Russell John J
Family Practice Residency Program, Abington Memorial Hospital, Abington, Pennsylvania, USA.
Am Fam Physician. 2002 Nov 15;66(10):1899-902.
Atopic dermatitis is a common problem affecting up to 10 percent of all children. The mainstays of therapy have been oral antihistamines, topical emollients, topical doxepin, and topical corticosteroids. Side effects associated with higher potency topical corticosteroids have limited their use in children and for facial areas. Tacrolimus (Protopic) is an immunosuppressive agent typically used systemically in transplant patients. Used topically, it has been found to be effective in treating moderate to severe atopic dermatitis without causing the atrophy that might occur with prolonged use of topical corticosteroids. Tacrolimus works equally well in children and adults, with more than two thirds of both groups having an improvement of greater than 50 percent. Despite its potency, very little of the medication is systemically absorbed, and absorption decreases as the atopic dermatitis resolves. The main side effects are burning and itching, but these also decrease with improvement of the atopic dermatitis.
特应性皮炎是一个常见问题，影响着高达10%的儿童。治疗的主要方法一直是口服抗组胺药、外用润肤剂、外用多塞平以及外用糖皮质激素。强效外用糖皮质激素相关的副作用限制了它们在儿童和面部区域的使用。他克莫司（普特彼）是一种免疫抑制剂，通常用于移植患者的全身治疗。局部使用时，已发现它在治疗中度至重度特应性皮炎方面有效，且不会导致长期使用外用糖皮质激素可能出现的萎缩。他克莫司在儿童和成人中效果相同，两组中超过三分之二的患者病情改善超过50%。尽管其效力强，但该药物很少被全身吸收，并且随着特应性皮炎的缓解，吸收会减少。主要副作用是烧灼感和瘙痒，但随着特应性皮炎的改善，这些症状也会减轻。
