Topical tacrolimus ointment for the treatment of lichen sclerosus, comparing genital and extragenital involvement

Introduction: Several treatment options e.g. topical corticosteroids, phototherapy like narrow-band ultra violet B (NB-UVB) and psoralen+ultra violet A (PUVA) etc are available for vitiligo. But none is so effective in single but combined one is more effective and superior. Objective: To compare the efficacy of NB-UVB vs NB-UVB with topical Tacrolimus ointment (0.1%) in the treatment of Vitiligo. Materials and Methods: This descriptive cross-sectional study was conducted in Combined Military Hospital, Dhaka from October 2015 to April 2016. Total 100 patients with vitiligo were divided into 2 groups of 50 patients. NB-UVB was given for 04 weeks to Group-A. In Group-B patients, topical Tacrolimus ointment (0.1%) twice daily was advised with simultaneous NB-UVB. The patients were followed-up at the baseline of the 4th, 8th and 16th week. Results: Majority (46%) of the patients were from 25-34 years of age with a mean age of 27.4±12.6 years. Among all risk factors, Family history of Vitiligo was the most common risk factor and common skin type (Fitzpatrick) was Type IV (40%). At the end of 4th week, maximum cases of Group-B showed good response (score 3) with a mean score of 1.74. Whereas, maximum cases of Group-A showed poor response (score 1) with a mean score of 0.86. End of the 16th week, maximum cases of Group-B improved successfully. In the end, 20% patients of Group-A showed an excellent result; but it was 42% from Group-B. Conclusion: It is revealed from this study that patients treated with a combination of NB-UVB with topical Tacrolimus ointment (0.1%) showed better treatment outcome, more effective and becomes a new mode of treatment. Journal of Armed Forces Medical College Bangladesh Vol.13(1) 2017: 86-89

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The Efficacy of 0.03% Dermatological Tacrolimus Ointment for Refractory Vernal Keratoconjunctivitis.

Pakistan Journal of Ophthalmology ◽

10.36351/pjo.v35i4.872 ◽

2020 ◽

Vol 35 (4) ◽

pp. 229-234

Author(s):

Hafiza Sadia Imtiaz

Keyword(s):

Clinical Symptoms ◽

Clinical Signs ◽

Vernal Keratoconjunctivitis ◽

P Value ◽

Baseline Score ◽

Assessment Data ◽

Tacrolimus Ointment ◽

Topical Tacrolimus ◽

Quasi Experimental ◽

Written Informed Consent

Purpose: To determine the efficacy of 0.03% dermatological tacrolimus ointment in patients with refractory vernal keratoconjunctivitis Study Design: Quasi-experimental study Study Place and Duration: Eye Department, DHQ-Teaching Hospital, Gujranwala, Pakistan from April 2018 to March 2019 Material and Methods: After approval from hospital ethical committee and obtaining written informed consent from each patient/guardian, patients of either gender between 4-16 years of age with VKC not responding to conventional treatment for more than 8 weeks or having steroid-induced complications were included in this study. Dermatological tacrolimus ointment 0.03% started to be placed in inferior fornix in BD frequency along with topical lubricants. Patients were followed up on a regular schedule. Individual symptoms score was assessed from the questionnaire and signs score from observer’s clinical assessment. Data were analyzed using SPSS v23.0. P-value <0.05 was considered as statistically significant. Results: 40 eyes of 20 patients were included in this study. Out of which 4(20%) were female and 16 were male (80%). Mean baseline score for clinical symptoms was 6.65±1.81 that reduced to 1.65±0.81 after 12 weeks treatment course of tacrolimus with a significant p-value of 0.006 (p<0.05). Mean baseline score for clinical signs was 5.9±1.59 that improved to 1.80±0.83 after 12 weeks treatment course with a statistically significant p-value of 0.003 (p<0.05). Conclusions: In conclusion, topical tacrolimus dermatological ointment 0.03% is highly effective in refractory VKC and can be safely used as an alternative in VKC patients who are steroid-responders.

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Topical Tacrolimus Ointment for Treatment of Intractable Atopic Keratoconjunctivitis: A Case Report and Review of the Literature

Cornea ◽

10.1097/ico.0b013e3181d83875 ◽

2011 ◽

Vol 30 (4) ◽

pp. 462-465 ◽

Cited By ~ 23

Author(s):

Diana Pérez García ◽

Juan Ibáñez Alperte ◽

José A Cristóbal ◽

Antonio J Mateo Orobia ◽

Enrique Mínguez Muro ◽

...

