
Mysore V
Swarnkar B
author_facet Sarkar R
Dogra S
Vinay K
Sinha S
Narayan VR
Kumaran MS
Podder I
Jagadeesan S
Bhalla M
Das A
Lakhani R
Sharma R
Barua S
Somani VK
Thappa DM
Mysore V
Swarnkar B
author_sort Sarkar R
collection DOAJ
description Rashmi Sarkar,1 Sunil Dogra,2 Keshavamurthy Vinay,2 Surabhi Sinha,3 Vignesh R Narayan,4 Muthu Sendhil Kumaran,2 Indrashis Podder,5 Soumya Jagadeesan,6 Mala Bhalla,7 Anupam Das,8 Ridhima Lakhani,9 Richa Sharma,10 Shyamanta Barua,11 Vijay K Somani,12 D M Thappa,13 Venkataram Mysore,14 Bhavesh Swarnkar15 1Department of Dermatology, Lady Hardinge Medical College and Associated KSCH and SSK Hospital, New Delhi, India; 2Department of Dermatology Venereology & Leprology, Postgraduate Institute of Medical Education & Research (PGIMER), Chandigarh, India; 3Department of Dermatology, Lady Hardinge Medical College and Associated Hospitals, New Delhi, India; 4Department of Dermatology Venereology and Leprology, MS Ramaiah Medical College, Bangalore, Karnataka, India; 5Department of Dermatology, CMSDH, Kolkata, West Bengal, India; 6Department of Dermatology, Amrita Institute of Medical Sciences, Kochi, Kerala, India; 7Department of Dermatology, Government Medical College and Hospital, Chandigarh, India; 8Department of Dermatology, KPC Medical College and Hospital, Kolkata, West Bengal, India; 9Consultant Dermatologist, Department of Dermatology, Fortis Hospitals, Shalimar Bagh, New Delhi, India; 10Consultant Dermatologist, Twacha Skin Clinic, New Delhi, India; 11Department of Dermatology, Assam Medical College & Hospital, Dibrugarh, Assam, India; 12Consultant Dermatologist, Dermatrendz, Hyderabad, Telangana, India; 13Department of Dermatology and STD, JIPMER, Puducherry, India; 14Consultant Dermatologist Venkat Center for Skin ENT and Plastic Surgery, Bengaluru, Karnataka, India; 15Consultant Dermatologist, Indore, Madhya Pradesh, IndiaCorrespondence: Rashmi Sarkar, Department of Dermatology, Lady Hardinge Medical College and Associated KSCH and SSK Hospital, New Delhi, India, Tel +91 9818244340, Email rashmisarkar@gmail.comBackground: Tacrolimus, a topical calcineurin inhibitor (TCI) with immunomodulatory effects, is considered a viable treatment option for vitiligo. A consensus building exercise was undertaken to determine the role and clinical utility of topical tacrolimus in the management of vitiligo using input from experts in the field of dermatology.Methods: Seventeen experts collaborated to create consensus statements using a modified Delphi methodology. A questionnaire on effectiveness, safety and utility of topical tacrolimus in different types of vitiligo, duration, frequency, monotherapy and combination and other aspects was shared, and a concordance rate of 75% was preset to have consensus. A physical meeting was conducted to discuss statements, which did not achieve consensus.Results: Amongst 34 statements derived from round one, consensus was not achieved for 9 statements. In the second round, consensus was achieved for 2/9 statements, hence in the physical meeting, discussion was done to reframe the remaining seven statements. Apart from these 34 statements, questions pertaining to “Vitiligo: types and presentation in clinical practice”, where consensus was not intended, are presented as descriptive statements.Conclusion: Topical tacrolimus ointment has a favorable risk benefit profile to be used as one of the first-line agents for vitiligo. Combination of topical tacrolimus and narrow band Ultraviolet-B (NBUVB) was recommended as an effective treatment for non-segmental vitiligo. Recommended frequency of application was once or twice daily for optimal results. Apart from a transient burning sensation, topical tacrolimus has a favorable safety profile.Keywords: topical calcineurin inhibitor, immunomodulatory, non-segmental vitiligo, depigmenting, autoimmune, autoreactive T cells, tacrolimus
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spelling doaj-art-dc5cb8c530664387b67d7608b23ea10a2025-08-20T02:49:37ZengDove Medical PressClinical, Cosmetic and Investigational Dermatology1178-70152024-12-01Volume 172875288698418Topical Tacrolimus in Vitiligo: Consensus Paper from the Pigmentary Disorders SocietySarkar RDogra SVinay KSinha SNarayan VRKumaran MSPodder IJagadeesan SBhalla MDas ALakhani RSharma RBarua SSomani VKThappa DMMysore VSwarnkar BRashmi Sarkar,1 Sunil Dogra,2 Keshavamurthy Vinay,2 Surabhi Sinha,3 Vignesh R Narayan,4 Muthu Sendhil Kumaran,2 Indrashis Podder,5 Soumya Jagadeesan,6 Mala Bhalla,7 Anupam Das,8 Ridhima Lakhani,9 Richa Sharma,10 Shyamanta Barua,11 Vijay K Somani,12 D M Thappa,13 Venkataram Mysore,14 Bhavesh Swarnkar15 1Department of Dermatology, Lady Hardinge Medical College and Associated KSCH and SSK Hospital, New Delhi, India; 2Department of