An Exploratory study to evaluate the efficacy of pimecrolimus cream 1% for the treatment of pityriasis alba

Background Use of topical corticosteroids for the treatment of pityriasis alba is limited by their potential side-effects, such as skin atrophy especially with long-term use on the face. Pimecrolimus cream 1% is a topical calcineurin inhibitor that has anti-inflammatory properties, lacks the cutaneous side-effects associated with steroids, and provide a potential benefit for the treatment of pityriasis alba.

Methods This 10-patient, prospective, single-arm, open-label, single-center, 12-week, investigator-initiated proof of concept study assessed the efficacy, safety, and patient acceptance of pimecrolimus cream 1% twice daily. In addition to pimecrolimus cream, patients used facial emollient containing SPF 15 sunscreen and mild soap-free cleanser. Efficacy assessments were Investigator Global Assessment (IGA) of disease severity and evaluation of uneven skin color, scaling, eczema, follicular keratosis, and pruritus. All efficacy assessments were reported on a 4-point scale (0 = none to 3 = severe).

Results Of the 10 patients enrolled (aged: 12–35 years), all had intensive sun-exposure, 90% had skin type IV–V, and 80% completed the 12-week treatment. At baseline, mean IGA was 1.20 (mild–moderate), uneven skin color was 2.3 (moderate–severe) and scaling was 1.2 (mild). IGA decreased to 0.25 by week 12, uneven skin color improved by week 3 with near complete resolution by week 12 (mean = 0.38) and scaling resolved at week 3. Pruritus, eczema, and follicular keratosis remained at low levels from baseline throughout the course of the study. Patients consistently reported satisfaction with the treatment (“satisfied” or “very satisfied”). No adverse events were reported.

Conclusions Pimecrolimus cream 1% may represent an alternative for the treatment of pityriasis alba.