Skip to main content
Erschienen in: American Journal of Clinical Dermatology 3/2009

01.06.2009 | Original Research Article

Efficacy of Topical Tacrolimus 0.1% in Active Plaque Morphea

Randomized, Double-Blind, Emollient-Controlled Pilot Study

verfasst von: Dr Elisabeth B.M. Kroft, Tamara J. Groeneveld, Marieke M.B. Seyger, de Elke M.G.J. Jong

Erschienen in: American Journal of Clinical Dermatology | Ausgabe 3/2009

Einloggen, um Zugang zu erhalten

Abstract

Background: Tacrolimus, a calcineurin inhibitor, is an immunomodulating and anti-inflammatory drug that inhibits T-cell activation and production of cytokines. The elevated level of cytokines in morphea causes fibroblast proliferation and subsequent overproduction of collagen. Theoretically, tacrolimus could inhibit the pathophysiologic process of morphea.
Objective: To assess whether tacrolimus 0.1% ointment is an effective treatment for active plaque morphea in a double-blind, placebo (petroleum emollient)-controlled pilot study.
Methods: Ten patients with active plaque morphea were included. All patients were treated with tacrolimus 0.1% ointment and with an emollient (petrolatum) on two selected morphea plaques, applied twice daily for 12 weeks. Initial and final assessment included surface area measurements, photography, durometer scores, and clinical feature scores. Adverse reactions were recorded.
Results: The scleroderma plaques treated with topical tacrolimus 0.1% improved, resulting in a significant reduction in durometer and clinical feature scores. Overall, a significant difference could be found between topical tacrolimus and petrolatum with regard to durometer score (p < 0.005) and the clinical feature score (p = 0.019).
Conclusion: In this first double-blind, placebo-controlled pilot study comparing tacrolimus 0.1% ointment with petrolatum in active plaque morphea, tacrolimus 0.1% ointment was shown to be an effective treatment for this condition.
Literatur
1.
Zurück zum Zitat Assmann T, Homey B, Ruzicka T. Applications of tacrolimus for the treatment of skin disorders. Immunopharmacology 2000; 47: 203–13PubMedCrossRef Assmann T, Homey B, Ruzicka T. Applications of tacrolimus for the treatment of skin disorders. Immunopharmacology 2000; 47: 203–13PubMedCrossRef
2.
Zurück zum Zitat Zulian F. Systemic manifestations in localized scleroderma. Curr Rheumatol Rep 2004; 6: 417–24PubMedCrossRef Zulian F. Systemic manifestations in localized scleroderma. Curr Rheumatol Rep 2004; 6: 417–24PubMedCrossRef
3.
Zurück zum Zitat Alecu M, Geleriu L, Coman G, et al. The interleukin-1, interleukin-2, interleukin-6 and tumour necrosis factor alpha serological levels in localised and systemic sclerosis. Rom J Intern Med 1998; 36: 251–9PubMed Alecu M, Geleriu L, Coman G, et al. The interleukin-1, interleukin-2, interleukin-6 and tumour necrosis factor alpha serological levels in localised and systemic sclerosis. Rom J Intern Med 1998; 36: 251–9PubMed
4.
Zurück zum Zitat Hasegawa M, Sato S, Nagaoka T, et al. Serum levels of tumor necrosis factor and interleukin-13 are elevated in patients with localized scleroderma. Dermatology 2003; 207: 141–7PubMedCrossRef Hasegawa M, Sato S, Nagaoka T, et al. Serum levels of tumor necrosis factor and interleukin-13 are elevated in patients with localized scleroderma. Dermatology 2003; 207: 141–7PubMedCrossRef
5.
Zurück zum Zitat Ihn H, Sato S, Fujimoto M, et al. Demonstration of interleukin 8 in serum samples of patients with localized scleroderma. Arch Dermatol 1994; 130: 1327–8PubMedCrossRef Ihn H, Sato S, Fujimoto M, et al. Demonstration of interleukin 8 in serum samples of patients with localized scleroderma. Arch Dermatol 1994; 130: 1327–8PubMedCrossRef
6.
