Linear Lichen Planopilaris of the Face Successfully Treated with Topical Calcineurin Inhibitor / 대한피부과학회지

No abstract available.

Effect of infosheet for topical tacrolimus 0.1% and its efficacy and compliance in the treatment of atopic dermatitis

PURPOSE: Topical calcineurin inhibitor is recently developed topical immunomodulator, and preliminary studies showed its effectiveness in the treatment of atopic dermatitis (AD). However, some side effects including transient irritation can influence the patient compliance. So, there are some needs to improve the patient compliance. The purpose of this study was to evaluate the efficacy, safety and patient compliance with using topical tacrolimus 0.1% to treat AD when the correct information about topical tacrolimus are properly given to patients. METHODS: We examined the medical recordings, clinical severity scoring of total 194 AD patients at 9 general hospitals in Seoul, Korea from September 2010 to August 2011. We offered an infosheet of topical tacrolimus 0.1% and the patients applied it twice a day for 2 weeks. And we measured the efficacy of the topical tacrolimus 0.1% with SCORing atopic dermatitis (SCORAD) index, patient's global assessment (PGA), and investigator's global assessment (IGA). RESULTS: Topical tacrolimus 0.1% effectively controlled AD with a reduction of the SCORAD index from baseline 31.9 to 20.2 at 2 weeks of application. In IGA results showed 98% got improvement and in PGA, results showed 96% got improvement after treatment. Although 42.3% of the patients complained of adverse effects, these were all transient. The effect of information on topical tacrolimus 0.1% showed 34% patients could predict the side effect, 35% patients could feel safety to use, and 18% patients experienced side effect but could maintain topical calcineurin inhibitor. CONCLUSION: Topical tacrolimus 0.1% may be an effective treatment modality for AD when patients show good compliance for applying the ointment. And properly given, the correct information may increase the patient compliance.

Pharmacologic Treatment of Atopic Dermatitis

Atopic dermatitis (AD) is a chronic inflammatory pruritic skin disease that affects a large number of children and adults in Korea. The treatment of AD requires a comprehensive approach that includes evaluation of potential triggers and education of the patients and family members regarding proper avoidance measures. Because existing remedies for AD do not cure the disorder itself, a program of disease control and management should be pursued. Topical corticosteroids are the effective and relatively safe therapy for patients with AD, but prolonged usage can result in skin atrophy and other side-effects. The topical calcineurin inhibitors such as pimecrolimus and tacrolimus allow a steroid-free, anti-inflammatory topical therapy of AD. Occasionally, however, children afflicted with severe AD require more intensive therapies (e.g., ultraviolet light exposure systemic corticosteroids, and cyclosporine) that need close monitoring. This review focuses on the current guidelines of managing AD regarding the efficacy and safety of several pharmacologic options. Management strategies discussed include topical corticosteroids, topical calcineurin inhibitors, antihistamines and anti-infectives. A management algorithm is also presented.