title: Resolution of severe atopic dermatitis after tacrolimus withdrawal.
abstract: Tacrolimus is an immunosuppressive agent used in solid organ and islet transplantation. Its topical form has shown benefit in the treatment of inflammatory skin conditions. Although tacrolimus has a wide spectrum of side effects, dermatological complications related to systemic tacrolimus therapy are limited in the literature. Atopic dermatitis (AD) is a chronic pruritic cutaneous condition that usually begins in infancy and is characterized by an increased Th2 response. We report the case of a patient with type 1 diabetes mellitus (T1DM) and history of AD latent for 10 years who developed severe dermatitis and alopecia 5 months after undergoing allogeneic islet transplantation and initiating a steroid-free immunosuppressive regimen with sirolimus and tacrolimus maintenance. After exclusion of other possible causes for the progression and exacerbation of the clinical presentation of AD, discontinuation of tacrolimus and introduction of mycophenolate mofetil resulted in full remission of the symptoms. The beneficial effects of tacrolimus withdrawal suggest a cause-effect relationship between this adverse event and the utilization of the drug. Islet graft function remained stable after modification of the therapeutic regimen (stable glycemic control and unchanged C-peptide).
authors: Diabetes Research Institute, University of Miami Leonard M. Miller School of Medicine, Miami, FL 33136, USA.
authors: Gaston M
authors: GM
authors: Ponte
authors: David A
authors: DA
authors: Baidal
authors: Paolo
authors: P
authors: Romanelli
authors: Raquel N
authors: RN
authors: Faradji
authors: Raffaella
authors: R
authors: Poggioli
authors: Pablo
authors: P
authors: Cure
authors: Tatiana
authors: T
authors: Froud
authors: Gennaro
authors: G
authors: Selvaggi
authors: Antonello
authors: A
authors: Pileggi
authors: Camillo
authors: C
authors: Ricordi
authors: Rodolfo
authors: R
authors: Alejandro
mesh_terms: D000328:Adult; D000506:Alopecia Areata / Q000473:pathology / Q000517:prevention & control; D003876:Dermatitis, Atopic / Q000209:etiology* / Q000473:pathology; D003922:Diabetes Mellitus, Type 1 / Q000150:complications / Q000601:surgery*; D005260:Female; D006801:Humans; D007166:Immunosuppressive Agents / Q000009:adverse effects* / Q000627:therapeutic use; D016381:Islets of Langerhans Transplantation; D016559:Tacrolimus / Q000009:adverse effects* / Q000627:therapeutic use; D014184:Transplantation, Homologous; D016896:Treatment Outcome
chemical_list: D007166:Immunosuppressive Agents; D016559:Tacrolimus