Tattoo machine-based delivery of 5-fluorouracil is effective for patients with idiopathic guttate hypomelanosis.

A new trial found that tattooing of 5-fluorouracil was found to be more effective and satisfactory than saline to re-pigment the lesions of Idiopathic guttate hypomelanosis. The procedure was also not associated with any adverse events. The trial results were published in the journal Dermatologic Surgery. 

Idiopathic guttate hypomelanosis (IGH) is a benign, complex, typically asymptomatic, esthetically displeasing, multifactorial leukodermic dermatosis of unknown etiology. It is typically seen in elderly, fair-skinned individuals, and is often unrecognized or undiagnosed. Sunscreens, avoiding scorching sunlight, and physical barriers are some of the treatment options for this dermatologic condition. Recent literature found that 5-fluorouracil via tattoo machine, might be a promising treatment option. Hence researchers conducted a split-body randomized single-blinded trial to assess the efficacy and safety of 5-fluorouracil (5FU) compared with saline, delivered using a tattoo machine, to re-pigment IGH lesions. 

Adults with symmetrical IGH lesions were enrolled for the trial. Using a tattoo machine 5FU was delivered in IGH lesions of one limb and saline in the contralateral limb. Outcomes were the number of achromic lesions 30 days after treatment compared with baseline, patient satisfaction, and local or systemic adverse events. 

Results: 

• Twenty-nine patients (28 women) were included.
• The median number of achromic lesions decreased significantly in 5FU-treated limbs and saline-treated limbs, but the reduction was significantly more pronounced in 5FU-treated limbs (p = .00003).

• All participants were satisfied with the results on 5FU-treated limbs. 
• No adverse events were seen. 

Thus, To re-pigment IGH lesions, 5-fluorouracil was delivered via a tattoo machine more successfully than saline, with high patient satisfaction and no negative side effects. 

Take home message: 

Patients with idiopathic guttate hypomelanosis in this split-body randomized study from Brazil were treated with tattoo machine-based distribution of 5-fluorouracil (5FU) to one extremity and regular saline to the other. At 30 days, the number of achromic lesions decreased in both groups. The 5FU group saw a bigger impact, with an average repigmentation improvement of 58.4%. Both local and systemic adverse effects were absent.

Delivery of 5FU using a tattoo machine was an effective treatment for patients with idiopathic guttate hypomelanosis. 

Further reading: Efficacy and Safety of 5-Fluorouracil Tattooing to Repigment Idiopathic Guttate Hypomelanosis: A Split-Body Randomized Trial. 10.1097/DSS.0000000000003793