Zurück zum Zitat Ihn H, Sato S, Fujimoto M, et al. Demonstration of interleukin-2, interleukin-4 and interleukin-6 in sera from patients with localized scleroderma. Arch Dermatol Res 1995; 287: 193–7PubMedCrossRef Ihn H, Sato S, Fujimoto M, et al. Demonstration of interleukin-2, interleukin-4 and interleukin-6 in sera from patients with localized scleroderma. Arch Dermatol Res 1995; 287: 193–7PubMedCrossRef
7.
Zurück zum Zitat Chung L, Lin J, Furst DE, et al. Systemic and localized scleroderma. Clin Dermatol 2006; 24: 374–92PubMedCrossRef Chung L, Lin J, Furst DE, et al. Systemic and localized scleroderma. Clin Dermatol 2006; 24: 374–92PubMedCrossRef
8.
Zurück zum Zitat Peterson LS, Nelson AM, Su WP. Classification of morphea (localized scleroderma). Mayo Clin Proc 1995; 70: 1068–76PubMedCrossRef Peterson LS, Nelson AM, Su WP. Classification of morphea (localized scleroderma). Mayo Clin Proc 1995; 70: 1068–76PubMedCrossRef
9.
Zurück zum Zitat Joly P, Bamberger N, Crickx B, et al. Treatment of severe forms of localized scleroderma with oral corticosteroids: follow-up study on 17 patients. Arch Dermatol 1994; 130: 663–4PubMedCrossRef Joly P, Bamberger N, Crickx B, et al. Treatment of severe forms of localized scleroderma with oral corticosteroids: follow-up study on 17 patients. Arch Dermatol 1994; 130: 663–4PubMedCrossRef
10.
Zurück zum Zitat Dytoc M, Ting PT, Man J, et al. First case series on the use of imiquimod for morphoea. Br J Dermatol 2005; 153: 815–20PubMedCrossRef Dytoc M, Ting PT, Man J, et al. First case series on the use of imiquimod for morphoea. Br J Dermatol 2005; 153: 815–20PubMedCrossRef
11.
Zurück zum Zitat Aragane Y, Kawada A, Maeda A, et al. Disseminated scleroderma of a Japanese patient successfully treated with bath PUVA photochemotherapy. J Cutan Med Surg 2001; 5: 135–9PubMedCrossRef Aragane Y, Kawada A, Maeda A, et al. Disseminated scleroderma of a Japanese patient successfully treated with bath PUVA photochemotherapy. J Cutan Med Surg 2001; 5: 135–9PubMedCrossRef
12.
Zurück zum Zitat Kreuter A, Gambichler T, Breuckmann F, et al. Pulsed high-dose corticosteroids combined with low-dose methotrexate in severe localized scleroderma. Arch Dermatol 2005; 141: 847–52PubMedCrossRef Kreuter A, Gambichler T, Breuckmann F, et al. Pulsed high-dose corticosteroids combined with low-dose methotrexate in severe localized scleroderma. Arch Dermatol 2005; 141: 847–52PubMedCrossRef
13.
Zurück zum Zitat Seyger MM, van Den Hoogen FH, de Boo T, et al. Low-dose methotrexate in the treatment of widespread morphea. J Am Acad Dermatol 1998; 39: 220–5PubMedCrossRef Seyger MM, van Den Hoogen FH, de Boo T, et al. Low-dose methotrexate in the treatment of widespread morphea. J Am Acad Dermatol 1998; 39: 220–5PubMedCrossRef
14.
Zurück zum Zitat Uziel Y, Feldman BM, Krafchik BR, et al. Methotrexate and corticosteroid therapy for pediatric localized scleroderma. J Pediatr 2000; 136: 91–5PubMedCrossRef Uziel Y, Feldman BM, Krafchik BR, et al. Methotrexate and corticosteroid therapy for pediatric localized scleroderma. J Pediatr 2000; 136: 91–5PubMedCrossRef
15.
Zurück zum Zitat Falanga V, Medsger Jr TA. D-penicillamine in the treatment of localized scleroderma. Arch Dermatol 1990; 126: 609–12PubMedCrossRef Falanga V, Medsger Jr TA. D-penicillamine in the treatment of localized scleroderma. Arch Dermatol 1990; 126: 609–12PubMedCrossRef
16.
Zurück zum Zitat Hunzelmann N, Anders S, Fierlbeck G, et al. Double-blind, placebocontrolled study of intralesional interferon gamma for the treatment of localized scleroderma. J Am Acad Dermatol 1997; 36: 433–5PubMedCrossRef Hunzelmann N, Anders S, Fierlbeck G, et al. Double-blind, placebocontrolled study of intralesional interferon gamma for the treatment of localized scleroderma. J Am Acad Dermatol 1997; 36: 433–5PubMedCrossRef
17.
