Successful Treatment of Recalcitrant Chronic Actinic Dermatitis with Tacrolimus

Schuster, Christian; Zepter, Karoline; Kempf, Werner; Dummer, Reinhard

doi:10.1159/000080857

Cited by 12 publications

(8 citation statements)

References 25 publications

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“…Due to its immunomodulatory activity and capability to penetrate the skin, topical tacrolimus is currently being investigated in numerous inflammatory skin disorders (e.g. cutaneous lupus erythematosus, recalcitrant chronic actinic dermatitis, lichen sclerosus et atrophicus) [18, 19]. Up to the present there are only few reports of tacrolimus in the treatment of pustular psoriasis, particularly of ACH [8, 20, 21].…”

Section: Discussionmentioning

confidence: 99%

“…Tacrolimus is a large molecule and therefore the location, skin thickness and erosions might also influence its efficacy. It is especially useful in early inflammatory facial lesions without prominent hyperkeratosis [18, 19]. In long-standing lesions previously unresponsive to corticosteroids with profound inflammation like in cutaneous lesions of dermatomyositis, 0.1% tacrolimus ointment does not seem to be very effective [24, 25].…”

Section: Discussionmentioning

confidence: 99%

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Successful Treatment of Acrodermatitis Continua of Hallopeau with Sequential Combination of Calcipotriol and Tacrolimus Ointments

Brill¹,

Elshorst-Schmidt²,

Valesky³

et al. 2005

Dermatology

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Acrodermatitis continua of Hallopeau (ACH) is a rare type of pustular psoriasis affecting the digits. We report on a 43-year-old female patient who had been suffering from ACH for more than 20 years. Despite the fact that the disease was localized on one finger during the whole period, several topical and systemic treatments resulted in only temporary or partial improvement of the lesion. Although the monotherapies with calcipotriol and tacrolimus ointments gave no satisfying results in the long-term management of the disease, the combination of both agents led to a continuous improvement of the patient’s skin condition.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Successful Treatment of Acrodermatitis Continua of Hallopeau with Sequential Combination of Calcipotriol and Tacrolimus Ointments

Brill¹,

Elshorst-Schmidt²,

Valesky³

et al. 2005

Dermatology

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“…Abe et al [10] as well as other groups [8, 9, 11] demonstrated the activity of topical tacrolimus in the treatment of CAD patients but did not assess patients with nodular lesions and heavily infiltrated skin as demonstrated in our case. Due to the inefficient percutaneous absorption of once daily applied tacrolimus in nodular lesions of prurigo or plaques in psoriasis [17], we decided to apply tacrolimus twice daily in combination with chemical and physical UV protection.…”

Section: Discussionmentioning

confidence: 72%

“…However, recurrence rates are high even under treatment. Because of its specific immunomodulatory effects on T-helper cells, topical administration of tacrolimus may be a potent immunosuppressant and has been used successfully in CAD patients [8,9,10,11]. In the present report, a patient with a successful treatment of tacrolimus in severe nodular AR resistant to standard therapy is described.…”

Section: Introductionmentioning

confidence: 90%

Successful Treatment of Nodular Actinic Reticuloid with Tacrolimus Ointment

Gröne

Kunz²,

Zimmermann³

et al. 2006

Dermatology

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Actinic reticuloid (AR) is the severest clinical variant of chronic actinic dermatitis (CAD) and describes a persistent photoinduced skin disorder often associated with delayed-type hypersensitivity reactions. Histopathologically, AR resembles pseudolymphoma and may also show features of cutaneous lymphoma. In contrast to other UV-induced skin diseases, AR patients show persistent photosensitivity to UV radiation and visible light parallel to permanent changes of skin texture with infiltrated papules and thickened plaques. Therapeutically, CAD is a problematic condition. Daily application of sun protection has to be combined with local or systemic immunosuppression. However, various therapeutic approaches including systemic corticosteroids and other systemic immunosuppressive agents are limited by severe side effects. Tacrolimus, a Streptomyces-derived immunosuppressive macrolide antibiotic and inhibitor of calcineurin, has been proven successful in vari ous inflammatory skin diseases including atopic eczema, allergic contact dermatitis and photodermatoses without undesired side effects. We present a case of severe recalcitrant and nodular chronic actinic dermatitis responding to topically applied tacrolimus (Protopic^®). To avoid further relapses we continued this therapy twice a day over a period of 2 years.

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“…Recently, tacrolimus has also been reported to decrease the number of LCs (9) in the skin and directly inhibit mast cell degranulation (10). CAD, a light-induced hypersensitivity, also responds well to topical tacrolimus, according to the literature (11)(12)(13). The anti-inflammatory effect, proved by previous studies, has made topical tacrolimus an effective treatment method against not only AD, but also other inflammatory skin diseases such as CAD, psoriasis, vitiligo, Behcet syndrome, gangrenous pyoderma, and acute graft versus host disease (14).…”

Section: Discussionmentioning

confidence: 98%