Download with Tacrolimus Clinical Experience Ointment in Atopic Dermatitis III

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11 Other Potential Dermatological Indications for Tacrolimus
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Conclusion
Anecdotal reports and pilot
studies in small numbers
of patients suggest that
topical tacrolimus is
effective in a variety of
inflammatory skin disorders
Numerous anecdotal reports and pilot studies in small numbers of patients suggest
that topical tacrolimus is effective in a variety of inflammatory skin disorders other
than atopic dermatitis (Fig. 11.5). Generally, T-cell-mediated skin diseases, which are
known to respond to cyclosporin, but also other inflammatory dermatoses mediated
by mast cells or other molecular or cellular factors represent possible targets for
topical tacrolimus therapy [5].
For example, animal studies in mice with lupus showed that systemic tacrolimus
reduced the incidence of skin lesions, suggesting that topical tacrolimus might be a
promising immunosuppressive agent for the control of cutaneous autoimmune skin
diseases, such as cutaneous lupus [18].
In the future, systematic and controlled studies in various glucocorticosteroidresponsive, T-cell-mediated inflammatory skin disorders such as cutaneous lupus
erythematosus, Behçet’s disease, and precursor or initial forms of cutaneous T-cell
lymphoma (“parapsoriasis en plaque”) are warranted to demonstrate the efficacy
and safety of tacrolimus ointment in analogy to atopic dermatitis.
There is promising evidence that atopic dermatitis will not remain the only skin
disease for approved treatment with tacrolimus ointment (Protopic®).
Psoriasis
Acrodermatitis
continua
ATOPIC DERMATITIS
Pyoderma
gangrenosum
Lichen planus
Graft-versushost disease
???
Steroid rosacea
Lichen sclerosus
Vitiligo
???
???
???
Rheumatoid ulcers
Figure 11.5. Approved (atopic dermatitis) and putative future indications for treatment with tacrolimus ointment
230