Baldo A, Prizio E, Mansueto G, Somma P, Monfrecola G
Department of Systematic Pathology, Section of Dermatology, University Federico II, Napoli, Italy.
J Dermatolog Treat. 2005;16(4):245-8. doi: 10.1080/09546630500281965.
The treatment of chronic actinic dermatitis (CAD), a sun-induced disorder characterized by a persistent eczematous eruption, involves photoprotective measures, topical corticosteroid therapy and, in more severe cases, systemic immunosuppression. The potential side effects of systemic immunosuppressant drugs prompted us to evaluate the efficacy of topical tacrolimus for treatment of CAD. PATIENT AND TREATMENT: A 58-year-old man with CAD, resistant to previous treatment with topical and systemic corticosteroids, oral cyclosporine and PUVA-photochemotherapy, was treated with tacrolimus ointment 0.1% once a day.
Tacrolimus ointment led to significant improvement of pruritus and severe eczematous skin lesions after 20 days of treatment.
Tacrolimus shows a beneficial effect on CAD; this could be attributed to the fact that CAD is characterized by a lymphohistiocytic infiltrate producing a chronic eczema and that tacrolimus blocks the activation of lymphocytes and other immune system cells, also inhibiting the release of mediators from cutaneous mast cells and basophils.
慢性光化性皮炎（CAD）是一种由阳光引起的疾病，其特征为持续性湿疹样皮疹，治疗方法包括光防护措施、外用糖皮质激素治疗，在病情更严重的情况下，还包括全身免疫抑制治疗。全身免疫抑制药物的潜在副作用促使我们评估外用他克莫司治疗CAD的疗效。
一名58岁的CAD男性患者，对先前外用和全身使用糖皮质激素、口服环孢素及补骨脂素加紫外线A光化学疗法（PUVA）治疗均耐药，接受0.1%他克莫司软膏每日一次治疗。
治疗20天后，他克莫司软膏使瘙痒及严重的湿疹样皮肤损害有显著改善。
他克莫司对CAD有有益作用；这可能归因于CAD的特征是淋巴细胞组织细胞浸润导致慢性湿疹，且他克莫司可阻断淋巴细胞和其他免疫系统细胞的活化，还可抑制皮肤肥大细胞和嗜碱性粒细胞释放介质。
