Tacrolimus-induced hyperpigmentation in a patch of vitiligo.

Area of Science:

• Dermatology
• Pediatric Dermatology

Background:

• Vitiligo vulgaris is a chronic autoimmune condition causing skin depigmentation.
• Topical treatments are a common approach for managing vitiligo vulgaris.

Observation:

• A 10-year-old boy with vitiligo vulgaris received 0.03% topical tacrolimus ointment.
• Treatment led to diffuse repigmentation across most affected areas within two months.
• Complete repigmentation was noted except in the infraorbital area, which developed brownish hyperpigmentation.

Findings:

• Topical tacrolimus demonstrated efficacy in repigmenting vitiligo lesions.
• Temporary hyperpigmentation in the infraorbital area was observed, a cosmetically sensitive region.
• The hyperpigmentation resolved spontaneously within one month of discontinuing tacrolimus treatment.

Implications:

• Topical tacrolimus may be a viable treatment option for pediatric vitiligo vulgaris.
• Close monitoring for side effects like hyperpigmentation, especially in sensitive areas, is crucial.
• The temporary nature of tacrolimus-induced hyperpigmentation suggests a reversible side effect profile.