Tacrolimus Ointment Research Articles

Les modalités d’utilisation de la ciclosporine locale pour l’allergie oculaire

Of the common allergic conjunctivitis in children, rare forms present more severe prognosis which include vernal keratoconjunctivitis and atopic keratoconjunctivitis. Vernal keratoconjunctivitis affects children mainly boys from 3 to 15 years old and represents a serious, descolarizing pathology affecting quality of life of the child. Atopic keratoconjunctivitis clearly affects adults more frequently with moderate to severe degrees of severity. Thus, the last few years have had the objective of developing innovative therapies to improve the management of these severe keratoconjunctivitis. It is essential to recognize the clinical form of these eye allergies for the implementation of appropriate treatment. Topical corticosteroids, although most often effective, can create dependence and moreover cause iatrogenic or even severe visual impairment complications. The latest studies on ciclosporin which is an immunosuppressive agent, have demonstrated major steroid-sparing effects. The proper use of topical cyclosporine must be well monitored. Nowadays, topical ciclosporine at 0.1%, has received the AMM for the indication of vernal keratoconjunctivitis and a new dosage at 2% received the AMM for the treatment of keratoplasty. Tacrolimus ointment having more powerful effects than cyclosporine is of interest in severe vernal keratoconjunctivitis and in fact especially in atopic keratoconjunctivitis. Therefore, in addition Tacrolimus treats atopic eyelid eczema. The various latest generation antiallergics can be useful in combination in ocular allergy. In very severe cases, Omalizumab, a human monoclonal antibody produced by the so-called recombinant DNA technique, selectively binds human immunoglobulin E (IgE) and has shown its effectiveness combined with ciclosporine in recent studies. Topical ciclosporine used appropriately can be a steroid-sparing agent in severe ocular allergy and improve the quality of life of children.

Nodular vasculitis or erythema induratum without cutaneous tuberculosis: An unusual presentation in an uncommon site

Erythema induratum (EI) is a rare chronic disease, which occurs with cutaneous tuberculosis (TB). Nodular vasculitis, much rarer than erythema induratum, describes the same condition but without cutaneous TB, with lesions usually in the lower legs and rarely on the breasts. We report the case of a 46-year-old female with a history of crusted skin and necrotic lesions two years before, which, once self-limited, multiplied one month before and transferred to uncommon sites of the body, such as the breast. There was no evidence of other clinical presentations, and a chest X-ray gave no pathological findings. A biopsy was taken from the lesions, and the patient was diagnosed with erythema induratum without cutaneous tuberculosis, that is, nodular vasculitis. After treatment with calcineurin-inhibiting tacrolimus ointment, topical corticosteroids, and immunosuppressive oral azathioprine, the lesions improved.

Experience in the treatment of dermatitis in children. Clinical examples

Modern external therapy of dermatoses is aimed at controlling the subjective symptoms, the dynamics of inflammatory manifestations, the achievement and duration of remission. The step-by-step approach to the treatment of dermatoses in children and adults is based on the adequate use of various external forms and means according to the inflammatory manifestations and localization of the inflammatory process. The article describes clinical cases of treatment of atopic dermatitis in patients aged 8 and 11, and contact allergic dermatitis in a 15-year-old adolescent using methylprednisolone aceponate cream with ceramides in its base, tacrolimus ointment and emollients. High efficacy and safety of anti-inflammatory drugs for external use have been shown. Clinical examples have proven that the combined use of topical corticosteroids and emollients contributes to a rapid reduction of skin dryness and itching, as well as the intensity of inflammation. The possibility of combining methylprednisolone aceponate cream with ceramides in the base once a day and emollients with physiological lipids increases the effectiveness of therapy and reduces the risks of side effects when using topical corticosteroids in children.

