Topical Tacrolimus for the Treatment of Atopic Dermatitis with Truncal Lesion
2
조회
0
다운로드
1
인용
0
참고문헌
키워드
초록
Background: Topical tacrolimus is an effective anti-inflammatory therapy for acute and chronic states of atopic dermatitis (AD) in both adults and children. Topical tacrolimus has particular use at sensitive areas such as the face, anogenitals, and skin folds of neck and extremities. However, many AD patients also experience aggravated symptoms on trunk. Objective: The aim of this study was to investigate the efficacy and safety of topical tacrolimus for AD patients with truncal lesions. Methods: AD patients with truncal lesions who were aged ≥2 years were recruited from 20 centres in Korea. They received treatment with topical tacrolimus ointment twice daily during 4 weeks. The primary end point was change of the local eczema area and severity index (EASI) of the trunk from baseline to day 28. The secondary end points were changes in the patient global assessment (PGA) score and itch visual analogue scale (VAS) score of the trunk between baseline and day 28. Results: Two hundred and ninety- one patients were recruited, and 176 patients completed the full 4-week treatment course. By the end of the treatment, the mean local EASI of the trunk (2.2±4.71) was significantly decreased from that at baseline (4.71±4.03, p<0.001). PGA (1.71±1.15) and itch VAS score of the trunk (2.61±2.19) on day 28 were also profoundly decreased compared with the baseline (2.96±1.07 and 5.15±2.47, respectively). No serious adverse events were observed during the study period. Conclusion: Topical tacrolimus is an effective and safe therapy for truncal lesions in AD patients.
Abstract
Background: Topical tacrolimus is an effective anti-inflammatory therapy for acute and chronic states of atopic dermatitis (AD) in both adults and children. Topical tacrolimus has particular use at sensitive areas such as the face, anogenitals, and skin folds of neck and extremities. However, many AD patients also experience aggravated symptoms on trunk. Objective: The aim of this study was to investigate the efficacy and safety of topical tacrolimus for AD patients with truncal lesions. Methods: AD patients with truncal lesions who were aged ≥2 years were recruited from 20 centres in Korea. They received treatment with topical tacrolimus ointment twice daily during 4 weeks. The primary end point was change of the local eczema area and severity index (EASI) of the trunk from baseline to day 28. The secondary end points were changes in the patient global assessment (PGA) score and itch visual analogue scale (VAS) score of the trunk between baseline and day 28. Results: Two hundred and ninety- one patients were recruited, and 176 patients completed the full 4-week treatment course. By the end of the treatment, the mean local EASI of the trunk (2.2±4.71) was significantly decreased from that at baseline (4.71±4.03, p<0.001). PGA (1.71±1.15) and itch VAS score of the trunk (2.61±2.19) on day 28 were also profoundly decreased compared with the baseline (2.96±1.07 and 5.15±2.47, respectively). No serious adverse events were observed during the study period. Conclusion: Topical tacrolimus is an effective and safe therapy for truncal lesions in AD patients.
참고문헌 (23)
- Won CH, "A multicenter trial of the efficacy and safety of 0.03% tacrolimus ointment for atopic dermatitis in Korea", J Dermatolog Treat, 15, pp.30~34 (2004)[DOI]
- Leung DY, "Disease management of atopic dermatitis: an updated practice parameter. Joint Task Force on Practice Parameters", Ann Allergy Asthma Immunol, 93(3 Suppl 2), pp.S1~S21 (2004)
- Eichenfield LF, "Guidelines of care for the management of atopic dermatitis: section 2. Management and treatment of atopic dermatitis with topical therapies", J Am Acad Dermatol, 71, pp.116~132 (2014)[DOI]
- Reitamo S, "Efficacy and safety of tacrolimus ointment compared with that of hydrocortisone acetate ointment in children with atopic dermatitis", J Allergy Clin Immunol, 109, pp.539~546 (2002)[DOI]
- Hanifin JM, "Diagnostic features of atopic dermatitis", Acta Derm Venereol Suppl (Stockh), 92, pp.44~47 (1980)
- Long CC, "The rule of hand: 4 hand areas = 2 FTU = 1 g", Arch Dermatol, 128, pp.1129~1130 (1992)[DOI]
- Kalavala M, "The fingertip unit: a practical guide to topical therapy in children", J Dermatolog Treat, 18, pp.319~320 (2007)[DOI]
- Hanifin JM, "The eczema area and severity index (EASI): assessment of reliability in atopic dermatitis. EASI Evaluator Group", Exp Dermatol, 10, pp.11~18 (2001)[DOI]
- Tofte S, "Eczema area and severity index (EASI): a new tool to evaluate atopic dermatitis", J Eur Acad Dermatol Venereol, 11(Suppl 2), pp.S197~ (1998)
- Murrell DF, "A randomized controlled trial of pimecrolimus cream 1% in adolescents and adults with head and neck atopic dermatitis and intolerant of, or dependent on, topical corticosteroids", Br J Dermatol, 157, pp.954~959 (2007)[DOI]
- Kawakami T, "Safe and effective treatment of refractory facial lesions in atopic dermatitis using topical tacrolimus following corticosteroid discontinuation", Dermatology, 203, pp.32~37 (2001)[DOI]
- Hoeger PH, "The treatment of facial atopic dermatitis in children who are intolerant of, or dependent on, topical corticosteroids: a randomized, controlled clinical trial", Br J Dermatol, 160, pp.415~422 (2009)[DOI]
- Reitamo S, "A multicentre, randomized, doubleblind, controlled study of long-term treatment with 0.1% tacrolimus ointment in adults with moderate to severe atopic dermatitis", Br J Dermatol, 152, pp.1282~1289 (2005)[DOI]
- Moftah NH, "Intense pulsed light versus photodynamic therapy using liposomal methylene blue gel for the treatment of truncal acne vulgaris: a comparative randomized split body study", Arch Dermatol Res, 308, pp.263~268 (2016)[DOI]
- Devaux S, "Adherence to topical treatment in psoriasis: a systematic literature review", J Eur Acad Dermatol Venereol, 26(Suppl 3), pp.61~67 (2012)[DOI]
- Jin H, "Inappropriate amounts of topical tacrolimus applied on Korean patients with eczema", J Dermatolog Treat, 28, pp.327~331 (2017)[DOI]
- Cury Martins J, "Topical tacrolimus for atopic dermatitis", Cochrane Database Syst Rev, (7) (2015)
- Wollenberg A, "Proactive treatment of atopic dermatitis in adults with 0.1% tacrolimus ointment", Allergy, 63, pp.742~750 (2008)[DOI]
- Schmitt J, "Efficacy and tolerability of proactive treatment with topical corticosteroids and calcineurin inhibitors for atopic eczema: systematic review and meta-analysis of randomized controlled trials", Br J Dermatol, 164, pp.415~428 (2011)[DOI]
- Tiwari A, "Topical-steroid-induced iatrogenic Cushing syndrome in the pediatric age group: a rare case report", Indian J Endocrinol Metab, 17(Suppl 1), pp.S257~S258 (2013)[DOI]
- Gen R, "Cushing syndrome caused by topical corticosteroid: a case report", Am J Med Sci, 333, pp.173~174 (2007)[DOI]
- Charman CR, "Topical corticosteroid phobia in patients with atopic eczema", Br J Dermatol, 142, pp.931~936 (2000)[DOI]
- 이진용, "Topical Corticosteroid Phobia among Parents of Children with Atopic Eczema in Korea", Annals of Dermatology, 27(5), pp.499~506 (2015), 대한피부과학회
