Author(s) : Thomas Ruzicka, Till Assmann, Mark Lebwohl , Department of Dermatology, University of Dsseldorf, Moorenstr 5, D-40225 Dsseldorf, Germany. Department of Dermatology, The Mount Sinai Hospital, New York, USA .
Summary : Tacrolimus ointment is a steroid-free topical immunomodulator developed for the treatment of atopic dermatitis, a common, chronic inflammatory skin disease. By inhibiting T-cell activation and cytokine production, topically applied tacrolimus modulates inflammatory responses in the skin. Numerous clinical trials have shown that it is effective and well tolerated for the treatment of atopic dermatitis, its licensed indication. In addition, numerous publications suggest that tacrolimus ointment may provide effective treatment for a variety of other inflammatory skin disorders, many of which are very difficult to manage with standard therapy. This paper reviews currently available evidence regarding the use of tacrolimus ointment in a range of dermatological disorders, including psoriasis, lichen planus, pyoderma gangrenosum, lichen sclerosus, contact dermatitis, leg ulcers in rheumatoid arthritis, steroid-induced rosacea and alopecia areata. It also provides recommendations for future clinical studies with tacrolimus ointment.
Figure 1. Oral mucosa of a 51-year-old patient
with refractory lichen planus (a) before and (b) after 8 weeks
of therapy with tacrolimus 0.1% ointment.
Figure 2. Legs of a patient with pyoderma
gangrenosum (a) at baseline and (b) after 12 weeks of
treatment with a topical 0.5% tacrolimus solution. Reproduced with
permission from reference [68].
Figure 3. Vulva of a patient with lichen sclerosus
(a) before and (b) after 6 weeks of treatment with tacrolimus
0.1% ointment. Reproduced with permission from reference [68].
Figure 4. Face of a female patient with
steroid-induced rosacea (a) before and (b) after 7 days of
treatment with tacrolimus 0.1% ointment. Reproduced with permission
from reference [68].
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