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[Practice experience with topical calcineurin inhibitors]
1Klinik und Poliklinik für Dermatologie und Venerologie, Hôpital Cantonal Universitaire, Geneva, Switzerland. jann.lubbe@hcuge.ch
Summary
Topical calcineurin inhibitors offer an alternative to corticosteroids for skin conditions, with minimal systemic absorption in most cases. Long-term use or severe skin barrier disruption may lead to relevant blood levels and potential side effects like local intolerance or rare skin infections.
Area of Science:
- Dermatology and immunology
- Pharmacology of topical agents
Context:
- Limited clinical experience with topical calcineurin inhibitors (TCIs) compared to topical corticosteroids.
- Uncertainty regarding long-term effects and systemic absorption of TCIs.
Purpose:
- To review the clinical experience and side effect profile of topical calcineurin inhibitors.
- To assess the safety and efficacy of TCIs in managing inflammatory skin conditions.
Summary:
- Systemic absorption of TCIs is generally negligible in atopic dermatitis but can become clinically relevant with severe skin barrier defects or non-responsive cases.
- Local intolerance (burning, alcohol intolerance) and skin infections (Eczema herpeticatum) are the primary side effects.
- Preventive measures can mitigate the risk of rare but serious complications like Eczema herpeticatum.
Impact:
- Provides a concise overview of TCI safety for clinicians.
- Highlights the importance of considering skin barrier integrity and long-term monitoring.
- Informs therapeutic decisions in managing inflammatory dermatoses with TCIs.