Comparative Efficacy and Safety of Topical Tacrolimus vs. Mometasone in Pediatric Localized Vitiligo: A Retrospective Study

Abstract Background: Mometasone furoate 0.1% cream and tacrolimus 0.03% cream are commonly used treatments for vitiligo, where achieving repigmentation and managing side effects are key outcomes. This study compares the efficacy and side effect profiles of these two treatments over 3 and 6 months using patients' medical records, as well as analyzing statistical significance through the Wilcoxon rank-sum (Mann-Whitney) test. Objective: The objective of this study is to compare the safety and efficacy of tacrolimus 0.03% ointment compared to mometasone furoate 0.1% cream in the treatment of vitiligo in children. Methods: For efficacy, repigmentation was categorized in ranges (1-24%, 25-49%, 50-74%, and 75-100%) and assessed at 3 and 6 months for both treatments to measure the efficacy. Adverse effects, such as atrophy, burning sensation, erythema, and pruritus, were assessed. The differences in efficacy and adverse effects were analyzed using a two-sample Wilcoxon rank-sum test. Results: Tacrolimus showed higher rates of repigmentation, with 40% of patients achieving 75-100% repigmentation at 3 months and 32% at 6 months, compared to mometasone which had the same repigmentation range in 34% of patients at 3 months and 23% at 6 months. However, the statistical analysis (p = 0.6170) indicated that there is no significant difference in the overall repigmentation efficacy between the treatments. In terms of adverse effects, tacrolimus had a slightly better safety profile, with fewer cases of atrophy and burning sensation, and a higher percentage of patients reporting no side effects. Nevertheless, no statistically significant difference was found (p = 0.6170). Conclusion: Both treatments were effective, but tacrolimus demonstrated a slightly better long-term repigmentation and fewer side effects, making it a favorable option for localized vitiligo in children. Although the side effect profiles were comparable, tacrolimus showed a marginally better tolerability. These findings suggest that treatment selection should consider patient-specific factors, such as skin sensitivity and lesion location, to optimize therapeutic outcomes.