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Topical Ointment

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3801. Efficacy and safety of combination ointment "fluticasone propionate 0.005% plus mupirocin 2.0%" for the treatment of atopic dermatitis with clinical suspicion of secondary bacterial infection: an open label uncontrolled study. (Abstract)

analog scale (VAS). However, after the treatment, this proportion increased to 51.77% and 78.60% patients on day 8 and on day 15 respectively.Twice daily topical application of a fluticasone propionate 0.005% and mupirocin 2.0% ointment is an effective and safe therapeutic regimen in atopic dermatitis. (...) Efficacy and safety of combination ointment "fluticasone propionate 0.005% plus mupirocin 2.0%" for the treatment of atopic dermatitis with clinical suspicion of secondary bacterial infection: an open label uncontrolled study. The skin of patients with atopic dermatitis is colonized with Staphylococcus aureus. Reduction of bacterial colonization has been reported to be effective in the treatment of atopic dermatitis.To assess the efficacy and safety of a combination of fluticasone propionate

2006 Indian journal of dermatology, venereology and leprology

3802. A comparison of twice-daily calcipotriol ointment with once-daily short-contact dithranol cream therapy: quality-of-life outcomes of a randomized controlled trial of supervised treatment of psoriasis in a day-care setting. (Abstract)

A comparison of twice-daily calcipotriol ointment with once-daily short-contact dithranol cream therapy: quality-of-life outcomes of a randomized controlled trial of supervised treatment of psoriasis in a day-care setting. Calcipotriol ointment and short-contact dithranol cream therapy are well-established topical treatments for psoriasis. Quality of life, i.e. the physical, psychological, and social functioning and well-being of the patient, has become an essential outcome measure in chronic (...) skin disease.To compare the quality-of-life outcomes of calcipotriol ointment with that of short-contact dithranol cream in a supervised treatment regimen, and to determine the degree of improvement in quality of life these topical treatments can accomplish.In a multicentre randomized controlled trial in six centres in the Netherlands, 106 patients with chronic plaque psoriasis were included, 54 receiving calcipotriol ointment twice daily and 52 dithranol cream once daily in a 12-week intensive

2008 The British journal of dermatology Controlled trial quality: uncertain

3803. Three times weekly tacrolimus ointment reduces relapse in stabilized atopic dermatitis: a new paradigm for use. Full Text available with Trip Pro

Three times weekly tacrolimus ointment reduces relapse in stabilized atopic dermatitis: a new paradigm for use. Long-term, safe and effective therapeutic options for managing the chronic relapsing nature of atopic dermatitis are essential for improving patient quality of life. To minimize the risks of continued topical corticosteroid usage and potentially reduce the incidence of flares, we tested the efficacy and safety of a rotational paradigm of initial brief application of topical (...) corticosteroid followed by long-term intermittent application of non-steroidal tacrolimus ointment to previously inflamed sites of dermatitis.In this 2-phase study, patients who were 2 to 15 years of age and had moderate to severe atopic dermatitis were randomly assigned to 4 days of twice-daily double-blind therapy with either alclometasone ointment 0.05% or tacrolimus ointment 0.03% (Phase I acute), followed by up to 16 weeks of twice-daily open-label tacrolimus ointment 0.03% (Phase I short-term

2008 Pediatrics Controlled trial quality: uncertain

3804. Tacrolimus 0.1% Ointment: Is It Really Effective in Plasma Cell Vulvitis?. Report of Four Cases. (Abstract)

Tacrolimus 0.1% Ointment: Is It Really Effective in Plasma Cell Vulvitis?. Report of Four Cases. Plasma cell vulvitis is a clinically and histologically well-characterized chronic disease that usually relapses after various topical therapies. Considering the inflammatory nature of the disease, the new topical calcineurin inhibitors have been also employed successfully in few cases of Zoon's balanitis, the corresponding male condition.The aim of our study is to evaluate the effectiveness (...) of tacrolimus ointment in a small group of plasma cell vulvitis sufferers.4 women affected by biopsy-proved plasma cell vulvitis were enrolled, after informed consent. The topical drug was applied twice daily for 6 weeks, then tapered on the basis of the clinical results. Symptoms and objective parameters were obtained periodically at the beginning, after 6 weeks and up to the end of the topical treatment. A final biopsy was performed in 3 out of our 4 patients. The follow-up is still ongoing.The