Efficacy of 2% Rebamipide Suspension for Vernal Keratoconjunctivitis: A Clinical Comparison with Topical Immune Modulators Cyclosporine and Tacrolimus

ABSTRACT Purpose To compare the efficacy of 2% rebamipide suspension with topical cyclosporine and tacrolimus for managing vernal keratoconjunctivitis (VKC) Methods In this prospective, interventional study, 38 patients with moderate to severe VKC were allocated to receive either 2% rebamipide in one eye and 0.03% tacrolimus ointment in the contralateral eye (n = 19) or 2% rebamipide in one eye and 0.05% cyclosporine in the contralateral eye (n = 19) for 12 weeks. Ten ocular signs and 7 symptoms were graded on a scale of 0-3 each for each eye at every visit. Results Total sign and symptom scores reduced significantly in all 4 subgroups (all p’s <0.05) at 12 weeks. Reduction of mean sign scores between rebamipide and tacrolimus (- 4.67 ± 4.63 and - 2.80 ± 3.18 respectively) and between rebamipide and cyclosporine (-6.00 ± 3.74 and -5.42 ± 3.68 respectively) was comparable. Reduction in symptom scores was also comparable between subgroups. Conclusion Our findings suggest that efficacy of topical rebamipide is comparable to topical cyclosporine and tacrolimus for managing moderate to severe VKC and it merits further evaluation as a novel steroid sparing alternative for this disorder.

Different methods of enhancing the efficacy of topical tacrolimus in extra-facial vitiligo: A comparative study.

Vitiligo is an acquired pigmentation disorder due to loss of melanocytes. Topical tacrolimus is effective in vitiligo treatment with minimal effect on extra-facial lesions. To assess different methods of enhancing the absorption of topical tacrolimus in extra-facial vitiligo sites using microneedling and occlusion. This study included 20 adult patients of both sexes with non-segmental vitiligo. Four extra-facial vitiligo lesions in each patient were randomly labeled A, B, C, and D and treated as follows: area A: tacrolimus ointment (0.03%) application twice/day, area B: microneedling once/week and tacrolimus ointment application directly after microneedling and twice/day the rest of the week, area C: microneedling once/week alone, and area D: tacrolimus ointment application twice/day under occlusion by polyethylene foil. The evaluation was done clinically by calculating the re-pigmentation percent after 6months of treatment. Responders in area B were 45%, and 35% in area C, and 25% in both areas A and D. No statistically significant difference was detected regarding the re-pigmentation percent between the four areas (p>0.05). No correlations were detected between re-pigmentation percent and patients' data. Combination of microneedling and topical tacrolimus has an edge over monotherapy in vitiligo, and further studies are needed to verify such results.

Effects of mineral complex material treatment on 2,4- dinitrochlorobenzene-induced atopic dermatitis like-skin lesions in mice model

BackgroundAtopic dermatitis (AD) is a chronic allergic inflammatory skin disease characterized by complex pathogenesis including skin barrier dysfunction, immune-redox disturbances, and pruritus. Prolonged topical treatment with medications such as corticosteroids, calcineurin inhibitors, and T-cell inhibitors may have some potential side-effects. To this end, many researchers have explored numerous alternative therapies using natural products and mineral compounds with antioxidant or immunomodulatory effects to minimize toxicity and adverse-effects. In the current study, we investigated the effects of mineral complex material (MCM) treatment on 2, 4-dinitrochlorobenzene (DNCB)-induced AD-like skin lesions in SKH-1 hairless mice.MethodsAnimals were divided into four groups; normal control (NC), negative control treated with DNCB only (DNCB only), positive control treated with DNCB and tacrolimus ointment (PC) and experimental group treated with DNCB and MCM patch (MCM). Skin inflammation and lesion severity were investigated through analyses of skin parameters (barrier score and strength, moisture and trans-epidermal water loss level), histopathology, immunoglobulin E, and cytokines. In addition, reactive oxygen species (ROS), nitric oxide (NO), glutathione peroxidase (GPx), and catalase (CAT) levels were measured in both serum and skin lysate.ResultsOur results demonstrates that MCM patch improved the progression of AD-like skin lesions by significantly increasing skin barrier strength and decreasing trans-epidermal water loss. Additionally, dermal administration of MCM patch significantly reduced epidermal thickness, ROS, and NO levels in skin lysate. Furthermore, we found that MCM suppressed the levels of AD-involved (Th1 and Th2) cytokines such as IL-2, IFN-γ, and IL-4 in blood. In addition, the levels of other Th1, and Th2 and inflammatory cytokines such as IL-1β, TNF-α, IL-6, IL-12(p70) and IL-10 were found lowest in the MCM group than in the DNCB only and PC groups. Moreover, we found total serum IgE level significantly increased after DNCB treatment, but decreased in the PC and MCM groups.ConclusionTaken together, our findings suggest that MCM application may have beneficial effects either systemic or regional on DNCB-induced AD lesional skin via regulation of the skin barrier function and immune-redox response.

