A Reassuring Rejoinder Against Malignant Influences of Topical Calcineurin Use in Children

Hanifin, Jon M.

doi:10.1001/jamadermatol.2014.4306

Cited by 4 publications

(6 citation statements)

References 8 publications

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“…Since then, there has been no evidence suggesting a link between TCI and malignancy. 38 For patients with frequent flares in predictable areas, basic skin care may be inadequate, and a more proactive approach with intermittent application of TCS or TCI to those areas even during periods of remission may be recommended. 10,26 Studies have found that this proactive approach with either TCS or TCI has extended the time to first relapse when compared with vehicle.…”

Section: Practice Guidelinesmentioning

confidence: 99%

“…The public concern with TCI use arose with the previously mentioned FDA announcement of TCI's lack of established long-term safety and subsequent "black box" warning designation. 38,[63][64][65] It was believed that there was potential for systemic absorption that could manifest as systemic adverse effects, including cancer. To date, there is no substantial evidence to suggest TCI are associated with increased cancer risk (including lymphomas) or systemic immunosuppression.…”

Section: Addressing Patient Concerns Regarding Ad Treatment Adverse Ementioning

confidence: 99%

“…To date, there is no substantial evidence to suggest TCI are associated with increased cancer risk (including lymphomas) or systemic immunosuppression. 38,[63][64][65] Pharmacists can play an important role in mitigating patient concerns by communicating this evidence.…”

Section: Addressing Patient Concerns Regarding Ad Treatment Adverse Ementioning

confidence: 99%

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Guidelines for the management of atopic dermatitis (eczema) for pharmacists

et al. 2017

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Section: Practice Guidelinesmentioning

confidence: 99%

Section: Addressing Patient Concerns Regarding Ad Treatment Adverse Ementioning

confidence: 99%

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Guidelines for the management of atopic dermatitis (eczema) for pharmacists

et al. 2017

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“…Although TCIs have demonstrated effectiveness in treating AD, they can induce local skin burning and stinging . Prescribing information for TCIs include a boxed warning in the United States for a theoretical risk of malignancy, although after years of use, no evidence that topical application can cause malignancy has emerged …”

Section: Introductionmentioning

confidence: 99%

“…Prescribing information for TCIs include a boxed warning in the United States for a theoretical risk of malignancy, although after years of use, no evidence that topical application can cause malignancy has emerged. [11,[14][15][16] Proactive use of TCIs after AD is controlled can result in longlasting flare-free periods and decrease the need for TCSs, leading to improvement in skin lesions and quality of life. [17] Proactive use of the medium-potency TCS fluticasone propionate (acute phase: twice daily; maintenance phase: 4 weeks of once-daily dosing 4 d/wk, followed by 16 weeks of once-daily dosing 2 d/wk) did not result in skin atrophy, which might otherwise occur as a result of improper reactive use, suggesting that maintenance use for prevention of flares could mitigate some of the limitations of these agents.…”

mentioning

confidence: 99%

The role of phosphodiesterase 4 in the pathophysiology of atopic dermatitis and the perspective for its inhibition

Guttman‐Yassky

Hanifin

Boguniewicz

et al. 2018

Experimental Dermatology

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Atopic dermatitis (AD) is a highly prevalent, chronic inflammatory skin disease that affects children and adults. The pathophysiology of AD is complex and involves skin barrier and immune dysfunction. Many immune cytokine pathways are amplified in AD, including T helper (Th) 2, Th22, Th17 and Th1. Current treatment guidelines recommend topical medications as initial therapy; however, until recently, only two drug classes were available: topical corticosteroids (TCSs) and topical calcineurin inhibitors (TCIs). Several limitations are associated with these agents. TCSs can cause a wide range of adverse effects, including skin atrophy, telangiectasia, rosacea and acne. TCIs can cause burning and stinging, and the prescribing information lists a boxed warning for a theoretical risk of malignancy. Novel medications with new mechanisms of action are necessary to provide better long‐term control of AD. Phosphodiesterase 4 (PDE4) regulates cyclic adenosine monophosphate in cells and has been shown to be involved in the pathophysiology of AD, making it an attractive therapeutic target. Several PDE4 inhibitors are in clinical development for use in the treatment of AD, including crisaborole, which recently became the first topical PDE4 inhibitor approved for treatment of mild to moderate AD. This review will further describe the pathophysiology of AD, explain the possible role of PDE4 in AD and review PDE4 inhibitors currently approved or being investigated for use in AD.

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Development and validation of a simultaneous analytical method for non‐steroidal therapeutic compounds in cosmetics using liquid chromatography–tandem mass spectrometry

Woo

Kim

et al. 2021

J of Separation Science

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Atopic dermatitis is a typical chronic inflammatory skin disease that affects all age groups and requires basic skin care for treatment. Anti-inflammatory and antiallergy steroids are the most frequently used treatments but they are limited due to their side effects caused by a weakening of the immune system. Many consumers focus on performance as a criterion for selecting cosmetics. However, steroids have been illegally used to improve the performance of cosmetics, and consumers have been adversely affected by the corresponding side effects. In this paper, we propose a simple and rapid method using liquid chromatographytandem mass spectrometry to simultaneously analyze ten non-permitted atopic therapeutic compounds in cosmetic products: chlorpheniramine maleate, ketotifen fumarate, doxepin hydrochloride, azelastine hydrochloride, bufexamac, clotrimazole, tranilast, fusidic acid, tacrolimus, and pimecrolimus. Additionally, the major characteristic fragment ions for tacrolimus, pimecrolimus, and clotrimazole were identified by time-of-flight mass spectrometry. The specificity, linearity, limit of detection, limit of quantification, recovery, precision, accuracy, and stability of the proposed method were validated. The limit of detection and quantification were in the ranges of 5.05-203.30 pg/mL and 15.15-609.90 pg/mL, respectively. The proposed analysis method could help improve the safety management of cosmetics. K E Y W O R D Satopic dermatitis, illegal cosmetics, liquid chromatography tandem mass spectrometry, therapeutics, topical calcineurin inhibitors Abbreviations: AD, atopic dermatitis; Q-TOF-MS, quadrupole time of flight mass spectrometry; MRM, multiple reaction monitoring; TCI, topical calcineurin inhibitor INTRODUCTIONAtopic dermatitis (AD) refers to a chronic refractory inflammatory skin disease caused by a combination of genetic, environmental, and immunological factors of an

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A Reassuring Rejoinder Against Malignant Influences of Topical Calcineurin Use in Children

Cited by 4 publications

References 8 publications

Guidelines for the management of atopic dermatitis (eczema) for pharmacists

Guidelines for the management of atopic dermatitis (eczema) for pharmacists

The role of phosphodiesterase 4 in the pathophysiology of atopic dermatitis and the perspective for its inhibition

Development and validation of a simultaneous analytical method for non‐steroidal therapeutic compounds in cosmetics using liquid chromatography–tandem mass spectrometry

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