Calcineurin inhibitors to treat Idiopathic Guttate Hypomelanosis (IGH)

Pimecrolimus for Idiopathic Guttate Hypomelanosis

Asawanonda P, Sutthipong T, Prejawai N.

J. Drugs Dermatol. 2010; 9 (3): 238-239

Idiopathic guttate hypomelanosis (IGH) is a common skin disease. Its cause is unknown although sun would be involved in the developmement of the lesions.  Tretaments are of limited succes and include cryotherapy, topical retinoids and dermabrasion. The authors of this study from Thailand report successful treatment of this skin condition with the use of pimecrolimus 1% cream (Elidel).

4 female patients of skin phototype IV were enrolled in this prospective study. The patients had the lesions of IGH  bilaterally and didn’t have any previous treatment. Application of the cream was done twice a day on the hypopigmented macules on one side of the body.

Progress was documented by photography every 4 weeks for a total of 16 weeks. The degree of improvement was graded by a blinded evaluator (up to 25% improvement, 26-50% improvement, 51-75% improvement, 76-100% improvement).

Results show a 26-75% improvement in 3 patients. Personal satisfaction was high. The treatment was well tolerated apart from a slight stinging sensation. No mention or photography of the evolution of the untreated side is done.

Pathogenetically, the authors advance the theory that pimecrolimus has been shown to stimulate melanocyte migration (pigment cells) in vitro (Kang HY et al; BJD. 2006; 155 (5): 1037’1040).

The study is very small and further studies would therefore be needed to ascertain the efficiency of the usage of calcineurin inhibitors in the treatment of IGH. The declared conflict of interest is that the creams for the study were supplied by Novartis Thailand. 2006

Contributors:

Dr Christophe HSU – dermatologist. Geneva, Switzerland