Familial median canaliform dystrophy of heller affecting multiple nails: a rare clinical entity

&lt;p class="abstract"&gt;Median canaliform dystrophy (MCD); first described by Heller in 1928 is characterized by a midline or paramedian split in the nail plate. Mostly idiopathic, some identifiable causes include habitual picking of the nails, oral isotretinoin use and positive family history. The familial occurrence of MCD has rarely been described. Till date, no therapy has proven to be consistently successful in effectively managing the condition. Commonly utilized treatments have been intralesional triamcinolone acetonide injections into the dystrophic nail, topical 0.1% tacrolimus ointment and topical tazarotene 0.05% ointment. Despite available treatment options, the condition has a tendency to recur. Here; we report a case of a 14‑year‑old male presenting with familial MCD affecting multiple finger and toe nails.&lt;/p&gt;

Successful Treatment of Corticosteroid-Induced Rosacea-Like Dermatitis with Platelet-Rich Plasma Mesotherapy: Report of Seven Cases.

IntroductionCorticosteroid-induced rosacea-like dermatitis (CIRD) is one of the cutaneous side effects of long and excessive application of topical corticosteroids, resembling rosacea that can present with a series of cutaneous manifestations. Most patients with CIRD undergo a variety of long-term treatments before their symptoms are relieved as there is no accepted standard therapy. We gave each of seven patients two sessions of platelet-rich plasma (PRP) mesotherapy before the routine treatment to restore their skin barrier function, and we were surprised to find that the patients’ symptoms and appearance were significantly improved without any further treatments. Here we report this unexpected finding in dealing with CIRD.Case PresentationSeven patients, one male and six female, who had history of applying topical corticosteroids on the face for more than 3 months continuously or intermittently for various reasons were diagnosed with CIRD, showing varying degrees of erythema, telangiectasia, and papules, with dry skin, pain, and burning or stinging sensation. We intended to use the restorative effect of PRP to restore the skin barrier function of the patients for further treatment such as tacrolimus ointment, intense pulsed light (IPL), or pulsed dye laser (PDL), so they were treated twice with PRP intradermal injections using a mesogun injector machine. We used the VISIA skin detector to photograph and compare the changes after the treatments. Clinical efficacy was also assessed by the Global Aesthetic Improvement Scale (GAIS). Patients’ assessments were recorded using three-point scale questionnaires. After two sessions of PRP treatment, before any further treatment, we were surprised to find that the patients' symptoms had improved significantly, as confirmed by VISIA skin detector and GAIS. All of the patients were satisfied with the outcomes, considering that mesotherapy was not painful and their appearance and symptoms had much improved.ConclusionsPRP mesotherapy may mitigate sensitivity and inflammation in patients with CIRD by reducing erythema, telangiectasia, and papules. It is worth conducting large randomized controlled trials to verify its safety and efficacy in treating corticosteroid-induced rosacea-like dermatitis and maybe rosacea.

