tacrolimus and Telangiectasis

Currently, there are no accurate and simple methods available to measure this risk of atrophy in patients treated with topical glucocorticosteroids. In the present clinical trial, we validated a new score (Dermaphot(®) score) to assess the atrophogenic potential of glucocorticosteroids. 36 healthy adult volunteers were included in an investigator-initiated, blinded, randomized, intra-individual comparison, vehicle controlled multi-centre study. Subjects were treated in a randomized manner for 3 weeks with pimecrolimus cream 1 %, mometasone furoate (1 mg/g), clobetasol propionate 0.05 % and vehicle. In addition, ultrasound examination for skin thickness was performed. Data demonstrated a direct correlation of the achieved Dermaphot(®) score and the ultrasound thickness measurements. Our study shows that the Dermaphot(®) score can be used as a simple method to evaluate the atrophogenic potential of glucocorticosteroids. Respectively, we showed that the new score is an easy, valid and sensitive new tool for early detecting and quantifying even subclinical glucocorticosteroid-induced skin damage. We demonstrated that the score is able to differentiate the extent of skin atrophy (damage) after 3 weeks of topical glucocorticosteroid application with different levels of skin transparency and levels of telangiectasia.

Topics: Adult; Atrophy; Clobetasol; Female; Glucocorticoids; Humans; Male; Middle Aged; Mometasone Furoate; Pregnadienediols; Reproducibility of Results; Severity of Illness Index; Skin; Tacrolimus; Telangiectasis; Young Adult

Steroid-induced rosacea-like eruption is characterized by facial rosacea-like dermatitis in patients that have been treated with topical steroids for relatively long periods.. To evaluate the efficacy and tolerability of 1% pimecrolimus topical cream for steroid-induced rosacea-like eruption.. In an open-label pilot study, 40 patients were enrolled and instructed to apply 1% pimecrolimus cream twice daily for 6 weeks. Patients were evaluated by a rosacea clinical score, investigator's global assessment, overall erythema severity, and tolerability at weeks 0, 2, and 6.. In 35 patients, the rosacea clinical score decreased significantly from 16.0+/-4.3 at baseline to 8.1+/-3.3 at week 2 and 4.2+/-2.5 at week 6 (P<0.0001). Investigator's global assessment was 4.1+/-1.1 (baseline), then decreased to 1.4+/-0.8 (week 2) and 0.5+/-0.6 (week 6) (P<0.0001). By week 6, 48.6% of the patients were clear. Overall erythema severity was 2.4+/-0.7 (baseline), 0.9+/-0.4 (week 2), and 0.3+/-0.4 (week 6) (P<0.0001). Cutaneous adverse events (local burning, stinging, and itching) occurred in 17.5%.. Pimecrolimus cream might be efficacious, safe, and well tolerated for steroid-induced rosacea-like eruption. The small sample size and open label nature of this study is its limitation. Further double-blind, vehicle-controlled studies are needed.

Topics: Administration, Cutaneous; Adolescent; Adrenal Cortex Hormones; Adult; Aged; Calcineurin Inhibitors; Dermatologic Agents; Drug Eruptions; Erythema; Facial Dermatoses; Female; Follow-Up Studies; Humans; Male; Middle Aged; Patient Satisfaction; Pilot Projects; Rosacea; Safety; Tacrolimus; Telangiectasis; Treatment Outcome

Intense pulsed light (IPL) is a good option for erythema and telangiectasia of rosacea. Demodex, which is light and heat sensitive, is an important risk of Rosacea. Sometimes, IPL can induce rosacea aggravation. Here, we show two cases of erythema rosacea aggravated as pustule in several hours after IPL. Both cases show high density of Demodex after IPL. Neither of them had photosensitivity, systemic disease, or any other contraindication for IPL. One of the patients received IPL again after Demodex infection relieved and this time there was no inflammation induction. We need to attract more attention to IPL-induced rosacea aggravation and latent Demodex infection may act as a cofactor.

Topics: Adult; Animals; Anti-Bacterial Agents; Biopsy; Erythema; Female; Follow-Up Studies; Humans; Immunosuppressive Agents; Intense Pulsed Light Therapy; Middle Aged; Minocycline; Mite Infestations; Retrospective Studies; Rosacea; Skin; Skin Cream; Tacrolimus; Telangiectasis; Treatment Outcome

Topics: Administration, Cutaneous; Aged; Cheek; Facial Dermatoses; Female; Humans; Immunosuppressive Agents; Lichen Sclerosus et Atrophicus; Tacrolimus; Telangiectasis

We describe herein 3 patients who developed rosacea-like dermatitis eruptions while using 0.03% or 0.1% tacrolimus ointment for facial dermatitis. Skin biopsy specimens showed telangiectasia and noncaseating epithelioid granulomatous tissue formation in the papillary to mid dermis. Continuous topical use of immunomodulators such as tacrolimus or pimecrolimus should be regarded as a potential cause of rosaceiform dermatitis, although many cases have not been reported.

Topics: Administration, Topical; Aged; Facial Dermatoses; Female; Humans; Immunosuppressive Agents; Male; Middle Aged; Rosacea; Skin; Tacrolimus; Telangiectasis