Topical tacrolimus in the treatment of atopic dermatitis

OBJECTIVE: To review the efficacy of topical tacrolimus in the treatment of atopic dermatitis (AD). DATA SOURCES: Searches of MEDLINE (1966-October 2000), International Pharmaceutical Abstracts (1970-October 2000), and ScienceDirect (1994-October 2000) were performed using the key search terms tacrolimus, FK506, and atopic dermatitis. DATA SYNTHESIS: Since patients with AD have defects in cell-mediated immunity, the immunosuppressant properties of the macrolides (cyclosporine and tacrolimus) may prove to be beneficial in the treatment of AD. Topical tacrolimus has been frequently studied in the treatment of AD because it was found to have better skin penetration and higher potentency than topically applied cyclosporine. Studies evaluating the use of topical tacrolimus are presented and provide evidence that topical tacrolimus is effective in the treatment of AD with no evidence thus far of systemic adverse effects. CONCLUSIONS: There is a fair amount of documentation of the efficacy and safety of topical tacrolimus. Further trials are needed to determine the optimal duration of therapy and its efficacy and safety in children less than seven years of age.