Pimekrolimus’un Kullanıldığı Bir Vitiligo Olgusu

Öz

Özet: 

Vitiligo; melanin pigmentinin kaybı sonucu deride beyazde pigmente yamalı plakların oluştuğu bir deri hastalığıdır. Klasik tedavi, topikal steroidler, fototerapi ve fotokemoterapiyi içerir. Askomisinden derive pimekrolimus, immunomodülatör makrolaktamlardan yeni bir sınıftır ve özellikle inflamatuvar deri hastalıklarının tedavisi için geliştirilmiştir. Topikal olarak uygulanan pimekrolimus düşük sistemi kabsorbsiyona sahiptir ve yan etkiler kullanım bölgesinde yanma hissinden ibarettir. Bu haliyle steroidlere iyi bir alternatif gibi durmaktadır. Burada, pimekrolimusla tedavi edilen bir vitiligo olgusu sunulmuştur.

Anahtar Kelimeler

• Vitiligo,topikal,pimekrolimus

A Case Of Vitiligo, Treated With Pimecrolimus

Abstract

Vitiligo is a skin disease characterized with loss of normal pigments and with white depigmented patchy plaques. Classical ways of therapy are topical corticosteroids, phototherapy and photochemotherapy. Pimecrolimus, derivated from ascomisin, is a new class of immunomodulatory macrolactams, and developed for inflammatory skin disease therapy. Side effects are mainly limited to a burning sensation at the application site. It seems a good alternative for steroids. In this case-report, a patient with vitiligo and who is treated with pimekrolimus is presented.

Keywords

• Vitiligo,topical,pimecrolimus

Kaynakça

1. 1. Torello L, Alessia G, Zanieri F, Colucci R, Moretti S: Vitiligo: new and emerging treatments. Dermatol Therapy 2008, 21:110-117.
2. 2. Kovacs SO. Vitiligo. J Am Acad Dermatol 1998;38: 647-66
3. 3. Mosher DB, Fitzpatrick TB, Ortonne JP, et al. Disorders of pigmentation. In: Fitzpatrick TB, Freedberg IM, editors. Fitzpatrick’s dermatology in general medicine. 5th ed. New York: McGraw-Hill, Health Professions Division, 1999: 945-55
4. 4. Boone B et al. Topical pimecrolimus in the treatment of vitiligo. Eur J Dermatol 2006; 17 (1): 1-7
5. 5. Njoo MD, Westernhof W, Bos D et al.The Development Of Guidelines For The Treatment Of Vitiligo.Arch Dermatol.1999;135:1514-21.
6. 6. Norris DA, Kiisinger RM, Naughton GM et al. Evidence of immunologic mechanisms in human vitiligo. J Invest Dermatol.1999;135:1514-21.
7. 7. Lan CCE, Chen GS, Chiou MH, et al. FK 506 promotes melanocyte and melanoblast growth and creates a favourable milieu for cell migration via keratinocytes. Br J Dermatol.2005;153:498-505
8. 8. Dawid M, Veensaku M, Grassberger M, et al. Efficacy and safety of pimecrolismus cream 1% in adult patients with vitiligo: Results of a randomized, double blind vehicle controlled study. JDDG .2006;942-46

9. 9. Scherschun L, Kim JJ, Lim HW. Narrow band ultraviolet-B is a useful and well tolerated treatment for vitiligo. J Am Acad Dermatol. 2001;999-1003
10. 10. Gambichler T, Breuckmann F, Boms S et al. Narrow band UVB phototherapy in skin conditions beyond psoriasis. J Am Acad Dermatol. 2005; 52: 660-670
11. 11. Fisher DA. Adverse effects of topical corticosteroid use. West J Med. 1995; 162 (2): 123-126
12. 12. Smith EW. Four decades of topical corticosteroid assessment. Curr Probl Dermatol 1995; 22: 124-31
13. 13. Pierard GE, Pierard-Franchimont C, Ben Mosbah T, et al. Adverse effects of topical corticosteroids. Acta Derm Venereol Suppl. 1989; 151: 26-30
14. 14. Hartmann A, Brocker EB, Becker JC. Hypopigmentary skin disorders: current treatment options and future directions. Drugs. 2004; 64 (1): 89-107
15. 15. Carnahan MC, Goldstein DA. Ocular complications of topical, peri-ocular, and systemic corticosteroids. Curr Opin Ophthalmol. 2000; 11 (6): 478-83
16. 16. Mosher DB, Fitzpatrick TB, Ortonne JP, Hori Y. Hypomelanoses and hypermelanoses. In: Freedberg IM, Eisen AZ, Wolff K, et al, eds. Dermatology in General Medicine. 5th ed. New York: McGraw Hill, 1999: 949-60.
17. 17. Kostovic K, Nola I, Bucan Z, Situm M. Treatment of vitiligo: current methods and new approaches. Acta Dermatovenerol Croat. 2003; 11: 163-70.
18. 18. Bos JD. Non-steroidal topical immunomodulators provide skin-selective, self-limiting treatment in atopic dermatitis. Eur J Dermatol. 2003; 13(5): 455-61.
19. 19. Gupta AK, Chow M. Pimecrolimus: a review. J Eur Acad Dermatol Venereol. 2003; 17: 493-503.
20. 20. Marsland AM, Griffiths CE. The macrolide immunosuppressants in dermatology: mechanisms of action. Eur J Dermatol. 2002; 12(6): 618-22.
21. 21. Mrowietz U. Macrolide immunosuppressants. Eur J Dermatol. 1999; 9(5): 346-51.
22. 22. Lansdown R, Rumsey N, Bradbury E, Carr T, Partridge J. Visibly different: Coping with disfigurement. Oxford: Butterworth-Heinemann. 1997; 2: 83–7
23. 23. Ramsey B, O’Reagan M. Asurvey of the social and psychological effects of psoriasis. British Journal of Dermatology. 1988; 118: 195–201.