Topical tacrolimus 0.1% ointment (Protopic®) reverses nickel contact dermatitis elicited by allergen challenge to a similar degree to mometasone furoate 0.1% with greater suppression of late erythema

Abstract

The aim of this study was to evaluate the ability of topical tacrolimus 0.1% under occlusion for 48 h to suppress nickel-elicited allergic contact dermatitis in a randomized, petrolatum- and mometasone furoate 0.1% ointment-controlled double-blind, intra-individual study which included 28 women volunteers. 3 closed patch tests (Finn Chambers on Scanpor, Epitest Ltd Oy, Tuusula, Finland) containing 0.1 ml of 5% nickel sulfate in petrolatum were applied on day 0. After removal on day 2, the study compounds were applied under occlusion for 48 h. The eczema reaction and the degree of erythema were evaluated clinically and by reflectance spectrophotometry at days 4 and 7, respectively. Mean visual scores corresponding to petrolatum-treated sites were significantly higher than those corresponding to both mometasone furoate and tacrolimus at days 4 (P < 0.001) and 7 (P < 0.001). In both tacrolimus- and mometasone furoate-treated sites, there was a significant decrease in visual scores with time (P < 0.001) from day 2 to day 7, and the corresponding mean decreases in scores were 0.73 and 1.04, respectively. The difference between both was 0.30 in favour of tacrolimus (95% confidence intervals, -0.04 and 0.65), although this did not reach statistical significance (P = 0.084). Mean erythema index values were similar at day 2. Significant differences among treatment sites were seen at days 4 (P < 0.001) and 7 (P < 0.001). The decrease was significantly more pronounced on day 7 in patches where tacrolimus had been supplied (P < 0.5). This method might provide useful means to compare different concentrations and/or presentations of tacrolimus or other calcineurin inhibitors and topical anti-inflammatory agents.

Tacrolimus ointment 0.1% in the treatment of allergic contact eyelid dermatitis

“…It has also been demonstrated to inhibit T‐lymphocyte activation and dermal skin Langerhans’ cells, but with a good safety profile and without the side‐effects of corticosteroids 7,8 . In contrast to corticosteroids, tacrolimus effectively controls erythema and oedema, not as a result of vasoconstriction, but perhaps by a direct anti‐inflammatory effect 9 …”

Allergic contact dermatitis: a case series and review for the ophthalmologist

“…However, Saripalli et al 49 induced nickel ACD in patients and found that tacrolimus was significantly more effective than vehicle. Alomar et al 50 corroborated this finding. Similarly, pimecrolimus at 0.2% and 0.6% formulations has successfully treated nickel-induced ACD 51…”

Diagnosis and Management of Common Dermatoses in Children: Atopic, Seborrheic, and Contact Dermatitis

“…The TCIs may offer a steroid-sparing treatment for some forms of CD. [106][107][108][109][110][111] Evaluation of tacrolimus ointment has shown a treatment benefit in nickel allergy, 107,109 protein contact dermatitis, 106 and eyeglass frame dermatitis. 107 Similarly, pimecrolimus has exhibited efficacy in the treatment of nickel 110 and chronic hand dermatitis.…”