Topical Tacrolimus Ointment Research Articles

Tacrolimus versus hydrocortisone in management of atopic dermatitis in children, a randomized controlled double-blind study: New insights on TARC, CTACK, TSLP, and E-selectin.

Atopic dermatitis (AD) is a type of chronic inflammatory disorder that affects all age groups including children. AD is characterized by elevated inflammatory marker levels. To assess the safety and effectiveness of topical tacrolimus ointment versus topical hydrocortisone cream in the treatment of pediatric AD by comparing the two treatments' ability to reduce serum cytokines. One hundred AD patients who fulfilled the eligibility criteria completed this clinical study. Two groups of 50 AD patients each were selected from Tanta University's Dermatology Department., Group 1 (the hydrocortisone group) was administered topical hydrocortisone cream for a duration of 4 months. For 4 months, Group 2 was administered tacrolimus topically. Serum levels of thymus and activation regulated chemokine (TARC), cutaneous T cell attractant chemokine (CTAC), interleukin-10 (IL-10), interleukin-6 (IL-6), E selectin (E-selectin), and thymic stromal lymphopoietin (TSLP) were measured during an evaluation of the patients by a dermatologist at the beginning and 4 months after the treatment had been started. Children's Dermatology Life Quality Index was used to assess quality of life in these patients. With the exception of E-selectin, IL-6, and IL-10 (p > .05), the tacrolimus group had a significant reduction in TARC, CTACK, TSLP (p < .05) when compared to its baseline and when compared to the hydrocortisone group. Both groups showed a significant improvement in quality of life but no significant changes between groups were observed. In children with AD, tacrolimus reduces inflammatory biomarkers better than hydrocortisone.

Efficacy and safety of fire needle therapy in treating non-segmental stable vitiligo: A randomized self-controlled clinical trial.

Vitiligo remains a challenging condition to treat. Fire needle therapy, a traditional Chinese medicine technique, has potential as an alternative therapeutic strategy. However, rigorous evidence on its efficacy is lacking. We aimed to evaluate the efficacy and safety of fire needle therapy, alone and combined with topical tacrolimus ointment, for non-segmental stable vitiligo. In this 6-month randomized self-controlled trial, 35 vitiligo patients were enrolled, providing three similar lesions each. Lesions were randomly allocated to receive fire needle monotherapy, 0.1% tacrolimus ointment monotherapy, or combined fire needle and tacrolimus ointment therapy. The main outcome was change in vitiligo surface area. In total, 29 patients completed the 6-month follow-up. The combination therapy group showed significantly greater reductions in vitiligo surface area compared to monotherapy groups starting at months 4 and 5. By the end of the study, combination therapy resulted in remarkably higher repigmentation responses, with 89.7% of lesions showing at least mild (≥25%) repigmentation and 51.7% showing good (≥50%) repigmentation. This significantly exceeded the outcomes with topical tacrolimus ointment alone, which only achieved 6.9% mild response and 6.9% good response. Fire needle monotherapy also demonstrated steady repigmentation over time, with 69% of lesions attaining a mild response by month 6. Importantly, no major adverse events occurred. This study provides promising preliminary evidence supporting the use of fire needle therapy, alone or in combination with topical tacrolimus ointment, for inducing repigmentation in non-segmental stable vitiligo. As a non-pharmacological approach, fire needle therapy warrants further study as an alternative vitiligo treatment.

Comparative study between efficacy of Excimer light with topical Tacrolimus 0.1% versus excimer light with topical Bimatoprost 0.01% in treatment of facial Vitiligo

Loss and absence of melanocytes due to a number of factors is responsible for vitiligo; known to be the commonest disorder of pigmentation. The aim of the current work was to compare the efficacy and safety of excimer light with topical tacrolimus ointment 0.1% versus excimer light with topical bimatoprost gel 0.01% in treatment of facial vitiligo. The study was carried out on 48 patients presented with facial vitiligo. The patients were divided randomly using sealed envelope method into two groups (24 patients each). Group 1 were treated with excimer light plus topical tacrolimus ointment 0.1% and group 2 treated with excimer light plus topical bimatoprost gel 0.01%. Clinical improvement based on the quartile grading scale at the end of treatment did not show any statistically significant difference between groups. The majority of subjects in both groups experienced good to excellent improvement. Only 20.9% of patients in group 1 and 33.3% of subjects in group 2 achieved less than 50% repigmentation (p = 0.889). Our study demonstrated that 0.01% topical bimatoprost gel in combination with excimer light is considered safe and effective as treatment of nonsegmental facial vitiligo with comparable results to 0.1% tacrolimus.