Self-microemulsification-assisted incorporation of tacrolimus into hydrophilic nanofibers for facilitated treatment of 2,4-dinitrochlorobenzene induced atopic dermatitis like lesions

Atopic Dermatitis (AD) is a chronic inflammatory skin disease, pruritus and dry skin are the principal signs of AD. Many people around the world are affected by this disease and their quality of life is severely diminished. The goal of this study was to design a patient friendly topical formulation containing tacrolimus to facilitate its application. Tacrolimus which is a highly hydrophobic drug was dispersed through an adopted self-microemulsifying drug delivery system (SMEDDS) which incorporated into a polymeric nanofibrous membrane. Through morphological and surface wettability analysis, sufficient proof was provided for the role of SMEDDS as a discrete structure that interacts with its surrounding polymers. Nanofibers were uniformly fabricated containing even distribution of tacrolimus that may reasonably justify membrane sustained drug release profile. Physicochemical characterization of the selected nanofibrous membrane showed molecular integration of amorphous form of tacrolimus into the nanofibers. Additionally, the membrane showed a desirable tensile strength. Evaluation of the effect of tacrolimus on AD model induced by 2,4-dinitrochlorobenzene in mice showed that tacrolimus nanofibrous membrane could be considered as a promising substitute for tacrolimus ointment due to its sustained release profile and less need for frequent application which would consequently result in less drug side effects.

Sequelae of microsporidial keratoconjunctivitis and its management.

Purpose:To characterize the sequelae of microsporidia keratoconjunctivitis (MKC) and outline its management.Methods:Retrospective analysis of microbiologically proven MKC returned with persistent disease between January 2015 and December 2019 was done. Demographics, clinical features, management, and outcome were analyzed.Results:Sixteen patients (21 eyes) of 332 treated for MKC returned with the persisting disease. The mean age of 11 males (68.7%), and 5 females was 35.1 ± 12.2 years. Three-quarter of them did not have a known predisposing risk factor and one-quarter of them were referred for chronic conjunctivitis. Past medications included topical antivirals (n = 8) and topical corticosteroid (n = 6). Three predominant presentations were persistent (>3 weeks) superficial punctate keratitis (SPKs, n = 7), sub-epithelial infiltrates (SEIs, n = 13), and uveitis (n = 2). The lesions recurred in eight eyes (SPK and SEI 4 each) after a disease-free interval of 60.4 ± 40.6 days; there were 13 episodes of recurrence. Topical low potent corticosteroids (loteprednol/fluorometholone), and tacrolimus ointment 0.03% were used in 17 (80.9%) and 8 (38%) eyes, respectively, for a mean duration of 44.8 ± 31.6 and 226.8 ± 180.5 days, respectively. At follow-up, 172.3 ± 183.6 days, visual recovery was statistically significant in persistent eyes (BCVA 0.07 ± 0.07 logMAR; P < 0.00001) but, not in recurrent eyes (BCVA 0.16 ± 0.08 logMAR; P = 0.07). Five of 21 eyes were left with residual significant scar.Conclusion:The sequelae of microsporidial keratoconjunctivitis are not uncommon. Topical 0.03% tacrolimus ointment appeared to be an effective corticosteroid-sparing agent for the treatment of SEIs and prevention of recurrence.

Activation of Transient Receptor Potential Vanilloid-3 Channels in Keratinocytes Induces Pruritus in Humans.

Carvacrol, a natural transient receptor potential vanilloid-3 activator, has been reported to cause pruritus in mice. This study aimed to evaluate the effects of carvacrol and various antipruritic agents in humans. A stimulation test with carvacrol, β-alanine, and histamine was performed. After application of the pruritic solutions, the skin was stimulated with pinpricks. In inhibition test A, Forsythia suspensa extract, containing forsythoside B (a transient receptor potential vanilloid-3 inhibitor), was applied by pricking prior to stimulation with pruritogens. In inhibition test B, olopatadine solution, tacrolimus ointment, and Scutellaria baicalensis root extract were applied, and carvacrol was applied to the same region. Carvacrol induces moderate pruritus in humans. The pruritus was relieved by Forsythia suspensa extract and olopatadine solution after 20 min of application and by tacrolimus ointment and Scutellaria baicalenis extract after 24 h of application. These results suggest that carvacrol is a pruritogen in humans, and that carvacrol-induced pruritus is inhibited by various antipruritic agents.

