Efficacy of topical tacrolimus in atopic dermatitis

Background Mainstay treatments for atopic dermatitis include cutaneous hydration, antihistamines and topical glucocorticoids. To avoid side effects associated with long term and higher potency topical corticosteroids, further topical immunosuppressive agents should be tried. Topical tacrolimus has been extensively studied and shows promise in treatment of inflammatory skin diseases such as atopic dermatitis. Objective To determine the safety and efficacy of tacrolimus in atopic dermatitis. Patients and method In this randomized, case-control study, out of 60 patients with atopic dermatitis (age ranging 2 to 45 years), 30 (case) were treated with tacrolimus (0.03%) ointment twice daily and 30 (control) were treated with vaseline twice daily for up to 3 weeks. Evaluation included per cent body durface area (%BSA) affected, individual signs of atopic dermatitis, the Severity Score of Atopic dermatitis (SCORAD), and the patient’s assessment of pruritus. Result The outcome variables like erythema, edema/papulation, oozing/crusting, excoriation, pruritus, body surface area involved and SCORAD in the case group improved significantly compared to those in the control group (p 0.001, 0.001, 0.001, 0.005, 0.001, 0.001 and 0.001, respectively). After 3 weeks of tacrolimus, all variables except lichenification score responded significantly. Significantly higher number complained of burning sensation in cases (20%) as compared to none in the control group. Conclusion Topical 0.03% tacrolimus is more effective than the vehicle alone.