Tacrolimus: a review of its use for the management of dermatoses

Abstract

The newly developed immunomodulator tacrolimus (FK506) is the first of a new class of agents that have enormous potential to change the way that dermatoses are treated and managed. Tacrolimus has been found to be active in a topical formulation with the latter exerting its effects by acting on the signal transduction pathways inside T cells and inhibiting gene transcription. The result is decreased responsiveness of T cells to antigens. Percutaneous absorption of tacrolimus is higher in diseased skin as opposed to healthy skin and, therefore, the drug will be taken in at progressively lower quantities as lesions heal. There is limited systemic absorption of tacrolimus over the course of therapy. The most extensive experience with tacrolimus has been in treating atopic dermatitis. In numerous trials, tacrolimus ointment 0.03-0.3% has shown to be effective in reducing the symptoms and severity of atopic dermatitis in adults and the paediatric population. Furthermore, there have been no significant toxic effects associated with topical therapy with tacrolimus. The most common complaint is that of local irritation after applying the ointment. This is generally transient and the patient is able to continue with therapy. The other dermatoses where tacrolimus has been used include contact dermatitis, psoriasis and pyoderma gangrenosum.

Effects of tacrolimus on ischemia-reperfusion injury

“…[15][16][17] Potential applications of this multifarious agent are still under investigation. Favorable results have been generated with the use of tacrolimus for treating various immune-mediated phenomena, including rheumatoid arthritis, 18 dermatological conditions, 19 ophthalmological ailments, 20 and inflammatory bowel disease. 21 In this review, we present currently available data addressing the impact of tacrolimus within the elaborate and injurious cellular mechanisms induced by ischemia and subsequent reperfusion (I-R).…”

Étude rétrospective de l’efficacité du Protopic® (tacrolimus) dans le traitement de la langue géographique algique

“…Le tacrolimus est un immunosuppresseur qui appartient à la famille des macrolides [5][6][7]. L'indication principale du tacrolimus est la prévention du rejet des allogreffes de rein, foie et coeur [6,7].…”

“…L'indication principale du tacrolimus est la prévention du rejet des allogreffes de rein, foie et coeur [6,7]. En dehors de cette indication figurant dans son autorisation de mise sur le marché, le tacrolimus topique a démontré son efficacité dans le traitement de nombreuses maladies inflammatoires dermatologiques cutanées et muqueuses comme l'eczéma ou la dermatite atopique [6,8].…”

Erosive Pustular Dermatosis of the Scalp Following Herpes Zoster: Successful Treatment with Topical Tacrolimus

“…However, in view of worsening cutaneous atrophy, topical tacrolimus has been proposed as an alternative therapy 10 . Tacrolimus is a potent antiinflammatory and immunosuppressive agent that has demonstrated to be effective in the management of chronic inflammatory dermatoses 11 . Recently, a few cases of successful treatment of EPDS with topical tacrolimus ointment have been reported 10,12 .…”