Lichen sclerosus in men: improving diagnostic and treatment methods

Objective of the study.To evaluate the effectiveness of systemic interferon alpha‑2b in the complex therapy of lichen scleroatrophic of the penis.Material and methods. The study involved 26 male patients with a verified diagnosis: lichen scleroatrophic of the penis. The main group was 19 people, the comparison group was 7 men. The duration of the disease in men was from 9 to 12 months. To estimate the area of lesion as well as to estimate their dynamic changes were developed: Scleroatrophic Lichen Area Index (LS-S in men) and Scleroatrophic Lichen Activity Index (LS-A). Treatment in the main group: topical corticosteroid momentasone cream two times a day for 21 days, as well as interferon alpha‑2b suppositories in a dose of 3 million ME two times a day, daily for 10 days, then three times a week for 2 months with subsequent external application of 1–2 times a day for 2 months of ointment with interferon alpha‑2b. In patients with balanopostitis the cream was used in combination with momentazone, economazole, gentamycin and dexpanthenol. Patients from the comparison group received momentazone cream for 21 days, and in case of recurrence of symptoms – the prescription of topical calcineurin inhibitors. Patients of both groups received vitamin E of 200 mg per day for 2 months. The end point of observation for patients of both groups was 3 months after the end of therapy.Results. Against the background of treatment, improvement was achieved in all patients in the main group within 21 days. Subsequent cancellation of topical corticosteroid and continuation of therapy with suppositories and ointment of the interferon alpha‑2b allowed to maintain positive dynamics of the skin process during the whole period of observation. The control group also achieved a positive effect from therapy with topical corticosteroids (cream with momentazone), but after its cancellation, in the period from 4 to 6 weeks, symptoms were recurrent, which required the continuation of therapy with topical calcinerin inhibitors – tacrolimus ointment 0.1% 1–2 times a day for 4 weeks. The use of the LS-A Index showed that the indices of skin manifestations were the fastest to regress than those of the LS-S index assessing the area of lesion.Conclusions. 1. The use of system therapy with interferon alpha‑2b, along with topical GCSs, in the complex treatment can reduce the severity of clinical manifestations of GSAL without resorting to prolonged use of topical GCSs. 2. The use of interferon alpha‑2b in the complex treatment of the genital lichen sclerosus has demonstrated its effectiveness in a small group of patients. 3. Application of the developed Lesion Area Index and Lichen Sclerosus Activity Index in men allow to objectively assess the effectiveness of treatment. 4. Lichen sclerosus assessment indices allow to develop an individual plan of rehabilitation measures. 5. It is expedient to continue studies on pathogenetic mechanisms of influence of alpha‑2b interferon in genital lichen sclerosus.

Isolated lip dermatitis (atopic cheilitis), successfully treated with topical tacrolimus 0.03.

Background Exfoliative and erosive cheilitis, may be a source of speech and chewing discomfort, but may also be an aesthetic issue for the patients affected. Such a clinical presentation may implicate a variety of inflammatory conditions, including atopic (eczematous) cheilitis. Topical and systemic agents, e.g. corticosteroids, have been used to treat inflammatory lip conditions. Topical tacrolimus has also been used in some inflammatory lip conditions. Material and Methods We performed a retrospective clinical analysis of atopic cheilitis patients. Results Between 2015 and 2020, we addressed 7 (seven) patients with atopic dermatitis affecting only lips and were diagnosed as atopic-eczematous cheilitis. They were treated with 0.03 per cent topical tacrolimus ointment and responded completely. Conclusions These cases represent an underreported atopy / eczema event;-few cases of atopic cheilitis without concomitant dermal lesions appear in the literature. We are also showing and discussing yet another application of tacrolimus in a local atopic form of inflammation affecting the lips. Key words:Atopy, cheilitis, tacrolimus.

