الفهرس 
Title : Topical Tacrolimus Alone and in Combination with Microneedling in Treatment of ExtrafacialVitiligo: A Comparative Study
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Abstract
Background: Vitiligo is an acquired disorder of pigmentation that is characterized by depigmented patches of skin due to the loss of melanocytes. Various lines are currently available for vitiligo patients. Among them, topical treatments including calcineurin inhibitors. Objective: The aim of the current work is to assess different methods of enhancing the absorption of topical tacrolimus in extrafacial vitiligo sites using microneedling and occlusion and to compare such results with its established efficacy in facial lesions. Patients and methods: Twenty patients were enrolled in this study. Four vitiliginous extrafacial lesions in each patient were randomly labeled A, B, C, D.The VASI, VIDA and pigment percent of each lesion in addition to any facial lesions were calculated at the date of enrollment. Tacrolimus ointment (0.03%) was applied twice daily for 6 months at area A. In area B, microneedling using dermaroller 0.5 mm was done once per week for 6 months (24 sessions) and tacrolimus ointment (0.03%) was applied directly after microneedling and twice daily for the rest of the week for 6 months. In area C, microneedling was applied once per week alone for 6 months (24 sessions). Tacrolimus ointment (0.03%) was applied twice daily under occlusion by polyethylene foil for 6 months at area D. Face or neck lesions, tacrolimus ointment (0.03%) was applied twice daily for 6 months