An open study of a lotion formulation to improve tolerance of tacrolimus in facial atopic dermatitis

Background We identified 19 patients with facial atopic eczema who failed t o respond to tacrolimus (FK506) ointment, although tacrolimus ointment has shown excellent benefit for the treatment of recalcitrant facial erythema i n most patients with atopic dermatitis. Objectives We attempted to determine the efficacy of an original lotion for mulation of tacrolimus for facial atopic dermatitis resistant to tacrolimus ointment. Patients/methods Recalcitrant facial erythema of these 19 patients was trea ted with an original tacrolimus lotion preparation for 6 months. Patch test ing with white petrolatum was performed in both the 19 patients and in 30 o ther atopic dermatitis patients who had experienced excellent results with tacrolimus ointment. Results Of the 19 resistant patients, those whose symptoms were greatly or moderately improved by the lotion were 95%, 89% and 89% after 2 weeks, 3 mo nths and 6 months of treatment, respectively. Further, patch testing to pet rolatum showed positive reactions in several (six of 19) patients, compared with none of 30 controls with atopic eczema that had responded to topical tacrolimus ointment. Conclusions The tacrolimus lotion had a significant effect on the recalcitr ant facial erythema in adult patients with atopic dermatitis who were resis tant to tacrolimus ointment. We suggest that one reason for the unresponsiv eness to tacrolimus ointment may be because of contact sensitivity to white petrolatum.