title: Topical tacrolimus treatment of atopic eyelid disease.
abstract: OBJECTIVE
  To describe the effects of topical tacrolimus treatment of severe atopic eyelid disease.
  
  
  METHODS
  Interventional consecutive case series.
  
  
  METHODS
  A description of clinical findings and therapeutic response for five consecutive adult patients (mean age, 56.2 years; range 44-62) treated with topical tacrolimus for severe atopic eyelid disease at one institution.
  
  
  RESULTS
  Five patients with bilateral atopic eyelid disease that was refractory to treatment with topical corticosteroids were treated with tacrolimus 0.03% ointment, applied to the affected eyelid skin of both eyes twice daily. Eyelid induration, erythema, and eczematous changes were substantially improved within 1 to 3 weeks after initiation of topical tacrolimus treatment in all patients. There was an associated decrease in ocular surface irritation and inflammatory signs in each of four patients who also had atopic keratoconjunctivitis. No adverse effect associated with tacrolimus treatment was noted during continued treatment for 5 to 14 months. All patients were able to discontinue longstanding use of topical corticosteroid drugs.
  
  
  CONCLUSIONS
  Application of topical tacrolimus on eyelid skin may be effective for treatment of severe atopic dermatitis of the eyelids, and may have secondary benefits for atopic keratoconjunctivitis. Topical tacrolimus may be used for at least 1 year without apparent adverse reaction in some patients, although the rate of adverse reaction cannot be determined from this small series.
authors.affiliation: Ocular Inflammatory Disease Center, Jules Stein Eye Institute, and the Department of Ophthalmology, University of California at Los Angeles, Los Angeles, California 90095-7003, USA.
authors.forename: Sarah M
authors.initials: SM
authors.lastname: Rikkers
authors.forename: Gary N
authors.initials: GN
authors.lastname: Holland
authors.forename: Gail E
authors.initials: GE
authors.lastname: Drayton
authors.forename: Franz K
authors.initials: FK
authors.lastname: Michel
authors.forename: Mark F
authors.initials: MF
authors.lastname: Torres
authors.forename: Stefani
authors.initials: S
authors.lastname: Takahashi
mesh_terms: D000287:Administration, Topical; D000328:Adult; D003233:Conjunctivitis, Allergic / Q000150:complications / Q000188:drug therapy; D003876:Dermatitis, Atopic / Q000150:complications / Q000188:drug therapy*; D005141:Eyelid Diseases / Q000150:complications / Q000188:drug therapy*; D005260:Female; D006801:Humans; D007166:Immunosuppressive Agents / Q000009:adverse effects / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D009824:Ointments; D016559:Tacrolimus / Q000009:adverse effects / Q000627:therapeutic use*
chemical_list: D007166:Immunosuppressive Agents; D009824:Ointments; D016559:Tacrolimus