{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,9]],"date-time":"2026-07-09T04:23:33Z","timestamp":1783571013691,"version":"3.55.0"},"reference-count":19,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2021,3,5]],"date-time":"2021-03-05T00:00:00Z","timestamp":1614902400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J of Cosmetic Dermatology"],"published-print":{"date-parts":[[2021,11]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Vitiligo is an acquired pigmentation disorder due to loss of melanocytes. Topical tacrolimus is effective in vitiligo treatment with minimal effect on extra\u2010facial lesions.<\/jats:p><\/jats:sec><jats:sec><jats:title>Objective<\/jats:title><jats:p>To assess different methods of enhancing the absorption of topical tacrolimus in extra\u2010facial vitiligo sites using microneedling and occlusion.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This study included 20 adult patients of both sexes with non\u2010segmental vitiligo. Four extra\u2010facial vitiligo lesions in each patient were randomly labeled A, B, C, and D and treated as follows: area A: tacrolimus ointment (0.03%) application twice\/day, area B: microneedling once\/week and tacrolimus ointment application directly after microneedling and twice\/day the rest of the week, area C: microneedling once\/week alone, and area D: tacrolimus ointment application twice\/day under occlusion by polyethylene foil. The evaluation was done clinically by calculating the re\u2010pigmentation percent after 6\u00a0months of treatment.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Responders in area B were 45%, and 35% in area C, and 25% in both areas A and D. No statistically significant difference was detected regarding the re\u2010pigmentation percent between the four areas (p\u00a0&gt;\u00a00.05). No correlations were detected between re\u2010pigmentation percent and patients\u02c8 data.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Combination of microneedling and topical tacrolimus has an edge over monotherapy in vitiligo, and further studies are needed to verify such results.<\/jats:p><\/jats:sec>","DOI":"10.1111\/jocd.14024","type":"journal-article","created":{"date-parts":[[2021,2,24]],"date-time":"2021-02-24T20:41:27Z","timestamp":1614199287000},"page":"3545-3551","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["Different methods of enhancing the efficacy of topical tacrolimus in extra\u2010facial vitiligo: A comparative study"],"prefix":"10.1111","volume":"20","author":[{"given":"Samia M.","family":"Esmat","sequence":"first","affiliation":[{"name":"Department of Dermatology Faculty of Medicine Cairo University Cairo 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