Topical Tacrolimus Ointment Alone versus in Combination with Microneedling for Refractory Stable Vitiligo.

To assess the efficacy of microneedling in combination with topical tacrolimus ointment 0.1% versus topical tacrolimus ointment 0.1% for treatment of refractory stable vitiligo. Comparative cross-sectional study. Place and Duration of the Study: Department of Dermatology, PNS Shifa, Karachi, Pakistan, from December 2022 to May 2023. The study included 30 clinically diagnosed individuals of either gender who had refractory symptoms and aged between 20 and 60 years. For every patient, two comparable lesions on two comparable limb regions were selected. Group A (right side) received treatment with both topical tacrolimus ointment 0.1% twice daily in addition to microneedling every two weeks, whereas, Group B (left side) was treated with topical tacrolimus ointment 0.1% only. Every lesion was investigated as a separate entity. Both groups were subsequently observed for a further six months. When topical tacrolimus ointment 0.1% was combined with microneedling, the total re-pigmentation rate was substantially higher than the usage of tacrolimus ointment 0.1% alone. Fifty-three percent of lesions treated with topical tacrolimus ointment 0.1% alone and 76.7% of lesions treated with microneedling in conjunction with it showed a good-to-excellent response. No adverse negative effects were noted. During the follow-up period, no problems or recurrences were noted. Tacrolimus ointment combined with microneedling is a successful treatment for refractory stable vitiligo. Dermapen, Depigmentation, Microneedling, Tacrolimus ointment, Vitiligo.

Peripheral ulcerative keratitis associated with tralokinumab therapy: a case report and review of IL-13 inhibitor-associated ocular surface disease

BackgroundDupilumab and tralokinumab are interleukin-binding monoclonal antibodies used to treat systemic atopic disease. Use of these medications in management of atopic dermatitis (AD) is known to cause conjunctivitis. Dupilumab therapy has also been associated with more severe ocular surface disease, which has not previously been described in association with tralokinumab. This report describes a case of tralokinumab-associated conjunctivitis and peripheral ulcerative keratitis and reviews the spectrum and proposed mechanisms of ocular surface disease triggered by these medications.Case presentationA 61-year-old male with no rheumatologic or ocular history presented with bilateral papillary conjunctivitis and right eye peripheral ulcerative keratitis (PUK). PUK was arrested using oral corticosteroids and doxycycline, and long-term control of papillary conjunctivitis was achieved using topical tacrolimus ointment, allowing continuation of effective AD management with tralokinumab.ConclusionThis case report documents ulcerative keratitis occurring in association with tralokinumab therapy for AD, which has previously been described with dupilumab but not tralokinumab. This report demonstrates the need for vigilant ocular surface monitoring for patients on tralokinumab and illustrates successful management and long-term control of adverse ocular events associated with this medication.

Serum cytokine profiles predict response to systemic glucocorticoid in active vitiligo.

Vitiligo is an immune-related skin disease. Cytokines regulate immune response and inflammation and are involved in the pathogenesis of vitiligo. To assess the serum levels of pro-inflammatory cytokines pre- and post- systemic glucocorticoid treatment in patients with active vitiligo. We measured serum cytokine levels using the enzyme-linked immunosorbent assay in 31 patients with active vitiligo before and after treatment. All patients received systemic glucocorticoid (compound betamethasone injection) in combination with topical halometasone cream and tacrolimus ointment for 3 months. Twenty healthy controls were also examined. The cytokines measured included TNF-α, IL-1β, IL-6, IFN-γ, IL-2, IL-17, IL-10, IL-8, and CXCL10. The serum levels of TNF-α, IL-1β, IL-6, IFN-γ, IL-2, IL-17, IL-8, and CXCL10 were significantly higher, and levels of IL-10 were lower in vitiligo patients compared to controls. Additionally, serum IFN-γ (r = 0.378; p = 0.036), IL-17 (r = 0.426; p = 0.017), and CXCL10 (r = 0.514; p = 0.003) showed a positive correlation with affected body surface area in vitiligo patients. After 3 months of systemic glucocorticoid treatment, the levels of IL-1β, IFN-γ, IL-2, IL-17, and CXCL10 in responders were significantly decreased and nearly restored to normal levels. The IL-10 level was also increased in response to treatment. In contrast, the non-responder group had persistently high IL-6, IL-17, IL-8, and CXCL10 levels, and negligible changes in TNF-α, IL-1β, IFN-γ, IL-2, and IL-10. Our study indicated that the levels of inflammatory cytokines were significantly ameliorated in the glucocorticoid responder group. Altered cell-mediated immunity may contribute to the resistance in vitiligo. The cytokines such as TNF-α, IL-1β, IFN-γ and IL-2 could serve as therapeutic targets for managing glucocorticoid-resistant vitiligo.

