Efficacy of topical pimecrolimus in the treatment of chronic vulvar pruritus: A prospective case series – a non‐controlled, open‐label study

Abstract

Background: Chronic vulvar pruritus has been a most distressing physical and sociologic disorder for many patients, as well as for their physicians. Potent topical steroids are the conventional therapy for this distressing condition. Side effects or steroid resistance can be encountered. A second‐line therapy is required. Objectives: A single‐centre, non‐controlled, open‐label study was designed to assess the efficacy of topical pimecrolimus in the treatment of chronic vulvar pruritus. Methods: Fifteen married adult women with symptoms of vulvar pruritus ⩾4 months were included in the study. The patients did not have any relief with topical steroids. There were no objective physical findings. Topical pimecrolimus 1% cream (Elidel cream®, Novartis) was applied twice daily to the vulvar region. Patients were followed up 4 weeks later. After the trial was stopped, the patients remained in regular review for 3 months. Results: Thirteen patients tolerated pimecrolimus. They showed a clinical response within 2–4 weeks. Ten patients showed a complete response, three showed a partial response. After the trial had stopped, the patients with complete response were followed‐up by telephone for another 3 months, and were found to be in remission. Conclusions: We found that topical pimecrolimus provides relief for chronic vulvar pruritus. Pimecrolimus can be chosen as the second‐line therapy in patients with vulvar pruritus.