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 treatment --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.