What is the role of tacrolimus and pimecrolimus in atopic dermatitis?

Abstract

When the standard therapies—mild topical corticosteroids and moisturizers—fail in the treatment of atopic dermatitis, patients are left with few proven remedies. The recently introduced topical immunosuppressive treatments—pimecrolimus and tacrolimus—offer an alternative to topical corticosteroids. Tacrolimus 0.1% (Protopic) appears to be both safe and effective in treating eczema in adults and children (strength of recommendation [SOR]: A). In multiple studies, it has been as effective as potent topical corticosteroids and more effective than mild topical corticosteroids (SOR: A). Pimecrolimus (Elidel) is more effective than placebo but less effective than potent topical corticosteroids (SOR: A). At this time, no data compare pimecrolimus with mild corticosteroids.