Topical mycophenolate mofetil in the treatment of vitiligo: a pilot study

BACKGROUND: Vitiligo is a multifactorial disease that is characterized by circumscribed depigmented macules and patches. Autoimmune reactions may play an important role in the pathogenesis of the disease. Mycophenolate mofetil is a drug that inhibits DNA synthesis in lymphocytes and has been used in autoimmune diseases such as immunobullous skin diseases, lupus erythematosus, and autoimmune hepatitis. OBJECTIVES: The objective of this study was to show the efficacy of topical mycophenolate mofetil in the treatment of vitiligo. METHODS: Thirty patients with limited vitiligo were enrolled in this study. The patients applied a topical preparation of mycophenolate mofetil 15% twice daily for three months and at the end of every month, repigmentation was assessed using the Vitiligo Area Scoring Index (VASI). RESULTS: At the end of the third month, 36.6 % (n=11) of the patients showed about 25% repigmentation of the lesions. No side effects were observed throughout the study. CONCLUSION: This study showed that topical mycophenolate mofetil can be somewhat effective in the treatment of vitiligo; however, it seems to be inferior to potent topical steroids in inducing repigmentation.