Allergic contact dermatitis from tacrolimus
Allergic contact dermatitis from tacrolimus
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DOI：
10.1016/j.jaad.2003.09.013
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发表时间：
2004-06-01
影响因子：
13.8
通讯作者：
Maibach, HI
中科院分区：
文献类型：
--
作者：
Shaw, DW;Eichenfield, LF;Maibach, HI
一名9岁男童因使用他克莫司软膏而发生过敏性接触性皮炎。他克莫司软膏0.1%与非活性溶剂每日两次应用于正常耳前和肘前皮肤的右与左双盲激发使用试验证明他克莫司是过敏原。1周后出现面部皮炎，7周后出现肘前皮炎。此外，仅他克莫司的每种成分的斑贴试验呈阳性;需要2.5%的乙醇浓度。40名对照患者用5%他克莫司乙醇溶液进行斑贴试验，结果为阴性。我们假设，引起手臂上的阳性使用试验所需的异常长的时间和背部所需的高斑贴试验浓度是由正常面外皮肤的低经皮吸收引起的。这可能部分是由他克莫司的高分子量引起的。当用硫酸新霉素进行斑贴试验时，可能会出现类似的现象。
A 9-year-old boy developed allergic contact dermatitis from tacrolimus ointment. Tacrolimus was proven to he the allergen by right-versus-left double-blinded provocative use testing of tacrolimus ointment 0.1% versus inactive vehicle applied twice daily to normal preauricular and antecubital skin. Facial dermatitis appeared after 1 week and antecubital dermatitis after 7 weeks. Furthermore, patch testing of each individual ingredient was positive only with tacrolimus; a concentration of 2.5% in ethanol was required. Forty control patients had negative patch tests with tacrolimus 5% in ethanol. We hypothesize that the unusually long time required to elicit a positive use test on the arm and the high patch test concentration required on the back are caused by low percutaneous absorption through normal extrafacial skin. This is likely to be caused in part by the high molecular weight of tacrolimus. A similar phenomenon May Occur when patch testing with neomycin sulfate.