Tacrolimus ointment, an interesting adjunctive therapy for childhood linear IgA bullous dermatosis

Abstract

and Power Doppler Ultrasonography showing increased vascularity close to malignant cell invasion of liposarcoma may be helpful. 3 A recent study showed a statistically significant clinical difference in size between intramuscular lipoma and liposarcoma, although size alone could not be a reliable factor. 3 Other differential diagnosis of neck mass should be included with haematoma, muscle herniation, cystic hygroma, fibrous myositis, metastatic carcinoma, and metastatic sarcoma. 2 The treatment of choice is total excision. However, complete excision can be difficult due to its infiltrating capacity. The recurrence rate was reported between 3% and 62.5%. 1,2 To our knowledge, only three cases of intramuscular lipoma in the SCM muscle have been reported in the literature of otorhinolaryngology and none in that of dermatology. 1,2,6 In conclusion, intramuscular lipoma should be considered in the differential diagnosis of patients with a neck mass. It is a benign tumour with variable recurrence and must be excised completely to rule out liposarcoma. Thus, we suggest that dermatologists be familiar with the intramuscular lipomas and make a decision for complete excision of them. References1 Moumoulidis I, Durvasula P, Jani P. Well-circumscribed intramuscular lipoma of the sternocleidomastoid muscle. Auris Nasus Larynx 2004; 31 : 283-285. 2 Ozcan C, Gorur K, Talas D, Aydin O. Intramuscular benign lipoma of the sternocleidomastoid muscle: a rare cause of neck mass. Eur Arch Otorhinolaryngol 2005; 262 : 148 -150. 3 Bassett MD, Schuetze SM, Disteche C et al . Deep-seated, well differentiated lipomatous tumors of the chest wall and extremities: the role of cytogenetics in classification and prognostication. Cancer 2005; 103 : 409-416. 4 Lerosey Y, Choussy O, Gruyer X et al . Infiltrating lipoma of the head and neck: a report of one pediatric case. Int J Pediatr Otorhinolaryngol 1999; 47 : 91-95. 5 Copcu E. Can intramuscular lipoma have a post-traumatic origin? Br J Dermatol 2003; 149 : 1084 -1085. 6 Mattel SF, Persky MS. Infiltrating lipoma of the sternocleidomastoid muscle.

Treatment of subepidermal immunobullous diseases

“…80,81 For a review of dosing, side effects, and monitoring of dapsone, please refer to the previous section, which describes the use of dapsone in the treatment of BP. Other reported treatments include colchicine, 82–86 trimethoprin-sulfamethoxazole, 87 tacrolimus ointment, 88 mycophenolate, 89 immunoadsorption, 90 and IVIg. 91,92 Obviously, in drug-induced cases, the offending medication should be discontinued.…”

Linear immunoglobulin A (IgA) bullous dermatosis

“…Flucloxacillin may be considered as an alternative therapy 11 . In dapsone resistant cases, tacrolimus ointment may be beneficial 12 .…”

Management Options for Linear Immunoglobulin A (IgA) Bullous Dermatosis: A Literature Review

“…Tacrolimus is a calcineurin inhibitor, which suppresses T-cell activation, which, in turn, decreases ILs (IL-2, IL-3, and Il-4), granulocyte colony-stimulating factor, and tumor necrosis factor production. Because the pathogenesis of LABD involves T-cell activation, tacrolimus 0.03% ointment may have a therapeutic role in treatment as it was successfully used in one case of resistant CBDC despite treatment with dapsone and topical corticosteroids [ 76 ]. Although no case reports utilizing pimecrolimus have been published, it may also be a potential option as both pimecrolimus and tacrolimus are topical calcineurin inhibitors.…”