Topical Calcineurin Inhibitors in Atopic Dermatitis

Abstract

Atopic dennatitis (AD) is one of the most common chronic skin diseases in children. Topical corticosteroid is effective for short tenn therapy. However, there are local and systemic side effects of long term use of topical corticosteroids. Currently, two topical calcineurin inhibitors, Tacrolimus (FK.506) and pimecrolimus (SDZ ASM 981) are new, safe and effective therapy for long tenn treatment ofatopic dennatits in childern and adults. Mechanism of the drugs is to block calcineurin and thereby suppress inflammatory T cells responses. Several clinical trials have shown the efficacy and safety of both drugs for treatment of atopic dennatitis. Tacrolimus has been recommended for moderate to severe AD>2 years to adults. Pimecrolimus has been used for mild to moderate AD infants from 3 months to adults. The side effects of both drugs are transient burning and itching sensation. There is no side effect such as skin atrophy. So far, long tenn use of topical calicineuril'I inhibitors has shown no increased incidence of skin infections, systemic absorption nor systemic immunosuppression.
Conclusion: Topical calcineurin inhibitors are alternative treatment for atopic dennatitis in children and adults.