Efficacy of combination therapy of pimecrolimus 1% cream and mometasone cream with either agent alone in the treatment of childhood vitiligo

Objective: to evaluate the efficacy of the combination therapy of mometasone and pimecrolimus in the treatment of vitiligo in children

Methods: in this double-blind randomized controlled trial, 50 patients were enrolled. Based on the planned treatment protocol, three lesions with approximately identical size at similar anatomic sites were selected in each patient. Lesions were divided to three groups: pimecrolimus cream 1 % [twice a day], mometasone furoate ointment 0.1 % [every night], and combined therapy group [pimecrolimus twice a day on weekdays and mometasone every night on weekends], all being applied for three months. They were followed up for three months

Results: forty patients [with 46% of cases being male] with a mean age of 10.6 years completed the study. There was no significant difference in response rate between three groups at the end of the treatment

Conclusion: our study results did not demonstrate significant difference in the response rate and adverse effects between combined treatment group and either alone

Koebnerization in a woman with extragenital lichen sclerosus

Lichen sclerosus [LS] is a chronic benign inflammatory disorder of skin and mucosa which affects patients of all age groups, sex and race, particularly caucasian prepubertal girls and postmenopausal women. The etiology of LS is unknown, but it has been suggested that genetic predisposition to inflammatory disorders, immunological constitutions, hormonal influences and local factors might play a role. Extragenital LS are most common on the neck, shoulders and upper portion of the trunk. It is generally asymptomatic, but occasionally pruritic. The Koebner sign is a well-known diagnostic marker in LS. Typical lesions have been noted to occur following surgical operations, infections, rubbing of skin, in old thermal burn scar, sexual abuse and under tight clothing. We describe a 25-year-old Iranian woman presented with a 2-month history of extragenital LS. The multiple classical lesions of disease were presented over her neck, shoulders, upper part of trunk, the medial area of her thighs and feet at the dorsal site. The diagnosis of LS was confirmed by histological findings. Beside LS classical lesions on her back, linear lesions including Koebner phenomenon were observed at the sites of rubbing and itching of skin