the tacrolimus molecule is relatively large (822AE05 Da) and might have difficulty in penetrating hyperkeratotic skin. Indeed, descaling overnight with 2% salicylic acid increases the topical antipsoriatic effect of tacrolimus. 8 Microdermabrasion is known to increase skin permeation of topical medication by altering the epidermal barrier. 9,10 In this study, we therefore added microdermabrasion once weekly to accelerate the delivery of tacrolimus to CLE lesions. Despite microdermabrasion, total clearance of the lesions was rarely achieved. Walker et al. 7 described the beneficial effect of 0AE3% tacrolimus in 0AE05% clobetasol propionate applied twice daily for recalcitrant DLE. In the present study, we found that tacrolimus was as efficient as clobetasol propionate in treating CLE. However, an obvious advantage of tacrolimus over clobetasol was its safety in terms of skin telangiectasia, which was commonly observed in the clobetasol-treated side. In conclusion, our study suggests that tacrolimus is a safer alternative in treating patients with facial CLE.
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