title: Topical tacrolimus 0.1% ointment for refractory skin disease in dermatomyositis: a pilot study.
abstract: BACKGROUND
  Dermatomyositis is an inflammatory disease primarily involving the striated muscles and skin. Muscle disease usually responds to aggressive therapy with systemic corticosteroids. However, cutaneous lesions can be very resistant to systemic and topical therapies, even in combination. More treatment options are needed. Tacrolimus is an immunomodulator now available in a topical ointment.
  
  
  OBJECTIVE
  To study the treatment of patients with refractory cutaneous lesions of dermatomyositis using topical tacrolimus 0.1% ointment.
  
  
  METHODS
  Six patients with recalcitrant cutaneous lesions of dermatomyositis were included in this brief observational study: five adults and one pediatric patient. Five patients had classic dermatomyositis and one had dermatomyositis sine myositis.
  
  
  RESULTS
  All had some degree of improvement of their dermatologic disease following 6-8 weeks of treatment with topical tacrolimus 0.1% ointment. Two had dramatic responses (>90% improvement), one had moderate (40-90%) improvement and three had minimal (20-40%) improvement.
  
  
  CONCLUSIONS
  The dermatologic manifestations of dermatomyositis can be very difficult to treat. Multiple systemic and topical therapies have been studied. Combinations of treatments are often used, sometimes still not successfully. The results of this brief observational study using topical tacrolimus ointment for the treatment of refractory cutaneous lesions of dermatomyositis are encouraging. Topical tacrolimus was a useful adjunct in the treatment of the dermatologic component of dermatomyositis in adults and children in this pilot study.
authors.affiliation: Department of Dermatology, Wake Forest University School of Medicine, Winston-Salem, NC 27157, USA.
authors.forename: C B
authors.initials: CB
authors.lastname: Hollar
authors.forename: J L
authors.initials: JL
authors.lastname: Jorizzo
mesh_terms: D000279:Administration, Cutaneous; D000368:Aged; D002675:Child, Preschool; D003882:Dermatomyositis / Q000188:drug therapy*; D005260:Female; D006801:Humans; D007166:Immunosuppressive Agents / Q000008:administration & dosage*; D008297:Male; D008875:Middle Aged; D009824:Ointments; D010865:Pilot Projects; D016559:Tacrolimus / Q000008:administration & dosage*
chemical_list: D007166:Immunosuppressive Agents; D009824:Ointments; D016559:Tacrolimus