Zurück zum Zitat Kreuter A, Hyun J, Stucker M, et al. A randomized controlled study of low-dose UVA1, medium-dose UVA1, and narrowband UVB phototherapy in the treatment of localized scleroderma. J Am Acad Dermatol 2006; 54: 440–7PubMedCrossRef Kreuter A, Hyun J, Stucker M, et al. A randomized controlled study of low-dose UVA1, medium-dose UVA1, and narrowband UVB phototherapy in the treatment of localized scleroderma. J Am Acad Dermatol 2006; 54: 440–7PubMedCrossRef
18.
Zurück zum Zitat Mancuso G, Berdondini RM. Topical tacrolimus in the treatment of localized scleroderma. Eur J Dermatol 2003; 13: 590–2PubMed Mancuso G, Berdondini RM. Topical tacrolimus in the treatment of localized scleroderma. Eur J Dermatol 2003; 13: 590–2PubMed
19.
Zurück zum Zitat Mancuso G, Berdondini RM. Localized scleroderma: response to occlusive treatment with tacrolimus ointment. Br J Dermatol 2005; 152: 180–2PubMedCrossRef Mancuso G, Berdondini RM. Localized scleroderma: response to occlusive treatment with tacrolimus ointment. Br J Dermatol 2005; 152: 180–2PubMedCrossRef
20.
Zurück zum Zitat Walker JG, Pope J, Baron M, et al. The development of systemic sclerosis classification criteria. Clin Rheumatol 2007; 26: 1401–9PubMedCrossRef Walker JG, Pope J, Baron M, et al. The development of systemic sclerosis classification criteria. Clin Rheumatol 2007; 26: 1401–9PubMedCrossRef
22.
Zurück zum Zitat Zachariae H, Bjerring P, Halkier-Sorensen L, et al. Skin scoring in systemic sclerosis: a modification. Relations to subtypes and the aminoterminal propeptide of type III procollagen (PIIINP). Acta Derm Venereol 1994; 74: 444–6 Zachariae H, Bjerring P, Halkier-Sorensen L, et al. Skin scoring in systemic sclerosis: a modification. Relations to subtypes and the aminoterminal propeptide of type III procollagen (PIIINP). Acta Derm Venereol 1994; 74: 444–6
23.
Zurück zum Zitat Kissin EY, Schiller AM, Gelbard RB, et al. Durometry for the assessment of skin disease in systemic sclerosis. Arthritis Rheum 2006; 55: 603–9PubMedCrossRef Kissin EY, Schiller AM, Gelbard RB, et al. Durometry for the assessment of skin disease in systemic sclerosis. Arthritis Rheum 2006; 55: 603–9PubMedCrossRef
24.
Zurück zum Zitat Seyger MM, van den Hoogen FH, de Boo T, et al. Reliability of twomethods to assess morphea: skin scoring and the use of a durometer. J Am Acad Dermatol 1997; 37: 793–6PubMedCrossRef Seyger MM, van den Hoogen FH, de Boo T, et al. Reliability of twomethods to assess morphea: skin scoring and the use of a durometer. J Am Acad Dermatol 1997; 37: 793–6PubMedCrossRef
25.
Zurück zum Zitat Zulian F, Meneghesso D, Grisan E, et al. A new computerized method for the assessment of skin lesions in localized scleroderma. Rheumatology (Oxford) 2007; 46: 856–60PubMedCrossRef Zulian F, Meneghesso D, Grisan E, et al. A new computerized method for the assessment of skin lesions in localized scleroderma. Rheumatology (Oxford) 2007; 46: 856–60PubMedCrossRef
26.
Zurück zum Zitat Goto T, Kino T, Hatanaka H, et al. Discovery of FK-506, a novel immunosuppressant isolated from Streptomyces tsukubaensis. Transplant Proc 1987; 19: 4–8PubMed Goto T, Kino T, Hatanaka H, et al. Discovery of FK-506, a novel immunosuppressant isolated from Streptomyces tsukubaensis. Transplant Proc 1987; 19: 4–8PubMed
27.
Zurück zum Zitat Brune A, Miller DW, Lin P, et al. Tacrolimus ointment is effective for psoriasis on the face and intertriginous areas in pediatric patients. Pediatr Dermatol 2007; 24: 76–80PubMedCrossRef Brune A, Miller DW, Lin P, et al. Tacrolimus ointment is effective for psoriasis on the face and intertriginous areas in pediatric patients. Pediatr Dermatol 2007; 24: 76–80PubMedCrossRef
28.
Zurück zum Zitat Simpson D, Noble S. Tacrolimus ointment: a review of its use in atopic dermatitis and its clinical potential in other inflammatory skin conditions. Drugs 2005; 65: 827–58PubMedCrossRef Simpson D, Noble S. Tacrolimus ointment: a review of its use in atopic dermatitis and its clinical potential in other inflammatory skin conditions. Drugs 2005; 65: 827–58PubMedCrossRef
