Tacrolimus ointment for the treatment of steroid-induced rosacea: a preliminary report.
BACKGROUND
Excessive topical corticosteroid application to facial areas commonly leads to steroid-induced rosacea. This may be a recalcitrant problem that requires months of antibiotic and anti-inflammatory therapy before it resolves.


OBJECTIVE
The purpose of this article is to review the use of tacrolimus ointment, a macrolide anti-inflammatory ointment for the treatment of 3 patients with steroid-induced rosacea.


METHODS
Three patients with steroid-induced rosacea applied tacrolimus ointment, 0.075% twice daily for 7 to 10 days. Patients were also instructed to avoid topical corticosteroid use and other rosacea-aggravating substances including caffeine, spicy foods, alcohol, hot fluids, and fluoride. Patients were observed for tenderness, erythema, and relief of pruritus.


RESULTS
Pruritus, tenderness, and erythema were resolved in all 3 patients after 7 to 10 consecutive days' use of tacrolimus 0.075% ointment in conjunction with avoidance of topical steroids, caffeine, spicy food, alcohol, hot fluids, and fluoride.


CONCLUSIONS
This preliminary study demonstrates that tacrolimus 0.075% ointment may be effective for patients with steroid-induced rosacea, when combined with avoidance of topical steroid use, as well as avoidance of other agents known to aggravate rosacea (caffeine, spicy foods, alcohol, hot fluids, and fluoride).
Goldman
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Department of Dermatology, NorthBay Healthcare Medical Group, Fairfield, CA 94533, USA. drdavidgoldman@msn.com
D000287:Administration, Topical; D000328:Adult; D004032:Diet; D005260:Female; D006801:Humans; D007166:Immunosuppressive Agents / Q000008:administration & dosage / Q000494:pharmacology*; D008297:Male; D008875:Middle Aged; D012393:Rosacea / Q000139:chemically induced* / Q000188:drug therapy*; D013256:Steroids / Q000009:adverse effects*; D016559:Tacrolimus / Q000008:administration & dosage / Q000494:pharmacology*; D016896:Treatment Outcome
D007166:Immunosuppressive Agents; D013256:Steroids; D016559:Tacrolimus