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Comparative Study on the Therapeutic Efficacy of Topical Bimatoprost (0.03%) Ophthalmic Solution and Tacrolimus
Riya Kalawat1, Kshitij Saxena1, Reyan Abdul Jamil1
1Department of Dermatology, Venereology & Leprosy, Eras Lucknow Medical College and Hospital, Lucknow, Uttar Pradesh, India.
Introduction:
Vitiligo is a chronic autoimmune skin disorder characterized by loss of melanocytes, leading to depigmented patches. Although not associated with physical morbidity, its appearance causes significant psychological distress, especially in dark-skinned individuals. Tacrolimus, a topical calcineurin inhibitor, is first-line treatment for localized, stable vitiligo. However, bimatoprost, a prostaglandin analog known for its melanin-stimulating activity, is emerging as a potential alternative.
Objectives:
PRIMARY OBJECTIVE: To compare the efficacy of topical bimatoprost 0.03% ophthalmic solution versus tacrolimus 0.1% ointment in stable vitiligo.
Secondary Objective:
To evaluate the clinical response of bimatoprost 0.03% ophthalmic solution versus tacrolimus 0.1% ointment and to assess their safety and adverse effects in stable vitiligo.
Material & Methods:
A randomized comparative study was conducted over 24 months in the Department of Dermatology at Era's Lucknow Medical College. Fifty clinically stable vitiligo patients (aged >18 years, <5% BSA involvement) were randomized into two groups: Group A received topical bimatoprost 0.03%, and Group B received topical tacrolimus 0.1%, both applied twice daily over the lesions. Treatment was continued for 12 weeks, with follow-up every four weeks. Efficacy was assessed using the Vitiligo Area Scoring Index (VASI), subjective score, and photographic documentation. Any side effect was documented at each follow-up.
Results:
Both groups showed clinical improvement, with Group A demonstrating faster onset of repigmentation, particularly in facial lesions. Bimatoprost was well tolerated, with minimal side effects such as local hypertrichosis, while tacrolimus was associated with mild burning sensation in some cases.
Conclusion:
Topical bimatoprost 0.03% is a safe and effective alternative to tacrolimus 0.1% ointment in treating stable vitiligo, especially for cosmetically sensitive areas. Therefore, it can be considered as a treatment option in stable vitiligo.