29.
Zurück zum Zitat Rustin MH. The safety of tacrolimus ointment for the treatment of atopic dermatitis: a review. Br J Dermatol 2007; 157: 861–73PubMedCrossRef Rustin MH. The safety of tacrolimus ointment for the treatment of atopic dermatitis: a review. Br J Dermatol 2007; 157: 861–73PubMedCrossRef
30.
Zurück zum Zitat Bohm M, Frieling U, Luger TA, et al. Successful treatment of anogenital lichen sclerosus with topical tacrolimus. Arch Dermatol 2003; 139: 922–4PubMedCrossRef Bohm M, Frieling U, Luger TA, et al. Successful treatment of anogenital lichen sclerosus with topical tacrolimus. Arch Dermatol 2003; 139: 922–4PubMedCrossRef
31.
Zurück zum Zitat Matsumoto Y, Yamamoto T, Isobe T, et al. Successful treatment of vulvar lichen sclerosus in a child with low-concentration topical tacrolimus ointment. J Dermatol 2007; 34: 114–6PubMedCrossRef Matsumoto Y, Yamamoto T, Isobe T, et al. Successful treatment of vulvar lichen sclerosus in a child with low-concentration topical tacrolimus ointment. J Dermatol 2007; 34: 114–6PubMedCrossRef
32.
Zurück zum Zitat Virgili A, Lauriola MM, Mantovani L, et al. Vulvar lichen sclerosus: 11 women treated with tacrolimus 0.1% ointment. Acta Derm Venereol 2007; 87: 69–72PubMedCrossRef Virgili A, Lauriola MM, Mantovani L, et al. Vulvar lichen sclerosus: 11 women treated with tacrolimus 0.1% ointment. Acta Derm Venereol 2007; 87: 69–72PubMedCrossRef
33.
Zurück zum Zitat Hawk A, English III JC. Localized and systemic scleroderma. Semin Cutan Med Surg 2001; 20: 27–37PubMedCrossRef Hawk A, English III JC. Localized and systemic scleroderma. Semin Cutan Med Surg 2001; 20: 27–37PubMedCrossRef
34.
Zurück zum Zitat Robinson N, Singri P, Gordon KB. Safety of the new macrolide immunomodulators. Semin Cutan Med Surg 2001; 20: 242–9PubMedCrossRef Robinson N, Singri P, Gordon KB. Safety of the new macrolide immunomodulators. Semin Cutan Med Surg 2001; 20: 242–9PubMedCrossRef
35.
Zurück zum Zitat Kikuchi K, Tagami H. Comparison of the effects of daily applications between topical corticosteroid and tacrolimus ointments on normal skin: evaluation with noninvasive methods. Dermatology 2002; 205: 378–82PubMedCrossRef Kikuchi K, Tagami H. Comparison of the effects of daily applications between topical corticosteroid and tacrolimus ointments on normal skin: evaluation with noninvasive methods. Dermatology 2002; 205: 378–82PubMedCrossRef
36.
Zurück zum Zitat Kyllönen H, Remitz A, Mandelin JM, et al. Effects of 1-year intermittent treatment with topical tacrolimus monotherapy on skin collagen synthesis in patients with atopic dermatitis. Br J Dermatol 2004; 150: 1174–81PubMedCrossRef Kyllönen H, Remitz A, Mandelin JM, et al. Effects of 1-year intermittent treatment with topical tacrolimus monotherapy on skin collagen synthesis in patients with atopic dermatitis. Br J Dermatol 2004; 150: 1174–81PubMedCrossRef
37.
Zurück zum Zitat Reitamo S, Rissanen J, Remitz A, et al. Tacrolimus ointment does not affect collagen synthesis: results of a single-center randomized trial. J Invest Dermatol 1998; 111: 396–8PubMedCrossRef Reitamo S, Rissanen J, Remitz A, et al. Tacrolimus ointment does not affect collagen synthesis: results of a single-center randomized trial. J Invest Dermatol 1998; 111: 396–8PubMedCrossRef
Metadaten
Titel
Efficacy of Topical Tacrolimus 0.1% in Active Plaque Morphea
Randomized, Double-Blind, Emollient-Controlled Pilot Study
verfasst von
Dr Elisabeth B.M. Kroft
Tamara J. Groeneveld
Marieke M.B. Seyger
de Elke M.G.J. Jong
Publikationsdatum
01.06.2009
Verlag
Springer International Publishing
Erschienen in
American Journal of Clinical Dermatology / Ausgabe 3/2009
Print ISSN: 1175-0561
Elektronische ISSN: 1179-1888
DOI
https://doi.org/10.2165/00128071-200910030-00004