Post-hoc safety/efficacy analyses from pediatric delgocitinib atopic dermatitis trials.

Delgocitinib ointment is usually recommended for use in children at a concentration of 0.25%. However, there are no clear criteria for dosing, except that a 0.5% formulation may also be used, depending on symptom severity. Treatment of atopic dermatitis is based on combinations of topical corticosteroids, tacrolimus ointment, and delgocitinib ointment, but there are no reports on the safety of delgocitinib ointment when used in combination with other drugs. This is a post-hoc analysis of data from two delgocitinib ointment trials with pediatric atopic dermatitis patients. The efficacy and safety of the 0.25% and 0.5% formulations were compared. Efficacy and safety were evaluated after up to 4 and 56 weeks of treatment, respectively. The safety of delgocitinib ointment when used in combination with topical corticosteroids and/or tacrolimus ointment was investigated. The dose-response relationship was examined according to baseline disease severity. The proportions of subjects with mild disease who achieved cumulative investigator's global assessment of 0 (clear) or 1 (almost clear) were 46.2% (0.25% ointment), 71.4% (0.5% ointment), and 7.7% (vehicle). For subjects with moderate to severe disease, the corresponding proportions were 19.0%, 20.0%, and 0.0%, respectively. No overall differences were seen in the safety profiles of the 0.25% and 0.5% delgocitinib ointment doses, or in the safety profiles of the two doses relating to disease severity or to concomitant use of topical corticosteroids and/or tacrolimus ointment. These analyses indicate that after up to 4 weeks of treatment, delgocitinib 0.5% ointment may be more effective than the 0.25% dose for mild atopic dermatitis, and that after up to 56 weeks of treatment, delgocitinib is well tolerated in a pediatric trial population when used as prescribed in combination with topical corticosteroids and/or tacrolimus ointment.

A comparative randomized clinical trial evaluating the efficacy and safety of tacrolimus versus hydrocortisone as a topical treatment of atopic dermatitis in children.

Background: Atopic dermatitis (AD) aetiology is not exactly identified, but it is characterized by pruritic skin reactions with elevation in the levels of inflammatory markers. Despite the fact that Corticosteroids are the mainstay therapy in the management of AD, they have many local and systemic adverse effects. Objective: The aim of this study is to evaluate the efficacy and safety of topical tacrolimus ointment in comparison to topical hydrocortisone cream in the management of the AD of children diagnosed with AD. Patients and Methods: This study was conducted on 200 children with AD. They were simply randomized into two groups, the tacrolimus group treated with 0.03% topical tacrolimus ointment and the hydrocortisone group treated with 1% hydrocortisone cream twice daily during the 3weeks study period. Results: At the end of the study, both the tacrolimus and hydrocortisone groups showed a significant decline in the mean serum level of IL-10, IL-17, and IL-23 (p < 0.05) when compared to their baseline levels. However, the tacrolimus group showed a more significant decrease (p < 0.05) in the mean serum level of IL-10, IL-17, and IL-23 as compared to the hydrocortisone group [Mean differences = 1.600, 95% CI: 0.9858-2.214; 1.300, 95% CI: 1.086-1.514 and 4.200, 95% CI: 3.321-5.079]. Moreover, the median mEASI decreased similarly from 32 to 21 in the tacrolimus group and from 30 to 22 in the hydrocortisone group (p > 0.05) [Median difference = -2.000, 95% CI: -2.651 to -1.349; Median difference = 1.000, 95% CI: 0.3489-1.651]. Mild to moderate transient stinging and erythema were the main adverse effects that showed higher incidence in the tacrolimus group than in the hydrocortisone group (p < 0.05). In most cases, they resolved within 3-4days. Besides, tacrolimus ointment did not cause skin atrophy as compared to the hydrocortisone group (p < 0.05). Conclusion: Tacrolimus ointment is more beneficial than hydrocortisone cream in managing AD in children in terms of lowering the inflammatory markers, however, there is no difference on the dermatitis severity scale. Moreover, tacrolimus is safer with a better side effect profile compared to hydrocortisone. Trial Registration: The trial is registered at ClinicalTrials.gov (CT.gov identifier: NCT05324618).

