Long-Term Efficacy of Occlusive Therapy with Topical Pimecrolimus in Severe Dyshidrosiform Hand and Foot Eczema

Schürmeyer-Horst, Funda; Luger, Thomas A.; Böhm, Markus

doi:10.1159/000096923

Cited by 21 publications

(9 citation statements)

References 8 publications

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“…The systemic absorption of topical pimecrolimus when used under occlusion to treat hand eczema was shown to be minimal and similar to that observed without occlusion in patients with atopic eczema [13,21] . Severe dyshidrosiform hand and foot eczema can also be a target of pimecrolimus under occlusion [24] .…”

Section: Chronic Hand Dermatitismentioning

confidence: 99%

Potential New Indications of Topical Calcineurin Inhibitors

Luger

Paul

2007

Dermatology

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The topical calcineurin inhibitors pimecrolimus (Elidel®) and tacrolimus (Protopic®) were initially developed for the treatment of atopic eczema (atopic dermatitis), a chronic or chronically relapsing skin condition most prevalent in infants and children. Their main advantages compared with conventional topical corticosteroid therapy are that they are more selective in their mode of action, do not induce skin atrophy and are not associated with significant systemic absorption. In addition, topical calcineurin inhibitors may represent a useful alternative to topical corticosteroids for the treatment of a number of other inflammatory skin diseases. Preferred sites for the use of topical calcineurin inhibitors are areas such as the face, neck, flexures, and genital areas, which are more susceptible to topical corticosteroid side effects. The efficacy of topical calcineurin inhibitors has been demonstrated for flexural psoriasis, seborrhoeic, contact and hand eczema. Preliminary data also support the efficacy of topical calcineurin inhibitors in lichen planus, facial lupus erythematosus, autoimmune bullous dermatosis, and vitiligo. In these latter indications, controlled studies are needed to better understand the efficacy and safety of topical calcineurin inhibitors and their role in disease management.

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Section: Chronic Hand Dermatitismentioning

confidence: 99%

Potential New Indications of Topical Calcineurin Inhibitors

Luger

Paul

2007

Dermatology

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“…Among the six patients who completed the 8-week trial, the DASI was significantly lower and itching and vesiculation disappeared earlier [17] . Another study with 10 patients compared the effect of BTXA alone (mean 162 U of Botox per palm in one hand).…”

Section: Botulinum Toxin Type Amentioning

confidence: 87%

“…Pimecrolimus has been used in combination with occlusion in pompholyx to improve drug delivery [17] . In a larger, randomized, double-blinded, vehicle-controlled trial, 294 patients with chronic hand dermatitis including pompholyx were treated with topical pimecrolimus 1% cream under occlusion.…”

Section: Topical Calcineurin Inhibitorsmentioning

confidence: 99%

Pompholyx: what's new?

Wollina

2008

Expert Opinion on Investigational Drugs

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Background : Pompholyx is a chronic relapsing inflammatory vesicobullous skin disease of the hands and feet belonging to the spectrum of eczema. Established treatments, both topical and systemic, are limited in efficacy, risk:benefit ratio and prevention of further relapses. New treatment options are needed. Objective : The article will discuss new treatment options, in particular for cheiropompholyx. Methods : A MEDLINE ® and ClinicalTrials.gov ® research has been conducted and publications about new and emerging treatments for pompholyx have been analysed. Results/conclusions : Among the recent developments, topical calcineurin inhibitors (TCI) and botulinum toxin A (BTXA) seem to be effective against pompholyx. The major disadvantage of BTXA is the need for injections, but efforts are being made to develop a topical form of application. Bexaroten gel has been used for chronic hand dermatitis, with good efficacy in the hyperkeratotic type. Further studies on pompholyx are needed. There is currently widespread interest in plant-based pharmaceuticals. Studies involving such topical drugs are on the way. In systemic treatment, retinoid alitretinoin has been most extensively studied in hand dermatitis. However, experiences relating to pompholyx are more limited. New types of anti-inflammatory oral drugs such as leukotriene inhibitors and phosphodiesterase-4 (PDE4) inhibitors have become available. These seem to have potential in the adjuvant treatment of pompholyx. Monoclonal antibodies of various types have been investigated in small series, but have failed to demonstrate consistent efficacy. Further investigations with new monoclonals are needed. Phototherapy of pompholyx is a cornerstone in treatment. High-dose UVA1 has been established as an effective modality in centres where the rather expensive equipment is available. Recently, UV-free phototherapy has been introduced, but more data are needed before final conclusions can be drawn.

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“…An occlusive therapy with pimecrolimus cream 1% leads to marked improvements and long-term clearance of relapsing dyshidrosiform eczema of the hand and foot [21]. In chronic hand dermatitis, treatment with pimecrolimus cream under occlusion was shown to be associated with low systemic exposure and a good efficacy and safety profile [22].…”

Section: Introductionmentioning

confidence: 99%

Percutaneous Absorption of Pimecrolimus Is Not Increased in Patients with Moderate to Severe Atopic Dermatitis when Pimecrolimus Cream 1% Is Applied under Occlusion

Thaçi

Kaufmann²,

Bieber³

et al. 2010

Dermatology

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Aim: To evaluate the systemic exposure of pimecrolimus cream 1% applied under occlusion in atopic dermatitis (AD) patients. Methods: A noncomparative, open-label study conducted in 3 groups of moderate to severe AD patients: A (adults, n = 9), B (adolescents, n = 4) and C (children, n = 6). Pimecrolimus cream 1% was applied twice daily for 8.5 days with overnight occlusion in patients with investigator’s global assessment scores of ≧3 and AD involving at least 30% of their body surface area. Pimecrolimus blood concentrations were analyzed. Results: The highest pimecrolimus blood concentrations observed in adults, adolescents and children were 1.84, 0.55 and 1.29 ng/ml, respectively. Pimecrolimus blood concentrations and affected body surface area showed no apparent correlation. Conclusion: No measurable differences were found in pimecrolimus blood concentrations, efficacy and safety profile when pimecrolimus cream 1% was applied under occlusion versus application without occlusion. These findings reflect the high lipophilic properties of pimecrolimus.

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Long-Term Efficacy of Occlusive Therapy with Topical Pimecrolimus in Severe Dyshidrosiform Hand and Foot Eczema

Cited by 21 publications

References 8 publications

Potential New Indications of Topical Calcineurin Inhibitors

Potential New Indications of Topical Calcineurin Inhibitors

Pompholyx: what's new?

Percutaneous Absorption of Pimecrolimus Is Not Increased in Patients with Moderate to Severe Atopic Dermatitis when Pimecrolimus Cream 1% Is Applied under Occlusion

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