2008 Dermatology

3805. Vasodilative effect of isosorbide dinitrate ointment in complex regional pain syndrome type 1. Full Text available with Trip Pro

Vasodilative effect of isosorbide dinitrate ointment in complex regional pain syndrome type 1. In complex regional pain syndrome type 1 (CRPS1) vascular changes occur from the initial, inflammatory event onto the trophic signs during chronicity of the disease, resulting in blood flow disturbances and marked temperature changes. Pharmacotherapeutic treatment is generally inadequate.To determine whether local application of the nitric oxide donor isosorbide dinitrate (ISDN) could cause (...) vasodilation and thereby improve tissue blood distribution in the affected extremity.In a pilot study, 5 female patients with CRPS1 in one hand were treated with ISDN ointment 4 times daily during 10 weeks. As a primary objective videothermography was used to monitor changes in blood distribution in both the involved and contralateral extremities.Patients treated with ISDN showed an increase of 4 degrees C to 6 degrees C in mean skin temperature of the cold CRPS1 hands, reaching values similar

2008 Clinical Journal of Pain

3806. Pharmacokinetics of 0.1% tacrolimus ointment after first and repeated application to adults with moderate to severe atopic dermatitis. Full Text available with Trip Pro

). Peak concentrations after first ointment application were ointment applications. Both the rate and extent of topical absorption decreased as the skin lesions healed. (...) Pharmacokinetics of 0.1% tacrolimus ointment after first and repeated application to adults with moderate to severe atopic dermatitis. The systemic exposure to tacrolimus after first and repeated application of 0.1% tacrolimus ointment was investigated in 32 adults with moderate to severe atopic dermatitis. Patients were allocated to treatment groups according to the size of the affected area to be treated: Group 13000 cm(2)6000 cm(2

2005 Journal of Investigative Dermatology

3807. Therapeutic Effects of Tacrolimus Ointment for Refractory Ocular Surface Inflammatory Diseases. (Abstract)

Therapeutic Effects of Tacrolimus Ointment for Refractory Ocular Surface Inflammatory Diseases. To investigate the therapeutic effects of topical tacrolimus ointment on refractory ocular surface inflammatory diseases.Retrospective interventional consecutive case series.Ten consecutive patients with severe ocular surface inflammatory diseases who were suspected to be steroid responders (elevation of intraocular pressure [IOP]) or were refractory to standard steroid therapy were studied. One (...) patient had peripheral ulcerative keratitis with impending corneal perforation, 1 had a Mooren's ulcer, 2 had scleroperikeratitis, 5 had atopic keratoconjunctivitis, and 1 had vernal keratoconjunctivitis.The clinical findings and therapeutic responses after treatment with 0.02% topical tacrolimus ointment were determined by conventional ophthalmological examinations.Resolution of the ocular surface diseases (e.g., decrease of hyperemia, ulceration, size of papillae) and IOP. The necessity to use

2007 Ophthalmology

3808. Detection of IgE antibodies to bacitracin using a commercially available streptavidin-linked solid phase in a patient with anaphylaxis to triple antibiotic ointment. (Abstract)

Detection of IgE antibodies to bacitracin using a commercially available streptavidin-linked solid phase in a patient with anaphylaxis to triple antibiotic ointment. Bacitracin is a commonly used topical antibiotic that has on occasion been reported to cause anaphylaxis. Evidence of the role of bacitracin specific IgE in such reactions has been demonstrated by skin testing. Because of the potential for provoking a systemic reaction by skin testing, it would be advantageous to develop (...) an in vitro test for bacitracin specific IgE.To report our experience coupling bacitracin to a solid phase and using it to detect specific IgE to bacitracin by fluorescent enzyme immunoassay.A patient with a history of recurrent anaphylaxis that developed after application of triple antibiotic ointment to an open wound underwent skin testing with triple antibiotic ointment. Bacitracin was biotinylated and coupled to streptavidin ImmunoCAPs. IgE against bacitracin in the patient's serum was detected

