Pimecrolimus as local therapy for atopic dermatitis

Abstract

Pimecrolimus is a topical calcineurin inhibitor. It is a macrolactam derivative with immunosuppressive properties. Pimecrolimus is fi rst line therapy in the treatment of sensitive skin areas such as the face (eyelid area), neck, genital region, axillary and inguinal region, as well as in cases that require continuous therapy. Furthermore, it is recommended as second line therapy in patients with mild-to-moderate atopic dermatitis that either do not tolerate treatment with topical corticosteroids or have low therapeutic response. Early and timely treatment with pimecrolimus decreases the progression to disease fl ares and extends the remission period. It eff ectively and rapidly improves pruritus, an essential symptom of atopic dermatitis, within 48 hours of treatment initiation. In addition, pimecrolimus signifi cantly enhances the quality of life of both patients and their parents. An additional benefi t of pimecrolimus is its substantial steroid sparing eff ect, as well as the good safety profi le and patient tolerability. In contrast to topical corticosteroids, it does not induce skin atrophy or epidermal barrier dysfunction, and is not associated with an increased risk of skin infection. The most common side eff ect is transient warmth or a burning sensation at the application site during the fi rst few days of treatment. Finally, the use of topical immunomodulators is recommended in 80% of atopic dermatitis patients, whereas the use of topical corticosteroids on sensitive skin areas is recommended exceptionally and limited to 3-4 days.