Unboxing the black box on topical calcineurin inhibitors and cancer risk

The topical calcineurin inhibitors, tacrolimus and pimecrolimus, are effective immunomodulators used in the management of moderate-to-severe atopic dermatitis. Topical tacrolimus ointment (0·03% and 0·1%) was approved by the US Food and Drug Administration (FDA) in 2000, and pimecrolimus cream (1%) in 2001, as second-line agents in children aged 2 years or older. However, in 2006, the FDA announced a black-box warning stating that the long-term safety of topical calcineurin inhibitors had not been established,1 citing post-marketing reports of increased risks of lymphoma and skin cancers in mainly isolated case reports, organ transplant recipients, and animal studies.

English Version of Clinical Practice Guidelines for the Management of Atopic Dermatitis 2021.

This is the English version of the Clinical Practice Guidelines for the Management of Atopic Dermatitis 2021. Atopic dermatitis (AD) is a disease characterized by relapsing eczema with pruritus as a primary lesion. In Japan, from the perspective of evidence-based medicine, the current strategies for the treatment of AD consist of three primary measures: (i) use of topical corticosteroids, tacrolimus ointment, and delgocitinib ointment as the main treatment of the inflammation; (ii) topical application of emollients to treat the cutaneous barrier dysfunction; and (iii) avoidance of apparent exacerbating factors, psychological counseling, and advice about daily life. In the present revised guidelines, descriptions of three new drugs, namely, dupilumab, delgocitinib, and baricitinib, have been added. The guidelines present recommendations to review clinical research articles, evaluate the balance between the advantages and disadvantages of medical activities, and optimize medical activity-related patient outcomes with respect to several important points requiring decision-making in clinical practice.

A comparative study of the effect of topical 0.03% tacrolimus plus 1% topical prednisolone with 1% topical prednisolone alone in preventing rejection after penetrating keratoplasty

Immunologic corneal allograft rejection represents one of the main cause for graft failure. This study was conducted to observe and comparing the beneficial effect of topical 0.03% tacrolimus on corneal graft survival.To compare the effect of topical 0.03% tacrolimus plus 1% topical prednisolone with 1% topical prednisolone alone in preventing rejection after PK.40 patients were randomly allocated into two groups:Group A: patients received 0.03% topical tacrolimus ointment twice daily for a month plus 1% prednisolone acetate eye drops 2 hourly and tapered monthly. Group B: patients received 1% prednisolone acetate eye drop only 2 hourly and tapered monthly.The clinical outcomes were assessed in terms of post-op complications, graft rejection, and visual acuity after 6 months of follow-up. SPSS software, 20.0 version, IBM, Chicago were used for statistical analysis.Out of 40 patients, 29 (72.5%) were male and 11(27.5%) were female. Type of surgery and continuous suture closure was found to be statistically significant (p-value &amp;#60; 0.05) with post-op visual acuity in both groups. Types of graft rejection were found to be statistically significant (p-value &amp;#60; 0.05) with enucleation transplantation time(hours) in both groups and with secondary glaucoma (p = &amp;#60;0.001) in group A.We conclude that 0.03% topical tacrolimus ointment along with 1% topical prednisolone shows promising results and can be considered as an effective modality for preventing complications like secondary glaucoma, graft rejection, and getting the better visual outcome, where p-value (&amp;#60;0.05) was statistically significant.All patients should be instructed with regards to the reasonable use of topical tacrolimus to avoid any side effects.

Efficacy of 0.1% Topical Tacrolimus in the Management of Symptomatic Geographic Tongue: A Placebo-Controlled Study

Background: Geographic tongue is characterized by erythematous patches with whitish margins across the surface of the tongue, with periods of exacerbation and remission that confer the typical migratory aspect of this entity. There is no definite treatment for geographic tongue as yet. The present study aims to evaluate the response of treatment with topical tacrolimus ointment 0.1% w/w (Protopic®) in geographic tongue. Materials and Methods: This was a prospective study involving a total of 14 patients who were randomly divided into two groups, namely Group A and Group B, with 7 patients in each group. Patients were requested to apply 0.1% topical tacrolimus ointment (Protopic®) in an oral base on their lesions and an identical placebo. At each visit, the burning sensation was tested through the Visual Analog Scale and the treatment responses were tested through Tel Aviv-San Francisco Scale. Data were assessed using IBM Statistical Package for Social Sciences (SPSS) Statistics version 21. Results: Patients in Group A (0.1% topical tacrolimus) depicted lower scores of burning sensation after the treatment as compared to Group B (placebo). The overall treatment response was significantly better in Group A than Group B. Conclusion: The results of the present study suggest that topical application of 0.1% tacrolimus is beneficial in the management of symptomatic geographic tongue.

