An open‐label pilot study to evaluate the safety and efficacy of topically applied tacrolimus ointment for the treatment of hand and/or foot eczema

Thelmo, MC; Lang, Wei; Brooke, E; Osborne, B E; McCarty, MA; Jl, Jorizzo; Fleischer, Alan B.

doi:10.1080/09546630310009491

Cited by 33 publications

(21 citation statements)

References 22 publications

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“…In Table 1 the search terms for our systematic search in both databases are given separately and the corresponding results are shown. Table 2 5,10,15–81 gives an overview of all the studies using scoring systems for assessing hand eczema severity. Table 2 includes a detailed comparison of published semiquantitative hand scores in both databases including the date of publication of the manuscript, the sample size and characterization of the study population, the score used, the potential combination with subjective complaints and the maximum score value.…”

Section: Resultsmentioning

confidence: 99%

“…These scores were first and foremost used for assessing the skin condition of participants with distinct hand eczema 5,10,15–19,21–25,27–31,33,35–38,41–43,45,47,49–60,62–65,67–70,74–78,80 except two studies that included only healthy volunteers 40,48 . In 16 trials the participants were exposed to ‘hazardous substances at workplace’ potentially harmful to their skin 18–20,23,26,32,34,38,45–47,57,65,66,71,73 .…”

Section: Resultsmentioning

confidence: 99%

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An overview of skin scores used for quantifying hand eczema: a critical update according to the criteria of evidence-based medicine

Weistenhöfer

Baumeister

Drexler

et al. 2009

British Journal of Dermatology

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The present review gives an overview of the enormous variety of skin scores used for assessing severity in patients suffering from hand eczema. In order to evaluate the validity and practical relevance of different scoring systems according to the criteria of evidence-based medicine, in May 2009 we performed a systematic search of the literature using PubMed and the Cochrane Library. A total of 69 articles reporting on 45 different methods for quantifying hand eczema were identified. The panel of methods varied from pure subjective categories to more or less quantitative scoring systems. Furthermore, by focusing on skin scores used in clinical trials in which the results led to the licensing of a systemic or topical drug for treatment of hand eczema, a panel of different scoring systems was identified. In addition to morphological pattern, some scoring systems included subjective complaints, which might cause an individual bias by overestimation of self-reports. Inter- and intraobserver reliability was rarely reported except for three scores. Among these validated scores interobserver reliability was reported for three scores, but only one of the three included reliability within observers (repeatability). Advantages and disadvantages of the different scoring systems are critically discussed. Depending on different indications and particular settings (e.g. occupational screening vs. clinical examinations, evaluating progress of treatment in everyday clinical practice or for research purposes) scoring systems have to fulfil diverging demands. We draw the conclusion that a standardized diagnostic procedure for assessing the severity of hand eczema would facilitate the comparability of outcome of clinical trials. However, scoring systems used for occupational screening have to fulfil different demands compared with scoring systems used for licensing of drugs. This striking difference might be explained by the skin condition, which is generally supposed to be much better in subjects at medical check-ups at the workplace.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

An overview of skin scores used for quantifying hand eczema: a critical update according to the criteria of evidence-based medicine

Weistenhöfer

Baumeister

Drexler

et al. 2009

British Journal of Dermatology

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“…At the end of the study, 28% of patients treated with pimecrolimus versus 18% using vehicle were clinically clear or almost clear of chronic hand eczema -it was ob- 47 served that lesions of the dorsum of the hands had a better response than palmar lesions. In an open study, Thelmo et al showed that tacrolimus 0.1% ointment, used three times daily, improved lesions of hand and foot eczema [22] . The systemic absorption of topical pimecrolimus when used under occlusion to treat hand eczema was shown to be minimal and similar to that observed without occlusion in patients with atopic eczema [13,21] .…”

Section: Chronic Hand Dermatitismentioning

confidence: 99%

“…Several clinical studies have evaluated the efficacy and tolerability of TCIs in the treatment of chronic hand dermatitis [20][21][22] , and some benefits have been noted following observational use [23] . In a double-blind controlled study randomizing 294 patients to pimecrolimus or vehicle, Belsito et al have shown that topical pimecrolimus used twice daily, with the evening application followed by 6-hour occlusion with vinyl gloves, reduced the clinical signs of cutaneous inflammation [20] .…”

Section: Chronic Hand Dermatitismentioning

confidence: 99%

Potential New Indications of Topical Calcineurin Inhibitors

Luger

Paul

2007

Dermatology

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The topical calcineurin inhibitors pimecrolimus (Elidel®) and tacrolimus (Protopic®) were initially developed for the treatment of atopic eczema (atopic dermatitis), a chronic or chronically relapsing skin condition most prevalent in infants and children. Their main advantages compared with conventional topical corticosteroid therapy are that they are more selective in their mode of action, do not induce skin atrophy and are not associated with significant systemic absorption. In addition, topical calcineurin inhibitors may represent a useful alternative to topical corticosteroids for the treatment of a number of other inflammatory skin diseases. Preferred sites for the use of topical calcineurin inhibitors are areas such as the face, neck, flexures, and genital areas, which are more susceptible to topical corticosteroid side effects. The efficacy of topical calcineurin inhibitors has been demonstrated for flexural psoriasis, seborrhoeic, contact and hand eczema. Preliminary data also support the efficacy of topical calcineurin inhibitors in lichen planus, facial lupus erythematosus, autoimmune bullous dermatosis, and vitiligo. In these latter indications, controlled studies are needed to better understand the efficacy and safety of topical calcineurin inhibitors and their role in disease management.

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“…Their anti-inflammatory potency has been approximated to that of lower mid-strength corticosteroids, such as 0.1 % hydrocortisone butyrate or 0.1 % betamethasone-17-valerate [48,49]. There are several studies in chronic hand eczema [48,50] (reviewed in [51]) where TCIs showed good therapeutic effects worthy of further study in large RCTs. As TCIs may not penetrate well through hyperkeratosis, in some of the studies they were applied under occlusion; for example, twice daily with overnight occlusion [52].…”

Section: Topical Calcineurin Inhibitors (Tcis)mentioning

confidence: 98%

Hand Dermatitis: A Review of Clinical Features, Prevention and Treatment

2015

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Hand dermatitis is a socially significant health problem. This review provides a discussion on the clinical features and patterns as well as the differential diagnosis of hand dermatitis, because these are essential for proper diagnosis in clinical practice. The morphology, however, is poorly related to the etiology in chronic cases. In all cases of chronic hand dermatitis, a full diagnostic examination should be undertaken and the etiology should be clarified and addressed in the treatment concept, instead of just moving directly from a morphological diagnosis to therapy. Preventive measures should be included in the treatment concept according to etiology. A stepwise approach for escalating therapy is advised, including basic topical therapy, topical corticosteroids, calcineurin inhibitors, as well as phototherapy and systemic therapy with corticosteroids, alitretinoin, cyclosporine, methotrexate, azathioprine, and others.

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An open‐label pilot study to evaluate the safety and efficacy of topically applied tacrolimus ointment for the treatment of hand and/or foot eczema

Abstract: Tacrolimus ointment 0.1% is a promising corticosteroid alternative for hand/foot eczema.

Cited by 33 publications

References 22 publications

An overview of skin scores used for quantifying hand eczema: a critical update according to the criteria of evidence-based medicine

An overview of skin scores used for quantifying hand eczema: a critical update according to the criteria of evidence-based medicine

Potential New Indications of Topical Calcineurin Inhibitors

Hand Dermatitis: A Review of Clinical Features, Prevention and Treatment

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