2007 Asthma & Immunology

3809. The safety of tacrolimus ointment for the treatment of atopic dermatitis: a review. (Abstract)

The safety of tacrolimus ointment for the treatment of atopic dermatitis: a review. Tacrolimus ointment is a topical calcineurin inhibitor (TCI) that was developed specifically for the treatment of atopic dermatitis (AD). It is one of the most extensively tested dermatological products, with more than 19 000 patients (including approximately 7600 children) having participated in the tacrolimus ointment clinical development programme. Recent regulatory reviews have focused on the potential risk (...) of malignancy with TCIs, based on their mode of action and the effects of systemic tacrolimus when given to transplant recipients. Studies have shown, however, that the systemic absorption of tacrolimus when applied topically is very low, with blood concentrations being below the level of quantification in most patients. Moreover, TCIs are not associated with a decrease in immunocompetence in the skin and there is no increase in the incidence of infections with long-term treatment. More than 5.4 million

2007 British Journal of Dermatology

3810. Wet-wrap treatment using dilutions of tacrolimus ointment and fluticasone propionate cream in human APOC1 (+/+) mice with atopic dermatitis. (Abstract)

Wet-wrap treatment using dilutions of tacrolimus ointment and fluticasone propionate cream in human APOC1 (+/+) mice with atopic dermatitis. Wet-wrap treatment (WWT) with diluted topical steroids is widely used in atopic dermatitis (AD). Mice with transgenic overexpression of human apolipoprotein C1 (APOC1) in the liver and the skin are not only characterized by hyperlipidaemia and raised IgE levels, but also by pruritic dermatitis and a disturbed skin barrier function, providing a novel (...) in vivo mouse model for AD.We investigated an adapted WWT method in the AD model in APOC1 mice in order to establish its efficacy.The effect of topical 0.1% and 0.03% tacrolimus ointment, tacrolimus base ointment, different dilutions of 0.05% fluticasone propionate (FP) cream and emollient on the development of dermatitis in APOC1 mice was investigated. WWT was performed with 0.03% tacrolimus ointment or 0.017% FP cream.AD in APOC1 mice responded to topical treatment with tacrolimus or FP. In contrast

2008 British Journal of Dermatology

3811. Successful treatment of perforating granuloma annulare with 0.1% tacrolimus ointment. (Abstract)

Successful treatment of perforating granuloma annulare with 0.1% tacrolimus ointment. Perforating granuloma annulare (PGA) is a rare subtype of granuloma annulare (GA) named in 1971 by Owens and Freeman. It is characterized by necrobiotic areas surrounded by histiocytes and lymphocytes with transepidermal elimination. Many treatments for PGA have been used, often with unsatisfactory results. Tacrolimus in its topical formulation has been established as a safe and effective alternative (...) to topical corticosteroids because of its mild side effects and its minimal systemic absorption. Topical tacrolimus has been approved for the treatment of atopic dermatitis; moreover, ample data exist which demonstrate the usefulness of tacrolimus for the specific treatment of other inflammatory diseases. We report a 70-year-old diabetic woman with PGA, in whom the ulceration due to PGA responded to 0.1% topical tacrolimus.

2008 Journal of Dermatological Treatment

3812. Tacrolimus ointment causes inflammatory dendritic epidermal cell depletion but no Langerhans cell apoptosis in patients with atopic dermatitis. (Abstract)

