Innovative use of topical calcineurin inhibitors.
Topical tacrolimus and pimecrolimus are indicated for treatment of atopic dermatitis, but they have been studied in many off-label uses. Double-blind and open studies have shown favorable results with topical tacrolimus and pimecrolimus in oral lichen planus. In 1 study of oral lichen planus, blood tacrolimus was detected in 54% of patients, but there were no signs of systemic toxicity. Double-blind and open studies of vitiligo have shown favorable results with tacrolimus in combination with excimer laser, especially for lesions over bony prominences and on extremities. Similarly, double-blind studies of vitiligo have shown favorable results when pimecrolimus is combined with narrow-band UVB, especially for facial lesions. Double-blind and open studies of psoriasis have shown favorable results for tacrolimus and pimecrolimus, especially for inverse psoriasis. Topical calcineurin inhibitors have been effective in many other cutaneous disorders, and further studies would help clarify their roles.
Division of Dermatology and Cutaneous Sciences, University of Alberta, 2-104 Clinical Sciences Building, Edmonton, Alberta, T6G 2G3, Canada. anlin00@yahoo.com
Andrew N
AN
Lin
D000279:Administration, Cutaneous; D065095:Calcineurin Inhibitors; D002648:Child; D002675:Child, Preschool; D003424:Crohn Disease / Q000188:drug therapy; D003876:Dermatitis, Atopic / Q000188:drug therapy; D003879:Dermatologic Agents / Q000627:therapeutic use; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D017676:Lichen Planus, Oral / Q000188:drug therapy; D008178:Lupus Erythematosus, Cutaneous / Q000188:drug therapy; D008297:Male; D056687:Off-Label Use; D011565:Psoriasis / Q000188:drug therapy; D012393:Rosacea / Q000188:drug therapy; D012871:Skin Diseases / Q000188:drug therapy*; D016559:Tacrolimus / Q000031:analogs & derivatives* / Q000627:therapeutic use*; D035703:Therapies, Investigational; D014820:Vitiligo / Q000188:drug therapy
D065095:Calcineurin Inhibitors; D003879:Dermatologic Agents; C117268:pimecrolimus; D016559:Tacrolimus