title: Multiple labial melanotic macules occurring after topical application of calcineurin inhibitors.
abstract: Topical calcineurin inhibitors are widely used to treat inflammatory dermatoses for their steroid-sparing advantage. Herein, we report a patient with chronic lip dermatitis who developed multiple labial melanotic macules after application of tacrolimus 0.1% ointment and pimecrolimus 1% cream. Prior and current reports raise concerns for potential development of pigmented lesions associated with topical calcineurin inhibitor use. These reports highlight the need for careful risk-benefit assessment when prescribing topical calcineurin inhibitors for inflammatory dermatoses, especially when used on sun-exposed sites.
authors.forename: Vivian Y
authors.initials: VY
authors.lastname: Shi
authors.forename: Jayne S
authors.initials: JS
authors.lastname: Joo
authors.affiliation: University of California, Davis.
authors.forename: Victoria R
authors.initials: VR
authors.lastname: Sharon
mesh_terms: D000279:Administration, Cutaneous; D000328:Adult; D001706:Biopsy; D065095:Calcineurin Inhibitors / Q000008:administration & dosage / Q000009:adverse effects*; D003876:Dermatitis, Atopic / Q000188:drug therapy*; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D007911:Lentigo / Q000139:chemically induced* / Q000473:pathology; D008047:Lip Diseases / Q000139:chemically induced* / Q000473:pathology; D019696:Peptidylprolyl Isomerase / Q000037:antagonists & inhibitors; D016559:Tacrolimus / Q000008:administration & dosage / Q000009:adverse effects / Q000031:analogs & derivatives*
chemical_list: D065095:Calcineurin Inhibitors; C117268:pimecrolimus; D019696:Peptidylprolyl Isomerase; D016559:Tacrolimus