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.

Odyssey toward an understanding of acquired postinflammatory lentiginosis

“…Shi et al[10] published a case report involving a 40year-old with chronic chapped lips who used TCIs chronically. After 2 weeks of twice daily topical tacrolimus, she went on to continue treatment with topical pimecrolimus twice daily for 6 months.…”