Tacrolimus in dermatologic disorders.
OBJECTIVE
To review the data surrounding the use of tacrolimus for skin disorders.


METHODS
Articles were obtained through a MEDLINE search of English-language literature (1990-May 2000); references of the retrieved publications were further reviewed for relevant literature.


METHODS
Orginal studies in humans regarding the use of tacrolimus for skin disorders were included.


METHODS
The major outcomes extracted from the literature involved patient response to therapy and adverse effects.


RESULTS
Tacrolimus offers an additional therapeutic approach to the treatment of immunologically based skin disorders. led trials and case reports indicates topical tacrolimus is a safe and effective alternative treatment in patients with atopic dermatitis. Case reports document efficacy in recalcitrant pyoderma gangrenosum, mucosal lichen planus, and ichthyosis linearis trolled trials and case reports indicate oral tacrolimus is effective in recalcitrant plaque psoriasis. Case reports document efficacy in recalcitrant pyoderma gangrenosum and leukocytclastic vascultis. The clinical utility of oral tacrolimus in skin disorders is limited due to potentially severe adverse effects such as infections, hypertension, hyperglcemia hyperkalemia, nephrotoxicity neurotoxicity, and increased risk of neoplasia.


CONCLUSIONS
Most of the available data indicate short-term (3 wk to 3 mo) topical tacrolimus is a safe and effective treatment alternative for inflammatory skin disorders. Further study is needed to evaluate long-term safety and efficacy and to determine the best dosage regimen. Although oral tacrolimus has demonstrated efficacy in inflammatory skin disorders, the potenial for serious adverse effects limits its utility to third-line therapy for patients who are resistant to, or intolerant of, conventional therapies.
Skaehill
P A
PA
Mercy Health Center, Southwestern Oklahoma State University, Oklahoma City 73120, USA. skaehip@swosu.edu
D000284:Administration, Oral; D000287:Administration, Topical; D000293:Adolescent; D000328:Adult; D002648:Child; D005260:Female; D006801:Humans; D007166:Immunosuppressive Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D016032:Randomized Controlled Trials as Topic; D012871:Skin Diseases / Q000188:drug therapy* / Q000503:physiopathology; D016559:Tacrolimus / Q000008:administration & dosage / Q000627:therapeutic use*
D007166:Immunosuppressive Agents; D016559:Tacrolimus