Tacrolimus - The drug for the turn of the millennium?

Background: Tacrolimus has been shown to be a powerful suppressor of the im mune system. It was introduced into clinical use to prevent allograft rejec tion and is now routinely used in kidney, liver, and heart transplantation. Recently, 2 double-blind multicenter studies demonstrated the therapeutic efficacy of topical and systemic tacrolimus in the inflammatory skin diseas es atopic dermatitis and psoriasis. Data Source: MEDLINE was searched for relevant publications and combined wi th our own clinical, in vitro, and in vivo studies. Study Selection: All studies dealing with tacrolimus and dermatology were r eviewed. Data Extraction: Publications with clinically relevant data were included i n this review. Conclusions: Topical tacrolimus is a safe and effective therapeutic agent t hat may open a new era in the treatment of inflammatory skin diseases, part icularly for patients with atopic dermatitis. Before its full potential in dermatology can be assessed, more clinical experience in treating children and comparison with the criterion standard of anti-inflammatory therapy, gl ucocorticosteroids, are needed.