tacrolimus and Lentigo

Topics: Administration, Topical; Child; Drug Eruptions; Humans; Immunosuppressive Agents; Lentigo; Male; Tacrolimus

Topics: Child; Facial Dermatoses; Female; Humans; Immunosuppressive Agents; Lentigo; Mouth; Tacrolimus; Vitiligo

Topical calcineurin inhibitors are widely used to treat inflammatory dermatoses for their steroid-sparing advantage. Herein, we report a patient with chronic lip dermatitis who developed multiple labial melanotic macules after application of tacrolimus 0.1% ointment and pimecrolimus 1% cream. Prior and current reports raise concerns for potential development of pigmented lesions associated with topical calcineurin inhibitor use. These reports highlight the need for careful risk-benefit assessment when prescribing topical calcineurin inhibitors for inflammatory dermatoses, especially when used on sun-exposed sites.

Topics: Administration, Cutaneous; Adult; Biopsy; Calcineurin Inhibitors; Dermatitis, Atopic; Diagnosis, Differential; Female; Humans; Lentigo; Lip Diseases; Peptidylprolyl Isomerase; Tacrolimus

Topics: Alopecia; Cafe-au-Lait Spots; Child; Drug Therapy, Combination; Female; Humans; Lentigo; Minoxidil; Tacrolimus

Topics: Administration, Cutaneous; Adolescent; Adult; Age of Onset; Calcineurin Inhibitors; Child; Child, Preschool; Female; Humans; Lentigo; Male; Retrospective Studies; Tacrolimus; Time Factors

Three children with severe atopic dermatitis were noted at routine follow-up to have developed multiple small pigmented macules during long-term therapy with topical tacrolimus 0.1% (Protopic, Fujisawa). Representative lesions in two of the three cases were confirmed histologically as simple lentigines. The focal distribution of lentigines to sites of tacrolimus use, and the temporal association between use of tacrolimus and development of lesions, suggest that topical tacrolimus is of direct aetiological relevance to their development. Careful long-term follow-up will be required to assess the clinical implications of these findings and whether they represent an increase in risk for melanocytic neoplasia.

Topics: Administration, Cutaneous; Child; Child, Preschool; Dermatitis, Atopic; Drug Eruptions; Female; Humans; Immunosuppressive Agents; Lentigo; Male; Tacrolimus