Document Detail

Topical calcineurin inhibitors for the treatment of vulvar dermatoses.
MedLine Citation:
PMID:  19631446     Owner:  NLM     Status:  MEDLINE    
Repeated courses of potent topical corticosteroids and maintenance therapy with moderately potent topical corticosteroids are frequently needed to treat various forms of vulvar dermatoses, which are often characterized by an abnormal proliferation or activation of T lymphocytes. Because such therapeutic regimen is associated with an increased risk of potential side effects, particularly skin atrophy, an anti-inflammatory alternative to topical corticosteroids is desirable. The two non-steroid topical calcineurin inhibitors pimecrolimus and tacrolimus are immunomodulators that block the release of inflammatory cytokines from T lymphocytes in the skin while promoting cutaneous innate host defences. They are currently approved in Europe and in the United States of America as second-line anti-inflammatory agents for the treatment of atopic dermatitis. We provide a comprehensive summary of existing case reports, series of cases, and open-label prospective studies concerning the use of topical pimecrolimus and tacrolimus for the treatment of anogenital lichen sclerosus, genital lichen planus, vulvar lichen simplex chronicus and related pruritic vulvar dermatoses (chronic vulvar pruritus and allergic contact dermatitis of the vulva). The available data suggest that both topical calcineurin inhibitors may be effective and well tolerated in these vulvar dermatoses, although topical pimecrolimus may exhibit a better long-term tolerability profile. Being devoid of steroid-related side effects, they may represent a useful second-line therapeutic option for patients who are intolerant of, or resistant to topical corticosteroids. Controlled clinical trials and comparative studies are warranted to substantiate the promising findings summarized in this review.
Andrew T Goldstein; Diamant Thaçi; Thomas Luger
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't; Review     Date:  2009-07-23
Journal Detail:
Title:  European journal of obstetrics, gynecology, and reproductive biology     Volume:  146     ISSN:  1872-7654     ISO Abbreviation:  Eur. J. Obstet. Gynecol. Reprod. Biol.     Publication Date:  2009 Sep 
Date Detail:
Created Date:  2009-08-17     Completed Date:  2009-10-20     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0375672     Medline TA:  Eur J Obstet Gynecol Reprod Biol     Country:  Ireland    
Other Details:
Languages:  eng     Pagination:  22-9     Citation Subset:  IM    
Division of Gynecologic Specialties, Department of Gynecology and Obstetrics, The John Hopkins School of Medicine, Baltimore, MD, USA.
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MeSH Terms
Administration, Cutaneous
Aged, 80 and over
Calcineurin / antagonists & inhibitors*
Dermatitis, Atopic / drug therapy*
Middle Aged
Skin Diseases / drug therapy
Tacrolimus / administration & dosage*,  analogs & derivatives*
Vulvar Diseases / drug therapy*
Reg. No./Substance:
0/pimecrolimus; 109581-93-3/Tacrolimus; EC

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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