Topical tacrolimus for the treatment of external eye inflammation in children

ABSTRACT Purpose To show our results with the use of topical tacrolimus in pediatric patients with anterior segment inflammatory disorders. Methods Retrospective case series review of pediatric patients treated with 0.03% topical tacrolimus ointment into the conjunctival sac once a day. All patients treated between 2015 and 2020 were included. Primary outcome was clinical improvement defined as a reduction in the clinical sign score in the last visit. Secondary outcome was a reduction in the topical steroidal treatment. Results A total of 12 patients with a mean age of 9 years were included. The average follow-up time was 23 months. The mean duration of tacrolimus use was 19.6 months. Clinical improvement was seen in 11 patients (92%) with a significant reduction in the mean clinical score from 4.5 baseline to 0.6 (P= 0.0002) and steroid reduction was achieved in all cases. Two patients stopped tacrolimus during the follow-up period for poor effect. Conclusion The use of topical conjunctival dermatological tacrolimus 0.03% ointment is an effective and safe treatment in children with external eye inflammation. Most of the patients presented clinical improvement and all steroid reduction with its use. The main side effect reported was discomfort with the application.

A comparative study of topical Mometasone and Tacrolimus ointment in the treatment of atopic dermatitis at Tertiary Care Centre, Telangana

A comparative study of topical Mometasone and Tacrolimus ointment in the treatment of atopic dermatitis at Tertiary Care Centre, Telangana

Treatment of oral chronic graft-versus-host disease: a retrospective cohort study.

ABSTRACTObjective The aim of this study was to evaluate patients with complete response of oral chronic graft-versus-host disease to immunosuppressive treatment.Methods A total of 29 patients submitted to allogeneic hematopoietic stem cell transplantation, with oral chronic graft-versus-host disease, were enrolled in this retrospective study, from September 2012 to February 2018. Patients were treated with combined topical dexamethasone solution and topical tacrolimus ointment, combined topical dexamethasone and topical tacrolimus, systemic immunosuppressive medication, and topical dexamethasone only.Results The mean time of complete response of lichenoid lesions, erythema, and ulcers using dexamethasone and systemic immunosuppressive medication was of 105, 42 and 42 days, respectively (p=0.013).When we associated dexamethasone, tacrolimus and systemic immunosuppressive medication, the mean time of complete response of lichenoid lesions, erythema and ulcers was of 91,84 and 77 days (p=0.011). When dexamethasone was used alone, the mean time of complete response of lichenoid lesions, erythema and ulcers was 182, 140, 21 days, respectively (p=0.042).Conclusion Our study shows that lichenoid lesions require more time to heal. Notably, lichenoid lesions tend to respond better to dexamethasone combined with tacrolimus and systemic immunosuppressive medication, whereas erythema and ulcers respond better to dexamethasone combined with systemic immunosuppressive medication and dexamethasone only, respectively.

Застосування топічного такролімуса у хворих із екземою рук з урахуванням ступеня тяжкості дерматозу, деяких показників цитокінового профілю, вмісту вітаміну д та генетичного поліморфізму гена глюкокортикоїдного рецептора