Keyword(s):

Case Report ◽

Review Of The Literature ◽

Tacrolimus Ointment ◽

Topical Tacrolimus ◽

Atopic Keratoconjunctivitis

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Lichenoid tattoo reaction responding to topical tacrolimus ointment

Clinical and Experimental Dermatology ◽

10.1111/j.1365-2230.2005.02012.x ◽

2006 ◽

Vol 31 (2) ◽

pp. 293-294 ◽

Cited By ~ 10

Author(s):

F. A. Campbell ◽

G. Gupta

Keyword(s):

Tacrolimus Ointment ◽

Topical Tacrolimus

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Efficacy of Topical Calcineurin Inhibitors in Lichen Planus

Journal of Cutaneous Medicine and Surgery ◽

10.1177/120347541201600403 ◽

2012 ◽

Vol 16 (4) ◽

pp. 221-229 ◽

Cited By ~ 15

Author(s):

Michael Samycia ◽

Andrew N. Lin

Keyword(s):

Lichen Planus ◽

Strong Evidence ◽

Oral Lichen Planus ◽

Case Reports ◽

Calcineurin Inhibitors ◽

Double Blind ◽

Tacrolimus Ointment ◽

Topical Tacrolimus ◽

Topical Calcineurin Inhibitors ◽

Oral Lichen

Background: Topical calcineurin inhibitors have been studied in many skin disorders, including lichen planus. Objective: To evaluate published reports of the use of topical calcineurin inhibitors in lichen planus. Methods: We searched PubMed, Ovid/Cochrane, and Embase using the keywords “tacrolimus,” “pimecrolimus,” “topical calcineurin inhibitors,” and “lichen planus.” Results: We examined 5 double-blind studies, 1 investigator-blinded study, 10 open prospective studies, 6 retrospective studies, and 28 case reports evaluating tacrolimus or pimecrolimus for oral, vulvovaginal, and cutaneous lichen planus. Conclusions: Strong evidence (double-blind and open studies) supports the use of topical tacrolimus ointment in oral lichen planus, with efficacy at least equal to topical clobetasol propionate 0.05% ointment. Treatment of oral lichen planus with topical tacrolimus ointment can result in demonstrable blood tacrolimus levels, but without clinically significant adverse events. Strong evidence (double-blind and open studies) supports the use of topical pimecrolimus 1% cream in oral lichen planus, with efficacy equal to that of topical triamcinolone acetonide 0.1% paste. For vulvovaginal lichen planus, pimecrolimus was superior to placebo in one double-blind study, and tacrolimus was effective in open studies. Only case reports support the efficacy of topical calcineurin inhibitors in cutaneous lichen planus.

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Comparison of efficacy and safety between Tacrolimus and Hydrocortisone acetate in 2-5 years old children with atopic dermatitis

Journal of Armed Forces Medical College Bangladesh ◽

10.3329/jafmc.v10i1.22924 ◽

2015 ◽

Vol 10 (1) ◽

pp. 53-58

Author(s):

Quazi Salim Yazdi ◽

Md Shamsul Huda ◽

Abdul Latif Khan ◽

Md Sayeed Hasan ◽

Mushtaq Ahmad ◽

...

Keyword(s):

Atopic Dermatitis ◽

Armed Forces ◽

Application Site ◽

Global Evaluation ◽

Hydrocortisone Acetate ◽

Tacrolimus Ointment ◽

Topical Tacrolimus ◽

Intense Pruritus ◽

Group 2 ◽

Group B

Introduction: Atopic dermatitis is a recurrent inflammatory skin disease with intense pruritus as its hallmark symptom. It often follows a chronic, relapsing course. Objectives: This comparative study was done with an aim to find out the efficacy of Tacrolimus and Hydrocortisone acetate in 2-5 year old children with Atopic dermatitis. Methods: This clinical trial was carried out on two equal groups of 60 patients. Group A was treated with topical tacrolimus ointment (0.03%) and group B with hydrocortisone acetate ointment (1%). Follow up was done at week 1, 2, 4, 8 and 12 of treatment for assessment of improvement and adverse event, which was measured by overall clinical improvement in the physician's global evaluation of clinical response. Data was collected in a predesigned data collection sheet, and analysis was performed by SPSS program (Version 12). Results: Excellent, marked and moderate improvement were observed in 19 (63.3%), 9 (30.0%), and 2(6.7%) patients of tacrolimus group and 1(3.3%), 2(6.7%) and 27(90.0%) patients of hydrocortisone group respectively. Tacrolimus group had significantly better improvement than hydrocortisone group (p<0.001). Skins burning at application site were observed significantly more in tacrolimus group 8(26.7%) than in hydrocortisone group 2 (6.7%). 53 JAFMC Bangladesh. Vol 10, No 1 (June) 2014 Conclusion: The study showed tacrolimus ointment is more effective than hydrocortisone acetate in the treatment of atopic dermatitis in paediatric patients. DOI: http://dx.doi.org/10.3329/jafmc.v10i1.22924 Journal of Armed Forces Medical College Bangladesh Vol.10(1) 2014

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