Dr. Saltiel received his Pharm.D. from the University of California, San Francisco, in 1980, following undergraduate work at UCLA. At UCSF, he was the recipient of the Outstanding Service Award and the Bowl of Hygeia Award. He completed a residency in clinical pharmacy practice at the University of Illinois, in Chicago.
Jay W. Marks, MD, is a board-certified internist and gastroenterologist. He graduated from Yale University School of Medicine and trained in internal medicine and gastroenterology at UCLA/Cedars-Sinai Medical Center in Los Angeles.
DRUG CLASS AND MECHANISM: Tacrolimus ointment is a topical drug (a drug that is applied to the skin) that is used for the treatment of atopic dermatitis (eczema). Atopic dermatitis is a chronic (long-lasting) disease of skin in which the skin becomes inflamed, causing itchiness, redness, swelling, cracking, weeping, crusting, and scaling. The inflammation is caused by activation of the immune system though the reason for the activation is unknown. Tacrolimus ointment suppresses the immune system and the inflammation by inhibiting an enzyme (calcineurin) crucial for the multiplication of T-cells, cells that are required for activation of the immune system. Tacrolimus ointment was approved for the treatment of atopic dermatitis in December 2000.
PRESCRIPTION: Yes
GENERIC AVAILABLE: No
PREPARATIONS: Tacrolimus ointment is available in concentrations of 0.03 and 0.1%. The 0.1% concentration of tacrolimus ointment is approved for the treatment of adults, while the 0.03% concentration is approved for the short and long-term treatment of both children (ages two and older) and adults.
STORAGE: Tacrolimus should be stored at room temperature 15-30°C (59-86°F).
PRESCRIBED FOR: Tacrolimus ointment is used for the treatment of atopic dermatitis.
DOSING: Tacrolimus ointment is applied to the affected areas of skin twice daily.
DRUG INTERACTIONS: No studies have been done to determine if tacrolimus ointment has important interactions with other drugs. Interactions are unlikely because only small amounts of tacrolimus are absorbed from the skin; however, it still is possible that important interactions might occur.
PREGNANCY: Only small amounts of tacrolimus are absorbed from the ointment, and it is not known if these amounts are toxic to the fetus. Among women who have received oral tacrolimus while pregnant, high potassium levels and kidney injury have been reported in their newborns. Therefore, tacrolimus ointment should be used during pregnancy only if the benefits outweigh the potential risks to the fetus.
NURSING MOTHERS: Only small amounts of tacrolimus are absorbed from the ointment, and it is not known how much, if any, appears in breast milk. However, it is known that tacrolimus, when taken orally, passes into breast milk. Consideration should be given to discontinuing either breast feeding or tacrolimus ointment in nursing mothers.
SIDE EFFECTS: The most common side effects of tacrolimus ointment are skin reactions at the site of use, including burning and itching. Flu-like symptoms and headache also have been reported.
Eczema is a general term for many types dermatitis (skin inflammation). Atopic dermatitis is the most common of the many types of eczema. Other types of eczema include: contact eczema, allergic contact eczema, seborrheic eczema, nummular eczema, stasis dermatitis, and. dyshidrotic eczema.
Keratosis pilaris (KP) is a common skin disorder in which small white or red bumps appear around hair follicles on the upper arms, thighs, buttocks, and cheeks. The cause of KP is unknown. There is no cure for keratosis pilaris, and the condition may resolve on its own. Gentle exfoliation, professional manual extraction, chemical peels, and microdermabrasion, along with topical products, are the best treatments for this condition.
Lichen sclerosus is a skin disease that causes white spots to form on the skin, which later grow into large, thin, and crinkled patches of skin that tear easily. Symptoms include itching, pain, blisters, and bleeding. Patches on the upper body usually go away over time, but patches in the genital region may scar if left untreated, causing problems with urination or sex. Treatment may involve surgery or the use of a very strong cortisone cream.
Lichen sclerosus is a long-term problem of the skin. It mostly affects the
genital and anal areas. Sometimes, lichen sclerosus appears on the upper body,
breasts, and upper arms.
Who gets lichen sclerosus?
Lichen sclerosus appears in:
Women (often after menopause)
Men (uncommon)
Children (rare).
What are the symptoms?
Early in the disease, small white spots appear on the skin. The spots are
usually shiny and smooth. Later, the spots grow into bigger patches. The skin on
the patches becomes thin and crinkled. Then the skin tears easily, and bright
red or purple bruises are common. Sometimes, the skin becomes scarred. If the
disease is a mild case, there may be no symptoms.
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