The purpose of the study was to evaluate and compare the therapeutic capacity of 0.1% topical tacrolimus ointment in patients with hand eczema who were resistant to glucocorticoid treatment, taking into account the severity of dermatosis, interleukin-17A and interleukin-2 concentrations, vitamin D and genetic polymorphism of the glucocorticoid receptor gene. Materials and methods. The venous blood of 143 patients with hand eczema aged (42.2±11.1) years was used in the study. During the patients examination the data on age, sex, body mass index (kg/m2), body mass index ≥25 kg/m2 (%), smoking, IgE (iu/ml), interleukin-17A (pg/ml), interleukin-2 (pg/ml), and 1,25(OH)2D3 (ng/ml) were obtained. The Hand Eczema Severity Index was also assessed in each subject. According to the Hand Eczema Severity Index value all patients were divided into three subgroups: mild, moderate and severe eczema. Patients with mild and moderate eczema were appointed topical glucocorticoid 0.1% mometasone furoate cream twice a day for 2 weeks. Patients with severe hand eczema was appointed additionally systemic corticosteroid – a solution of dexamethasone by intramuscular injection at the dose of 8 mg/day No. 3, then another 4 mg/day for other 2 days. After 2 weeks, individuals who did not respond well to glucocorticoid treatment were prescribed tacrolimus 0.1% ointment twice a day for 2 weeks. BclI SNP (rs41423247) of the glucocorticoid receptor gene (NR3C1) was determined using the polymerase chain reaction-restriction fragment length polymorphism method (Fleury et al. 2003). The statistical analysis was performed using the program SPSS 22.0. The quantitative variables were tested for normal distribution by the Shapiro-Wilk method. The comparisons of the means between the two subgroups were performed using Student's t-test for independent samples. The comparison of the frequencies distribution in the subgroups was performed using the Pearson test. The P value &lt;0.05 was considered as significant. Results and discussion. Findings in a previous study showed that not all people with hand eczema responded well to treatment with topical 0.1% mometasone furoate cream and systemic glucocorticoid. After 2 weeks of topical tacrolimus, of 51 patients who were not responsive to glucocorticoid treatment, 39 responded well to therapy. The concentration of interleukin-17A in the blood serum of such people was significantly lower than in people who did not respond to treatment. Conclusion. We did not find any differences in the content of immunoglobulin E, interleukin-2, 1α,25(OH)2D3 and BclI polymorphism of the glucocorticoid receptor gene in the subjects under study

Topical Tacrolimus vs Topical Triamcinolone equally effective in the Treatment of Oral Lichen Planus

Background: Lichen planus is a disease that can involve either skin, mucosa or both. Although there is no definite treatment but many medications are available for the relieving the symptoms of this autoimmune disease and recent literature has brought into light the use of an immunosuppressant such as Tacrolimus that may be effectively used as topical application in treatment of Oral Lichen Planus (OLP). Methods: We conducted a study on 80 patients to determine the use of results of topical Tacrolimus (0.1%) versus Triamcinolone acetonide (0.1%) ointment for the treatment of Oral Lichen Planus over a period of six months at Oral &amp; Maxillofacial Surgery Department, HITEC Dental College Taxila. Results: Outcome of the study was determined in terms of ‘Improvement in pain’. Conclusion: This study showed an insignificant difference in improvement in pain of patients of lichen planus treated with tacrolimus and triamcinolone. Keywords: Oral lichenplanus, treatment outcome, symptomatic management, improvement in pain,

Plasma cell vulvitis: A systematic review.

BackgroundPlasma cell vulvitis (PCV) is an inflammatory vulvar dermatosis that is not well characterized. Diagnosis is often delayed, and the condition can be refractory to treatment. To date, there are no systematic reviews on this topic.ObjectiveThis study aimed to provide a systematic review of PCV, including epidemiologic, clinical, and histopathologic findings, as well as associated comorbidities and treatment options.MethodsA primary literature search was conducted using the PubMed, Ovid Medline, Cochrane, and CINAHL databases.ResultsFifty-three publications with 196 patients (mean age: 55.3 ± 14.5 years) were included. The majority of studies were case reports and case series. Common symptoms included burning/stinging (52%), dyspareunia (44%), and pruritus (41%). Common findings included erythema (84%), glistening/shiny appearance (29%), well-demarcated lesions (25%), and erosions (22%). Common anatomic sites were the labia minora (45%), introitus (31%), and periurethral (19%). Fifty-three percent of patients had a solitary lesion. Common histologic findings were a predominant plasma cell infiltrate (88%), presence of other inflammatory cells (55%), hemosiderin/siderophages (46%), and epidermal atrophy (43%). Topical corticosteroids (64%) and tacrolimus ointment (13%) were the most frequent treatment modalities. In most reports, previous treatments were tried, and there was a diagnostic delay.ConclusionPCV is likely underrecognized and should be considered in patients with erythema of the mucous and modified mucous membranes, symptoms of burning or stinging, and a predominant plasma cell infiltrate on histopathology. First-line therapy should begin with high-potency topical corticosteroids, with the most evidence for clobetasol 0.05% or tacrolimus 0.1% ointment. Prospective studies are needed to further characterize this condition and to develop treatment guidelines.

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.

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.