Tacrolimus ointment in the treatment of occupationally induced chronic hand dermatitis.
BACKGROUND
Occupational hand dermatitis (OHD) is a common and often chronic condition. Usage of topical corticosteroids is limited in long-term therapy because of potential side-effects. New treatment options are highly appreciated.


OBJECTIVE
To study efficacy and safety of tacrolimus in patients suffering from OHD.


METHODS
In a prospective, open, multicentre study, 29 patients with OHD of predominantly mild-to-moderate severity were treated with tacrolimus ointment (Protopic 0.1%) during a 4-week active treatment period with twice daily application followed by a 2-month optional treatment period. Efficacy was evaluated by the use of a standardized hand eczema score and by clinical severity rating, conducted on all study visits (screening, baseline and weeks 2, 4, 6, and 12). Adverse events were recorded for safety evaluation.


RESULTS
The hand eczema score declined significantly after 2 weeks of treatment compared with baseline and further declined until the end of the study. Finally, 12 (44%) patients were clear of hand eczema. Worsening of the dermatitis occurred in 2 patients (7%). Clinical grading indicated improvement too. Overall tolerability was good.


CONCLUSIONS
Topical tacrolimus might be an efficacious treatment option for chronic OHD. Blinded and randomized controlled studies are necessary to confirm the results of this pilot study.
Schliemann
Sibylle
S
Department of Dermatology, Friedrich-Schiller-University, D-07740 Jena, Germany. schliemann@derma.uni-jena.de
Kelterer
Daniela
D
Bauer
Andrea
A
John
Swen M
SM
Skudlik
Christoph
C
Schindera
Ingo
I
Wehrmann
Wolfgang
W
Elsner
Peter
P
D000279:Administration, Cutaneous; D000328:Adult; D000368:Aged; D009783:Dermatitis, Occupational / Q000175:diagnosis / Q000188:drug therapy*; D004198:Disease Susceptibility; D005260:Female; D006229:Hand Dermatoses / Q000175:diagnosis / Q000188:drug therapy*; D006801:Humans; D007166:Immunosuppressive Agents / Q000009:adverse effects / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D009790:Occupations; D011446:Prospective Studies; D012720:Severity of Illness Index; D016559:Tacrolimus / Q000009:adverse effects / Q000627:therapeutic use*; D016896:Treatment Outcome
D007166:Immunosuppressive Agents; D016559:Tacrolimus