An open study of a lotion formulation to improve tolerance of tacrolimus in facial atopic dermatitis.
BACKGROUND
We identified 19 patients with facial atopic eczema who failed to respond to tacrolimus (FK506) ointment, although tacrolimus ointment has shown excellent benefit for the treatment of recalcitrant facial erythema in most patients with atopic dermatitis.


OBJECTIVE
We attempted to determine the efficacy of an original lotion formulation of tacrolimus for facial atopic dermatitis resistant to tacrolimus ointment.


METHODS
Recalcitrant facial erythema of these 19 patients was treated with an original tacrolimus lotion preparation for 6 months. Patch testing with white petrolatum was performed in both the 19 patients and in 30 other atopic dermatitis patients who had experienced excellent results with tacrolimus ointment.


RESULTS
Of the 19 resistant patients, those whose symptoms were greatly or moderately improved by the lotion were 95%, 89% and 89% after 2 weeks, 3 months and 6 months of treatment, respectively. Further, patch testing to petrolatum showed positive reactions in several (six of 19) patients, compared with none of 30 controls with atopic eczema that had responded to topical tacrolimus ointment.


CONCLUSIONS
The tacrolimus lotion had a significant effect on the recalcitrant facial erythema in adult patients with atopic dermatitis who were resistant to tacrolimus ointment. We suggest that one reason for the unresponsiveness to tacrolimus ointment may be because of contact sensitivity to white petrolatum.
Sugiura
H
H
Department of Dermatology, Shiga University of Medical Science, Seta Tsukinowa-cho, 520-2192 Otsu, Japan. sugiurah@belle.shiga-med.ac.jp
Uehara
M
M
Hoshino
N
N
Yamaji
A
A
D000293:Adolescent; D000328:Adult; D003876:Dermatitis, Atopic / Q000188:drug therapy*; D003877:Dermatitis, Contact / Q000209:etiology; D004304:Dosage Forms; D004337:Drug Carriers / Q000009:adverse effects; D003875:Drug Eruptions / Q000209:etiology; D004351:Drug Resistance; D005148:Facial Dermatoses / Q000188:drug therapy*; D005500:Follow-Up Studies; D006801:Humans; D007166:Immunosuppressive Agents / Q000009:adverse effects / Q000627:therapeutic use*; D009824:Ointments; D010328:Patch Tests; D010577:Petrolatum / Q000009:adverse effects; D016559:Tacrolimus / Q000009:adverse effects / Q000627:therapeutic use*
D004304:Dosage Forms; D004337:Drug Carriers; D007166:Immunosuppressive Agents; D009824:Ointments; D010577:Petrolatum; D016559:Tacrolimus