Dermatology Venereology & Leprology, Postgraduate Institute of Medical Education & Research (PGIMER), Chandigarh, India; 3Department of Dermatology, Lady Hardinge Medical College and Associated Hospitals, New Delhi, India; 4Department of Dermatology Venereology and Leprology, MS Ramaiah Medical College, Bangalore, Karnataka, India; 5Department of Dermatology, CMSDH, Kolkata, West Bengal, India; 6Department of Dermatology, Amrita Institute of Medical Sciences, Kochi, Kerala, India; 7Department of Dermatology, Government Medical College and Hospital, Chandigarh, India; 8Department of Dermatology, KPC Medical College and Hospital, Kolkata, West Bengal, India; 9Consultant Dermatologist, Department of Dermatology, Fortis Hospitals, Shalimar Bagh, New Delhi, India; 10Consultant Dermatologist, Twacha Skin Clinic, New Delhi, India; 11Department of Dermatology, Assam Medical College & Hospital, Dibrugarh, Assam, India; 12Consultant Dermatologist, Dermatrendz, Hyderabad, Telangana, India; 13Department of Dermatology and STD, JIPMER, Puducherry, India; 14Consultant Dermatologist Venkat Center for Skin ENT and Plastic Surgery, Bengaluru, Karnataka, India; 15Consultant Dermatologist, Indore, Madhya Pradesh, IndiaCorrespondence: Rashmi Sarkar, Department of Dermatology, Lady Hardinge Medical College and Associated KSCH and SSK Hospital, New Delhi, India, Tel +91 9818244340, Email rashmisarkar@gmail.comBackground: Tacrolimus, a topical calcineurin inhibitor (TCI) with immunomodulatory effects, is considered a viable treatment option for vitiligo. A consensus building exercise was undertaken to determine the role and clinical utility of topical tacrolimus in the management of vitiligo using input from experts in the field of dermatology.Methods: Seventeen experts collaborated to create consensus statements using a modified Delphi methodology. A questionnaire on effectiveness, safety and utility of topical tacrolimus in different types of vitiligo, duration, frequency, monotherapy and combination and other aspects was shared, and a concordance rate of 75% was preset to have consensus. A physical meeting was conducted to discuss statements, which did not achieve consensus.Results: Amongst 34 statements derived from round one, consensus was not achieved for 9 statements. In the second round, consensus was achieved for 2/9 statements, hence in the physical meeting, discussion was done to reframe the remaining seven statements. Apart from these 34 statements, questions pertaining to “Vitiligo: types and presentation in clinical practice”, where consensus was not intended, are presented as descriptive statements.Conclusion: Topical tacrolimus ointment has a favorable risk benefit profile to be used as one of the first-line agents for vitiligo. Combination of topical tacrolimus and narrow band Ultraviolet-B (NBUVB) was recommended as an effective treatment for non-segmental vitiligo. Recommended frequency of application was once or twice daily for optimal results. Apart from a transient burning sensation, topical tacrolimus has a favorable safety profile.Keywords: topical calcineurin inhibitor, immunomodulatory, non-segmental vitiligo, depigmenting, autoimmune, autoreactive T cells, tacrolimushttps://www.dovepress.com/topical-tacrolimus-in-vitiligo-consensus-paper-from-the-pigmentary-dis-peer-reviewed-fulltext-article-CCIDtopical calcineurin inhibitorimmunomodulatorynon-segmental vitiligodepigmentingautoimmuneautoreactive t cells
spellingShingle Sarkar R
Dogra S
Vinay K
Sinha S
Narayan VR
Kumaran MS
Podder I
Jagadeesan S
Bhalla M
Das A
Lakhani R
Sharma R
Barua S
Somani VK
Thappa DM
Mysore V
Swarnkar B
Topical Tacrolimus in Vitiligo: Consensus Paper from the Pigmentary Disorders Society
Clinical, Cosmetic and Investigational Dermatology
topical calcineurin inhibitor
immunomodulatory
non-segmental vitiligo
depigmenting
autoimmune
autoreactive t cells
title Topical Tacrolimus in Vitiligo: Consensus Paper from the Pigmentary Disorders Society
title_full Topical Tacrolimus in Vitiligo: Consensus Paper from the Pigmentary Disorders Society
title_fullStr Topical Tacrolimus in Vitiligo: Consensus Paper from the Pigmentary Disorders Society
title_full_unstemmed Topical Tacrolimus in Vitiligo: Consensus Paper from the Pigmentary Disorders Society
title_short Topical Tacrolimus in Vitiligo: Consensus Paper from the Pigmentary Disorders Society
title_sort topical tacrolimus in vitiligo consensus paper from the pigmentary disorders society
topic topical calcineurin inhibitor
immunomodulatory
non-segmental vitiligo
depigmenting
autoimmune
autoreactive t cells
url https://www.dovepress.com/topical-tacrolimus-in-vitiligo-consensus-paper-from-the-pigmentary-dis-peer-reviewed-fulltext-article-CCID
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