Practice experience with topical calcineurin inhibitors

Abstract

The clinical experience with topical calcineurin inhibitors in the field is still rudimentary, if compared to our knowledge of topical corticosteroids. This is especially true for the long-term effects. The systemic transcutaneous absorption that occurs during the therapy of atopic dermatitis is quantitatively irrelevant. However, in the setting of permanent disruption of the skin barrier, as may be encountered in rare Genodermatoses, but as well in cases that do not respond to therapy, continued treatment my result in clinically relevant blood levels. Side effects of topical calcineurin inhibitors may be separated into two groups, i.e. local intolerance reactions, and skin infections. While the typical burning sensation of the newly treated skin is ephemeral, local alcohol intolerance, albeit less frequent, will persist throughout the treatment period. Regarding skin infections, Eczema herpeticatum seems to be the only serious complication; adequate preventive will further reduce the risk of this rare complication.