Weitere Artikel der Ausgabe 3/2009

American Journal of Clinical Dermatology 3/2009 Zur Ausgabe

Leitlinien kompakt für die Dermatologie

Mit medbee Pocketcards sicher entscheiden.

Seit 2022 gehört die medbee GmbH zum Springer Medizin Verlag

Studienlage spricht für Isotretinoin zur Rosazea-Therapie

23.05.2024 Rosazea Nachrichten

Isotretinoin wird off-label zur Behandlung von Rosazea eingesetzt. Wie solide die Evidenz dafür ist, wurde jetzt in einem systematischen Review überprüft.

So sicher sind Tattoos: Neue Daten zur Risikobewertung

22.05.2024 Melanom Nachrichten

Das größte medizinische Problem bei Tattoos bleiben allergische Reaktionen. Melanome werden dadurch offensichtlich nicht gefördert, die Farbpigmente könnten aber andere Tumoren begünstigen.

„Übersichtlicher Wegweiser“: Lauterbachs umstrittener Klinik-Atlas ist online

17.05.2024 Klinik aktuell Nachrichten

Sie sei „ethisch geboten“, meint Gesundheitsminister Karl Lauterbach: mehr Transparenz über die Qualität von Klinikbehandlungen. Um sie abzubilden, lässt er gegen den Widerstand vieler Länder einen virtuellen Klinik-Atlas freischalten.

Riesenzellarteriitis: 15% der Patienten sind von okkulter Form betroffen

16.05.2024 Riesenzellarteriitis Nachrichten

In einer retrospektiven Untersuchung haben Forschende aus Belgien und den Niederlanden die okkulte Form der Riesenzellarteriitis genauer unter die Lupe genommen. In puncto Therapie und Rezidivraten stellten sie keinen sehr großen Unterschied zu Erkrankten mit kranialen Symptomen fest.

Update Dermatologie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.