Tacrolimus ointment causes inflammatory dendritic epidermal cell depletion but no Langerhans cell apoptosis in patients with atopic dermatitis. The topical immunomodulators tacrolimus and pimecrolimus are novel therapeutic options for atopic dermatitis (AD). The inhibition of nuclear factor of activated T cell-dependent proinflammatory cytokine production in cutaneous lymphocytes is an established effect of topical immunomodulators, which additionally influence mast cells, eosinophils (...) , and dendritic cells (DCs). The latter include a reduced expression of the high-affinity IgE receptor FcepsilonRI, a reduced stimulatory capacity of lesional DCs, and a selective depletion of the inflammatory dendritic epidermal cells (IDECs) but not of Langerhans cells (LCs) from the lesional skin.Because induction of apoptosis in lymphocytes is a reported tacrolimus effect, we asked whether tacrolimus ointment induces apoptosis of LCs or IDECs in AD lesions.Epidermal single-cell suspensions were prepared

2004 Journal of Allergy and Clinical Immunology

3813. Contact dermatitis with clostridiopeptidase A contained in Noruxol ointment. (Abstract)

Contact dermatitis with clostridiopeptidase A contained in Noruxol ointment. Clostridiopeptidase A, also called collagenase 1, is a proteolytic enzyme capable of digesting collagen. Preparations containing clostridiopeptidase A are used topically for the debridement of dermal ulcers, burns and other necrotic lesions to facilitate the formation of granulation tissue and subsequent epithelization. We observed 4 patients with a periulcerative eczema after repeated applications of Noruxol ointment (...) (Smith & Nephew Ltd, L Hull, UK). Patch testing with Noruxol ointment as is and its excipients (soft paraffin and white petrolatum), as well as scaled dilutions of the main ingredient of this topical preparation, clostridiopeptidase A (Firma, Florence, Italy), showed doubtful reactions to Noruxol ointment in 3 patients and a positive reactions only in 1 patient. All patients showed positive reactions to clostridiopeptidase A 1% in pet. This study shows the sensitizing capacity of clostridiopeptidase

2007 Contact Dermatitis

3814. Efficacy and safety of tacrolimus ointment 0.03% treatment in a 1-month-old "red baby": a case report. (Abstract)

Efficacy and safety of tacrolimus ointment 0.03% treatment in a 1-month-old "red baby": a case report. Several trials have indicated that topical tacrolimus is safe and effective for several immunologic-based skin disorders. We report a child <2 months old, who was admitted to our pediatric department because of generalized erythroderma. We started tacrolimus ointment 0.03% therapy by applying the ointment to the skin once daily, on a limited surface of 10 cm(2), changing the skin areas only (...) to the treatment was good. We conclude that 0.03% tacrolimus ointment is efficacious and safe even in an infant <2 months of age.

2006 Allergy and Asthma Proceedings

3815. Tacrolimus ointment promotes repigmentation of vitiligo in children: a review of 57 cases. (Abstract)

Tacrolimus ointment promotes repigmentation of vitiligo in children: a review of 57 cases. Vitiligo is an autoimmune disorder characterized by loss of pigmentation. Phototherapy and application of topical corticosteroids are most commonly prescribed. However, these therapies are often not effective and use of corticosteroids on the face may lead to cutaneous atrophy, telangiectasia, and ocular complications.We sought to assess the efficacy of topical tacrolimus ointment in the treatment (...) of pediatric vitiligo.A retrospective review was performed of 57 pediatric patients with vitiligo at two clinical sites. Patients were treated with tacrolimus ointment for at least 3 months. Clinical responses were documented during clinic visits, and by pretacrolimus and posttacrolimus photography.At least partial response was noted to tacrolimus ointment on the head and neck in 89%, and on the trunk and extremities in 63% of patients. Facial vitiligo of the segmental type showed the best response rate

2004 Journal of American Academy of Dermatology

3816. The efficacy and safety of tacrolimus ointment: a clinical review. (Abstract)

The efficacy and safety of tacrolimus ointment: a clinical review. Topical tacrolimus ointment was approved for the treatment of atopic dermatitis in Japan in 1999, the United States in 2000, and Europe in 2001. The safety and efficacy of tacrolimus ointment was established in vehicle-controlled, randomized, 12-week clinical trials; 1-year open-label trials; and comparative studies with topical steroids. Although an extensive database exists on the safety and efficacy of tacrolimus ointment (...) based on the global development program, clinicians desire additional information on the long-term safety and efficacy of this novel agent. In this supplement, additional studies are reported that extend the safety and efficacy profile of tacrolimus ointment in patients with atopic dermatitis, including long-term safety studies for up to 4 years. The studies presented in this supplement address important questions regarding the selection and use of tacrolimus ointment in the treatment of patients

