Topical Use of Calcineurin Inhibitors in Dermatology

Emollients have long been used to maintain the skin barrier function in patients with atopic dermatitis. For many years, topical corticosteroids have been mainstay for atopic dermatitis (AD) treatment. The introduction of topical calcineurin inhibitors represented the first new class of medication approved for the treatment of AD since topical corticosteroids. Topical calcineurin inhibitors, pimecrolimus and tacrolimus, were developed to provide an effective and safe alternative therapy for longterm control of the disease. They provide targeted anti-inflammatory activity without local or systemic side-effects seen with topical corticosteroids. They have been used not only in AD, but also in other inflammatory skin diseases such as psoriasis, lichen planus, seborrheic dermatitis, contact dermatitis, alopecia areata, acne rosacea, pyoderma gangrenosum and vitiligo.

In this chapter, mechanism of action, the efficacy, safety, adverse effects of topical calcineurin inhibitors and their innovative use in dermatology will be reviewed.

Keywords: Topical therapy, topical macrolide immunomodulator, calcineurin inhibitor, pimecrolimus, tacrolimus, atopic dermatitis, mechanism of calcineurin inhibitors, immunology of the skin.