Topical tacrolimus in atopic dermatitis: Effects of ... - Helda - Helsinki.fi

AIMS OF THE STUDY
Atopic dermatitis is a chronic pruritic skin disease often complicated by Staphylococcus
aureus colonization and superinfection. In patients with AD, concomitant occurrence of
other atopic diseases like asthma and allergic rhinoconjunctivitis is common. Skin
atrophy is the major problem in conventional corticosteroid-based treatment of AD,
which limits treatment to short periods, especially in thin skin areas. After the treatment
period, AD often relapses. In practice, mainly the patients with mild disease achieve a
longer remission with short-term use of topical corticosteroids. Patients with moderate
or severe AD are usually poorly controlled with short-term treatments and experience
continuous skin inflammation of varying degrees. The barrier function of the inflamed
skin is weakened, possibly enabling an epicutaneous sensitization to occur which may
lead to atopic respiratory disease. The need is therefore great for a non-atrophogenic
treatment option, especially for patients with moderate-to-severe AD requiring longterm
treatment.
Tacrolimus ointment, a safe and efficient topical treatment for AD, belongs to the
group of topical immunomodulators which have a more specific mode of action on the
skin than the broad-scale effects of topical corticosteroids. Based on a short-term study
tacrolimus has shown no atrophogenic properties.
The general aim of this study was to evaluate the effects of tacrolimus ointment
on clinically important problem areas related to AD with an emphasis on long-term AD
treatment.
The specific aims of the study were to discover:
1. The effect of tacrolimus ointment on Staphylococcus aureus colonization in
patients with moderate-to severe AD before and during treatment.
2. The characteristics of skin collagen synthesis and skin thickness in patients with
moderate-to-severe AD before and after tacrolimus treatment.
3. Retrospectively, the efficacy of 0.03% tacrolimus ointment in treatment of
atopic blepharoconjunctivitis and its effect on conjunctival inflammatory cells.
4. The prevalence of bronchial hyper-responsiveness, symptoms of asthma and
allergic rhinitis, and sputum eosinophilia in patients with moderate-to-severe
AD, and the effect of long-term treatment of AD with tacrolimus. The effect of
long-term improvement in AD was indirectly evaluated by observation of the
patients with the best long-term response.
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