ABSTRACT
Topical corticosteroids (TCSs) have been applied in vitiligo since the 1950s for their anti-inflammatory and immunomodulating effects, and they still remain the first-line treatment option. Corticosteroids might decrease disease progression, but it should be clearly explained to the patient that the primary aim of TCS is to achieve disease stability. In children and adults, once-daily application of potent TCS can be advised for patients with limited involvement for a period no longer than 3 months, according to a continuous treatment scheme or, better, a discontinuous scheme. The use of tacrolimus for vitiligo was reported for the first time in 2002, particularly for skin areas where the use of potent TCS is contraindicated. The use of creams/ointments containing pseudocatalase may help in vitiligo repigmentation and in stabilizing the lesions. Topical tacrolimus and pimecrolimus belong to the drug group of calcineurin inhibitors, which affects T-cell activity, inhibits their activation and maturation, and decreases the production of proinflammatory cytokines.
