Topical tacrolimus--a novel treatment alternative for cutaneous chronic graft-versus-host disease

Graft-versus-host disease (GVHD) may be resistant to accepted treatments. Therefore, the aim of the present preliminary study was to evaluate the efficacy of topical treatment with tacrolimus, an immunosuppressive agent, for cutaneous GVHD. Ten patients with chronic steroid-dependent cutaneous GVHD were treated with 0.03-0.1% tacrolimus ointment, twice to three times a day. The dermal manifestations of GVHD were monitored, and a score was given to the cutaneous response by both the physician and patient. Seven patients demonstrated a response to the tacrolimus ointment. Three out of the ten patients were scored as showing a "good" or "complete" response in the objective examiner's view or subjective patient's view. Another four patients showed "moderate" or "mild" response; only three patients showed "no response". Topical tacrolimus is suggested as an alternative treatment for cutaneous chronic steroid-dependent GVHD. This conclusion concurs with a previous study on this medication.