外用吡美莫司治疗人类过敏性接触性皮炎。

Topical pimecrolimus in the treatment of human allergic contact dermatitis.

作者信息

Amrol David, Keitel Duane, Hagaman David, Murray John

机构信息

Vanderbilt University, Nashville, Tennessee, USA.

出版信息

Ann Allergy Asthma Immunol. 2003 Dec;91(6):563-6. doi: 10.1016/S1081-1206(10)61535-9.

DOI:10.1016/S1081-1206(10)61535-9

PMID:14700441

Abstract

BACKGROUND

Contact dermatitis is a common clinical problem, with prevalent sensitizers being cosmetics, metals, medicines, and plants. Plants of the Toxicodendron species cause allergic contact dermatitis (ACD) in 50% to 70% of the population. Pimecrolimus is an ascomycin macrolactam developed for the treatment of inflammatory skin diseases and approved by the US Food and Drug Administration for atopic dermatitis. There are studies supporting the effectiveness of macrolactams when administered before antigen challenge, but there are no studies describing the effectiveness of these drugs in the treatment of established human ACD.

OBJECTIVE

To investigate the effect of topical pimecrolimus in the treatment of Toxicodendron-induced ACD once rash is evident.

METHODS

Poison ivy tincture was applied to the bilateral anterior forearms of 12 subjects with Finn Chambers (Allerderm Diagnostic Products, Petaluma, CA). After dermatitis was evident, volunteers treated each arm twice daily with either 1% topical pimecrolimus cream or placebo in a blinded fashion. Outcomes measured were a dermatitis grading score and time to rash and itch resolution.

RESULTS

The median +/- SEM time for rash resolution was 16.55 +/- 1.59 days in the treatment group and 16.27 +/- 1.82 days in the placebo group (P = 0.601). The median time for itch resolution was 4.73 +/- 1.56 days in the treatment group and 4.91 +/- 1.59 days in the placebo group (P = 0.167). The average dermatitis score was 2.26 +/- 0.17 in the treatment group and 2.32 +/- 0.15 in the placebo group (P = 0.62).

CONCLUSIONS

The application of topical pimecrolimus is ineffective in the treatment of ongoing Toxicodendron-induced ACD.

摘要

背景

接触性皮炎是常见的临床问题，常见的致敏原包括化妆品、金属、药物和植物。毒漆树属植物可导致50%至70%的人群发生过敏性接触性皮炎（ACD）。吡美莫司是一种子囊霉素大环内酯类药物，用于治疗炎症性皮肤病，已获美国食品药品监督管理局批准用于特应性皮炎。有研究支持大环内酯类药物在抗原激发前给药的有效性，但尚无研究描述这些药物在治疗已确诊的人类ACD中的有效性。

目的

探讨皮疹出现后外用吡美莫司治疗毒漆树所致ACD的效果。

方法

将毒漆树酊剂涂于12名受试者双侧前臂的Finn Chambers（Allerderm诊断产品公司，加利福尼亚州佩塔卢马）上。皮炎明显后，志愿者以盲法每天两次用1%外用吡美莫司乳膏或安慰剂治疗每只手臂。测量的结果为皮炎分级评分以及皮疹和瘙痒消退时间。

结果

治疗组皮疹消退的中位时间（±SEM）为16.55±1.59天，安慰剂组为16.27±1.82天（P = 0.601）。治疗组瘙痒消退的中位时间为4.73±1.56天，安慰剂组为4.91±1.59天（P = 0.167）。治疗组的平均皮炎评分为2.26±0.17，安慰剂组为2.32±- 0.15（P = 0.62）。