Induction of rosaceiform dermatitis during treatment of facial inflammatory dermatoses with tacrolimus ointment
Induction of rosaceiform dermatitis during treatment of facial inflammatory dermatoses with tacrolimus ointment
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DOI：
10.1001/archderm.140.4.457
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发表时间：
2004-04-01
影响因子：
--
通讯作者：
Lübbe, J
中科院分区：
文献类型：
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作者：
Antille, C;Saurat, JH;Lübbe, J
背景资料：他克莫司软膏越来越多地用于面部等敏感部位的抗炎治疗，最近的观察表明，该治疗对类固醇加重的酒渣鼻和口周皮炎有效。我们报告玫瑰花状皮炎作为一个并发症的治疗与他克莫司ointage.Observations：6名成人患者与炎症性面部皮肤病进行了治疗与他克莫司软膏，因为无效的标准治疗。在最初有效且耐受性良好的治疗的2至3周内，3名有酒渣鼻病史的患者和1名有痤疮病史的患者发生了脓疱性玫瑰状病变的突然恶化。活检显示，丰富的蠕形螨在这些患者中的2个。1例眼睑湿疹患者治疗3周后逐渐出现玫瑰花状眼周皮炎。在1例特应性皮炎，毛细血管扩张和丘疹性酒渣鼻不知不觉地出现后5个月的treatment.Conclusions：我们的观察表明，频谱玫瑰花状皮炎作为一个并发症与他克莫司软膏治疗是异质性的。各种因素，如他克莫司的血管活性，由于局部免疫抑制的蠕形螨的增殖，以及软膏的闭塞性，可能涉及所观察到的现象。未来的研究需要确定个体风险因素。
Background: Tacrolimus ointment is increasingly used for anti-inflammatory treatment of sensitive areas such as the face, and recent observations indicate that the treatment is effective in steroid-aggravated rosacea and perioral dermatitis. We report on rosaceiform dermatitis as a complication of treatment with tacrolimus ointment.Observations: Six adult patients with inflammatory facial dermatoses were treated with tacrolimus ointment because of the ineffectiveness of standard treatments. Within 2 to 3 weeks of initially effective and well-tolerated treatment, 3 patients with a history of rosacea and 1 with a history of acne experienced sudden worsening with pustular rosaceiform lesions. Biopsy revealed an abundance of Demodex mites in 2 of these patients. In 1 patient with eyelid eczema, rosaceiform periocular dermatitis gradually appeared after 3 weeks of treatment. In 1 patient with atopic dermatitis, telangiectatic and papular rosacea insidiously appeared after 5 months of treatment.Conclusions: Our observations suggest that the spectrum of rosaceiform dermatitis as a complication of treatment with tacrolimus ointment is heterogeneous. A variety of factors, such as vasoactive properties of tacrolimus, proliferation of Demodex due to local immunosuppression, and the occlusive properties of the ointment, may be involved in the observed phenomena. Future studies are needed to identify individual risk factors.