الفهرس 
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Abstract
Vitiligo is an acquired, idiopathic disorder characterized by depigmented macules that result from destruction of melanocytes. Tacrolimus is a macrolide antibiotic produced by Streptomyces tsukubaensis with strong T-specific, immunosuppressant activity. Topical tacrolimus suppresses inflammation in a similar way to steroids, and is equally as effective as a mid-potency steroid. An important advantage of tacrolimus is that, unlike steroids, it does not cause skin thinning (atrophy), or other steroid related side effects as telangectisea, straia, acneiform eruption, hirsutism and poor healing.
The aim of this study is to evaluate the effectiveness of 0.03% tacrolimus ointment monotherapy in patients with vitiligo. Out of 69 who continued the study 8 (11.5%) did not show up after the 3rd visit. The patients were divided into 2 treatment groups, group A (n =36) received tacrolimus 0.03% ointment and group B (n =33) received hydrocortisone acetate 1% ointment twice daily for 6 months.
Topical tacrolimus is found to be an effective treatment for both adults and children with vitiligo. Children will have a better outcome. The vulgaris and focalis types showed the best response. Facial vitiligo respond well to 0.03% tacrolimus ointment alone, but extremities doesn`t respond well to tacrolimus alone. Tacrolimus alone was safe as there was no cutaneous adverse effect except transient burning in a few patients.
Recommendations
Future studies are needed to examine the effectiveness and safety of topical tacrolimus at other concentrations and for longer periods of treatment.