Topical tacrolimus (FK506) and mometasone furoate in treatment of dyshidrotic palmar eczema: a randomized, observer-blinded trial.
BACKGROUND
Dyshidrotic palmoplantar eczema is a frequent disease often running a chronic relapsing course. Topical glucocorticosteroids form the mainstay of therapy, and alternatives are urgently warranted.


OBJECTIVE
This study was performed to compare the efficacy of tacrolimus (FK506) 0.1% ointment and mometasone furoate 0.1% ointment in the treatment of dyshidrotic palmoplantar eczema.


METHODS
Sixteen patients were included in the study after a randomized, observer-blind, intrapersonal comparison protocol. After a 2-week washout period, the active treatment phase amounted to 4 weeks with twice-daily topical application of test substances and additional use of emollients at will. Thereafter, patients were monitored at weekly intervals up to 8 weeks.


RESULTS
The dyshidrotic area and severity index showed a more than 50% reduction of baseline values after 2 weeks of active treatment both for FK506 (P =.003) and mometasone furoate (P =.022) in palmar areas. After active treatment, a nonsignificant increase in the dyshidrotic area and severity index was seen with FK506 treated areas. Fourteen of 16 patients had recurring symptoms requiring further therapy within 3 weeks after the active treatment phase.


CONCLUSIONS
Treatment with FK506 offers the possibility for rotational therapy with mometasone furoate in long-standing cases of chronic dyshidrotic palmar eczema.
Schnopp
Christina
C
Department of Dermatology and Allergy Biederstein, Technical University Munich, Germany. nina.schnopp@lrz.tu-muenchen.de
Remling
Roland
R
Möhrenschlager
Matthias
M
Weigl
Lorenz
L
Ring
Johannes
J
Abeck
Dietrich
D
D000279:Administration, Cutaneous; D000328:Adult; D000900:Anti-Bacterial Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D000893:Anti-Inflammatory Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D011146:Eczema, Dyshidrotic / Q000188:drug therapy* / Q000473:pathology; D005260:Female; D005533:Foot Dermatoses / Q000188:drug therapy / Q000473:pathology; D005938:Glucocorticoids; D006229:Hand Dermatoses / Q000188:drug therapy / Q000473:pathology; D006801:Humans; D007166:Immunosuppressive Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D000068656:Mometasone Furoate; D011244:Pregnadienediols / Q000008:administration & dosage / Q000627:therapeutic use*; D012720:Severity of Illness Index; D016037:Single-Blind Method; D016559:Tacrolimus / Q000008:administration & dosage / Q000627:therapeutic use*; D016896:Treatment Outcome
D000900:Anti-Bacterial Agents; D000893:Anti-Inflammatory Agents; D005938:Glucocorticoids; D007166:Immunosuppressive Agents; D011244:Pregnadienediols; D000068656:Mometasone Furoate; D016559:Tacrolimus