2005 Journal of American Academy of Dermatology

3817. Pneumococcal seroconversion after vaccination for children with atopic dermatitis treated with tacrolimus ointment. (Abstract)

Pneumococcal seroconversion after vaccination for children with atopic dermatitis treated with tacrolimus ointment. We sought to determine the effect of treatment with topical tacrolimus on B- and T-cell immunity including the primary antibody response to pneumococcal polysaccharide vaccine in children with atopic dermatitis.In this open-label, noncomparative study, 23 children aged 2 to 12 years with moderate to severe atopic dermatitis were treated with tacrolimus 0.03% ointment twice daily (...) , immunoglobulin levels, antibody titers to tetanus and Haemophilus influenzae , or lymphoproliferative responses were noted during the tacrolimus ointment treatment period. Tacrolimus blood levels were 1 ng/mL or less in all 23 children. Protective pneumococcal titers to all 12 serotypes were observed in 2 of 23 (9%) children prevaccination and in 16 of 23 (70%) children postvaccination. All 6 children who had protective titers to 0 to 5 of the 12 serotypes developed protective titers to an additional 5 to 11

2005 Journal of American Academy of Dermatology

3818. Treatment of eosinophilic pustular folliculitis with tacrolimus ointment. (Abstract)

Treatment of eosinophilic pustular folliculitis with tacrolimus ointment. We describe a patient with eosinophilic pustular folliculitis who partially responded to oral indomethacin, but intermittently experienced new eosinophilic pustular folliculitis lesions. Treatment with tacrolimus ointment 0.1% resulted in the rapid improvement of each recurred lesion and allowed withdrawal of indomethacin. To our knowledge, this is the first report of the use of topical tacrolimus in the treatment

2004 Journal of American Academy of Dermatology

3819. Localized childhood vulval pemphigoid treated with tacrolimus ointment. (Abstract)

cicatricial pemphigoid, although the autoantigen(s) involved could not be characterized. Her disease responded to treatment with topical tacrolimus ointment 0.1% within 3 months without any evidence for disease activity, except for slight residual scarring. After 12 months, her treatment was stopped without relapse.This observation suggests that in this rare immune-mediated blistering disease topical tacrolimus is an interesting therapeutic option without the adverse effects associated with topical (...) Localized childhood vulval pemphigoid treated with tacrolimus ointment. Localized vulval childhood pemphigoid is a rare variant within the pemphigoid group. Although its prognosis seems favorable, the best therapeutic strategy remains unclear.We here describe the case of an 8-year-old girl presenting with a 5-year history of relapsing vulval pain and lesions suggestive of lichen sclerosus. Clinical features, light microscopy and direct immunofluorescence microscopy were consistent with vulval

2004 Dermatology

3820. Quality of life in patients with atopic dermatitis: impact of tacrolimus ointment. (Abstract)

Quality of life in patients with atopic dermatitis: impact of tacrolimus ointment. Atopic dermatitis (AD), a significant problem in Japan, has a major impact on health-related quality of life (QOL). The development of steroid phobia in patients with AD may restrict the therapeutic options available to these patients. Tacrolimus ointment is a safe and effective nonsteroid treatment for AD. It may be an appropriate alternative for patients with AD and steroid phobia. The aim of this study (...) was to determine the impact of AD on QOL and to investigate the effect of tacrolimus ointment on QOL in patients with steroid phobia.Firstly, QOL scores were investigated in patients with AD and steroid phobia using the World Health Organization Quality of Life instrument, WHOQOL-26, and were compared with QOL scores from a previous study in volunteers from Tokyo, Japan. Secondly, patients with steroid phobia received tacrolimus ointment treatment for 12 weeks. Quality of life scores were assessed using WHOQOL

2006 International Journal of Dermatology

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