Exploring Treatment Options in a Patient with Hypothyroidism & Vitiligo

A 38-year-old female with a history of hypothyroidism presents with nonscaly, asymptomatic, white macules and patches on the elbows, knees, and periorbital regions for the last 5 years. Wood’s lamp exam reveals depigmented macules, some coalescing into larger patches on the elbows, knees, and periorbital regions. She has treated her body lesions with clobetasol ointment BID alternating every other week with tacrolimus 0.1% ointment. For her face, she applies tacrolimus 0.1% ointment BID. Despite consistent usage her macules and patches have remained unchanged. She travels frequently and is looking for another topical alternative.

Image Credit: Erik Domingues, MD