ABSTRACT
BACKGROUND: Rosacea is a common disease, which is often resistant to treatment. Topical calcineurin inhibitors have been efficacious in the treatment of other inflammatory disorders of the skin, and tacrolimus has been reported as an effective treatment option for erythrotelangiectatic rosacea. OBJECTIVE: Because of the benefits seen with tacrolimus in previous publications, we investigated the efficacy of a closely related compound, pimecrolimus, in patients with erythrotelangiectatic, papulopustular, and edematous rosacea. METHODS: Twelve patients with erthryotelangiectatic or papulopustular rosacea who had failed conventional therapy were treated with topical pimecrolimus cream twice daily for 12-18 weeks. No patients had used any other treatment for rosacea within 30 days of the start of therapy. During the course of the study, no other topical or systemic treatment of rosacea was allowed. RESULTS: Ten of 12 patients showed substantial improvement of erythema, while five of six patients with a papulopustular component noted at least an 80% decrease in the number of lesions. CONCLUSIONS: It appears pimecrolimus may be efficacious in the treatment of erythrotelangiectatic and papulopustular rosacea and may be considered in patients with recalcitrant disease.
Subject(s)
Dermatologic Agents/administration & dosage , Rosacea/drug therapy , Tacrolimus/analogs & derivatives , Tacrolimus/administration & dosage , Administration, Topical , Aged , Female , Follow-Up Studies , Humans , Male , Treatment OutcomeABSTRACT
We present a case of nevoid basal cell carcinoma syndrome, also known as Gorlin syndrome, or basal cell nevus syndrome, which clinically follows a course more consistent with multiple hereditary infundibulocystic basal cell carcinomas or multiple hereditary trichoepitheliomas. The following article describes the case in detail and gives an overview of other genodermatosis, which were initially considered in the differential and which may be linked pathogenetically.
Subject(s)
Basal Cell Nevus Syndrome/pathology , Skin Neoplasms/pathology , Aged , Basal Cell Nevus Syndrome/diagnosis , Carcinoma, Basal Cell/diagnosis , Carcinoma, Basal Cell/genetics , Diagnosis, Differential , Humans , Male , Neoplastic Syndromes, Hereditary/diagnosis , Skin Neoplasms/diagnosis , Skin Neoplasms/geneticsABSTRACT
A 6-year-old boy was brought to his primary care provider by his mother, who complained of a pruritic rash near his right eye. The eruption was described as a small, erythematous, slightly scaly plaque at the lateral margin of the right eyelid. The child was in good health and took no medications. The diagnosis of eczema was made; the patient was treated with pimecrolimus cream b.i.d. to the affected area. After 2-3 days of treatment, the itching and erythema completely resolved; however, a rough and scaly plaque persisted. After 1-2 weeks of treatment, the itching gradually returned, and the lesion began to increase in size. Multiple, similar lesions appeared several centimeters from the initially affected area. Pimecrolimus was discontinued; topical nystatin/triamcinolone ointment was prescribed. The eruption continued to spread, and the patient was referred to dermatology for further evaluation. The patient presented to the dermatology clinic with multiple annular, scaly papules and plaques with central clearing. Excoriations and mild inflammation were noted around all affected areas (Figure). A potassium hydroxide examination of the lesions revealed numerous hyphae. The nystatin/triamcinolone ointment was discontinued; oral griseofulvin was prescribed. The eruption improved dramatically after 3 weeks and eventually cleared completely after 5 weeks of treatment. Topical 2% ketoconazole cream was applied b.i.d. for the final 2 weeks of treatment.