Use of tacrolimus ointment (0.03%) for refractory VKC

We report a series of 8 children with severe vernal keratoconjunctivitis who presented to us over last two years. The mean age was 7.375 years. The mean vision was 0.375 OD and 0.3625 OS. All these children were using topical steroids of varying strengths for more than two year. 2 out of 8 children had secondary glaucoma. The mean intraocular pressure was 21.75 + 4.74 OD and 23.25 + 6.25 mm of Hg OS. The highest IOP recorded was 28 mm Hg. All patients with glaucoma had early optic disc changes. Topical steroids were stopped for all patients and they were started on topical tacrolimus eye ointment (0.03%) twice a day along with lubricants. Patients relative were counseled to avoid eye rubbing, ignore minimal redness of eyes and counseled against any form of steroids. All patients continued tacrolimus for 3 months. Tacrolimus ointment was stopped at 3 month and lubricants were continued. Follow up was done at 1st week, 3rd week, 6th week, 3rd month and monthly thereafter till 6 months. At 6 months follow up all except one patient was discontinued of antiglaucoma medication. Keywords: VKC, Tacrolimus.

Clinical Diagnosis and Treatment of Infants with Angular Cheilitis

As a cross-disciplinary discipline, medicine culture can reflect the characteristics of its cultural system. Thepurpose of this article is to study the clinical diagnosis and treatment of infants and young children aftersuffering from angular cheilitis, and to analyze more effective rehabilitation methods. This article compares thediagnosis of infants and young children with the corresponding antibiotics, combined vitamin B combined witherythromycin eye ointment, and tacrolimus ointment after treatment. In the corresponding antibiotic treatment,the total effective rate of the patients in the experimental group (98.22%) was higher than the total effective rateof the conventional group (83.14%). The total effective rate of the combined vitamin B combined witherythromycin eye ointment was 38 cases (95%) is significantly higher than the total effective 28 cases (70%) ofthe control group. The clinical cure rate of tacrolimus ointment over time is 92.3% after 2 weeks of treatment.From these results, it can be concluded that with targeted diagnosis and treatment, infants and young children'sangular cheilitis disease can be fully and effectively recovered, and the healing time is greatly shortened. It ismore conducive to the healthy growth and development of infants and young children.

16900 Dupilumab-associated ocular surface disease: Clinical characteristics and treatment

Dupilumab is the first biologic medication approved for treatment of moderate to severe atopic dermatitis (AD). While few adverse events were reported in clinical trials, increased incidence of conjunctivitis with dupilumab vs placebo was consistently observed. The optimal treatment for dupilumab-associated ocular surface disease (DAOSD) has not been well established. This study aims to describe the spectrum of clinical presentations of DAOSD, and to evaluate therapeutic responses. Retrospective chart review of patients with AD and DAOSD who received ophthalmologic evaluation at Oregon Health & Science University from 2014 to 2019 yielded 29 patients (mean age 46 years; M/F: 12/17). Facial and eyelid AD were observed in 26 (90%) and 19 (66%) patients, respectively. Common ocular symptoms included irritation (n = 26, 90%), redness (n = 24, 83%), pruritus (n = 18, 62%), and tearing (n = 18, 62%). Twenty-two patients were diagnosed with conjunctivitis, 4 blepharitis, 2 keratitis, and 1 other. Topical steroids were the most commonly utilized therapy (67%), and 89% of these experienced moderate improvement or full resolution. Other therapies included artificial tears (n = 5), antihistamine drops (n = 4), lifitegrast (n = 3), tacrolimus ointment (n = 2), and cyclosporine (n = 1). Three patients discontinued dupilumab because of severe DAOSD. This study’s results suggest that patients with facial and eyelid AD may be more susceptible to DAOSD. This study also provides insight into the common ocular symptoms associated with DAOSD, which may prove useful when screening dupilumab-treated AD patients for ophthalmology referral. Very few patients discontinued dupilumab due to DAOSD, suggesting the symptoms may be controllable with ocular therapies with high efficacy rates observed with topical steroids.

Effect of topical tacrolimus ointment on SCORAD index in pediatric atopic dermatitis.

