Which medications in the drug class Calcineurin Inhibitors are used in the treatment of Vesicular Palmoplantar Eczema?

Updated: Aug 23, 2019
  • Author: Jessica Dunkley, MD, MHSc, CCFP; Chief Editor: Dirk M Elston, MD  more...
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Answer

Calcineurin Inhibitors

Topical immunosuppressive agents, such as tacrolimus, have been successfully used to decrease the severity of chronic palmar eczema. These drugs may be used as steroid-sparing agents.

Tacrolimus topical (Protopic)

Tacrolimus topical reduces itching and inflammation by suppressing the release of cytokines from T cells; it inhibits transcription for genes that encode IL-3, IL-4, IL-5, GM-CSF, and TNF-alpha (all involved in early T-cell activation). Tacrolimus topical may inhibit the release of preformed mediators from skin mast cells and basophils; it may down-regulate FCeRI expression on Langerhans cells. It can be used in patients as young as 2 years. Drugs of this class more expensive than topical corticosteroids.  Tacrolimus is available in an ointment formulation.

Pimecrolimus (Elidel)

Pimecrolimus is a calcineurin inhibitor that has an anti-inflammatory effect through decreasing cytokine production. It leads to decreased expression of IL-3, IL-4, IL-5, and TNFα, and it inhibits mast cell and neutrophil activation. It is available in a cream formulation.


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