title: Successful treatment of patch type mycosis fungoides with tacrolimus ointment 0.1%.
abstract: Cutaneous T cell lymphomas (CTCLs) are a heterogenous group of lymphoproliferative disorders caused by clonally-derived, skin-invasive T cells. A variety of skin-directed and systemic therapies are available to treat mycosis fungoides/Sézary syndrome (MF/SS), the therapeutic choices of which are guided by the stage of disease. A 29-year-old man presented at our clinic with pruritic, erythematous macules located on the sternum and the lower back. Histological findings and immunohistochemistry studies showed patch stage MF. The patient was treated with tacrolimus ointment 0.1% twice daily for one month, achieving complete remission. Three months after the first episode a relapse was successfully treated with the same therapeutic regimen. Tacrolimus is an immunomodulatory macrolide that reduces the stimulatory capacity toward T cells and is therefore worth investigating as a treatment of CTCL. Topical tacrolimus has been related to an unknown effect with the risk for secondary malignancies including CTCL. Also, black box warnings have been proposed by the FDA for the topical calcineurin inhibitors. Nevertheless, our results in the treatment of early stage MF are in agreement with other unpublished data that have observed its efficacy. To our knowledge, there is no other case of patch type mycosis fungoides treated with tacrolimus ointment 0.1% in the medical literature.
authors.affiliation: Department of Dermatology, General Military Hospital, Athens, Greece. efrall@otenet.gr
authors.forename: Efstathios
authors.initials: E
authors.lastname: Rallis
authors.forename: Afrodite
authors.initials: A
authors.lastname: Economidi
authors.forename: Constantinos
authors.initials: C
authors.lastname: Verros
authors.forename: Pavlos
authors.initials: P
authors.lastname: Papadakis
mesh_terms: D000279:Administration, Cutaneous; D000328:Adult; D003937:Diagnosis, Differential; D006801:Humans; D007166:Immunosuppressive Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D008297:Male; D009182:Mycosis Fungoides / Q000175:diagnosis* / Q000188:drug therapy* / Q000473:pathology; D009824:Ointments; D012720:Severity of Illness Index; D012878:Skin Neoplasms / Q000175:diagnosis* / Q000188:drug therapy* / Q000473:pathology; D016559:Tacrolimus / Q000008:administration & dosage / Q000627:therapeutic use*
chemical_list: D007166:Immunosuppressive Agents; D009824:Ointments; D016559:Tacrolimus