Objectives: To determine topical tacrolimus ointment’s efficacy in atopic dermatitis. Study Design: Descriptive case series study. Setting: Outpatient Department of Dermatology, Liaquat University of Medical and Health Sciences (LUMHS), Civil Hospital, Hyderabad. Period: 12 October 2017 to 12 April 2018. Material &amp; Methods: Consisted of 106 patients. Detailed History was taken from patients and systemic review was also done to assessed any co-morbidity. Data was analyzed through SPSS version 23.0. Results: In this study 71 (66.98%) patients were men and 35 (33.01%) were female; with male to female ratio 2:1. The mean age was 6.1+1.8 years. Clinical signs of patients were erythema 88(83.01%), edema 76(71.69%), Oozing/ crusting 45(42.45%), excoriation 59(55.66%) and lichenification 64(60.37%). Before treatment start the SCORAD index (SCORAD I) mean was 61.8 ± 11.12 (range 7–103): moderate cases were observed in 87(82.07%) patients (SCORAD I 30 – 49) and 19(17.92%) patients had severe AD (SCORAD I ≥50). After treatment, the SCORAD index mean was 35.8 ± 13.15 (range 7–103): 57(53.77%) patients had SCORAD index values ≤30; moderate cases (SCORAD I 30-49) were observed in 42(39.62%) patients and 7(6.60%) patients had severe AD (SCORAD I &gt;50). In 57(53.77%) cases topical tacrolimus ointment (0.1%) showed positive efficacy in atopic dermatitis, while in 49(46.22%) cases observed negative. Conclusion: The application of topical tacrolimus ointment (0.1%) is effective in the treatment of atopic dermatitis in children.

Utilization and cost of topical calcineurin inhibitors in the Medicare population: 2013 to 2017

To the Editor: Topical calcineurin inhibitors (TCIs) are steroid-sparing agents used to treat atopic dermatitis and other inflammatory dermatoses.1 The 2 commercially available TCIs are tacrolimus ointment (0.03% and 0.1%) and pimecrolimus cream (1%). Prescription and cost trends for TCIs have not been studied.

Efficacy and safety of oral simvastatin in the treatment of patients with vitiligo

Vitiligo, an autoimmune disease, is a depigmentation skin disorder characterized by hypopigmentation spots and patches that are difficult to treat. The purpose of this study is to analyze the clinical...

Current management options for rosacea: clear skin is our reality

BACKGROUND: Treatment of rosacea makes enough difficulties. Review of current etiology, pathogenesis and social burden of rosacea are presented, as well as results of international studies on efficacy of brimonidine gel (Mirvaso Derm) and ivermectin creme (Soolantra) usage in erytemato-teleangiectatic and papulopustular rosacea.&#x0D; AIMS: To evaluate efficacy and safety of topical ivermectin and brimonidine for the treatment of rosacea.&#x0D; MATERIALS AND METODS: Results of our own experience of using these drugs in 87 rosacea patients are presented. Depending on the subtype and severity of the disease, patients with erythematotelangiectatic subtype rosacea were treated with Mirvaso Derm gel (59%), Soolantra cream, and tacrolimus ointment (41%); doxycycline 0.10.2 g twice a day and Soolantra cream (29%); and minocycline 0.050.1 g a day and Soolantra cream (37%).&#x0D; Moreover, patients with papulopustular subtype rosacea were treated with the following combined therapy: doxycycline/minocycline + Mirvaso Derm gel + Soolantra cream (34%). Regardless of the severity of the process, all patients received Cetaphil Pro for redness prone skin (Cetaphil Redness Control line until 2018) as daily skin care products. The mean duration time of therapy for antibiotics was 1.52 month and topical therapy had a relatively longer duration time of therapy: from 8 to 24 months for Mirvaso Derm and 3 to 10 months for Soolantra.&#x0D; RESULTS: After the therapy 43 and 55% of patients with papulopustular rosacea achieved Investigator Global Assessment (IGA) scores of 0 (clear) and 1 (almost clear), respectively; and 41% and 50% of patients with erythemato-telangiectatic rosacea achieved IGA scores 0 and 1, respectively. During the 1-year follow-up clear and almost clear skin (IGA = 01) remained in 87% of patients with papulopustular subtype rosacea and 79% of patients with erythemato-telangiectatic subtype rosacea.&#x0D; CONCLUSION: Thus, based on the results, Mirvaso Derm gel and Soolantra creme have demonstrated to be very effective and safe options for rosacea treatment.