Wollina Uwe
Department of Dermatology and Allergology, Academic Teaching Hospital Dresden-Friedrichstadt, Dresden, Germany.
Am J Clin Dermatol. 2007;8(3):157-73. doi: 10.2165/00128071-200708030-00003.
The topical calcineurin inhibitors (TCIs) pimecrolimus and tacrolimus are approved for atopic dermatitis but have additional potential in other inflammatory skin diseases. This article reviews their clinical use in non-atopic dermatitis diseases. In seborrheic dermatitis, asteatotic eczema, and contact dermatitis, TCIs are of great benefit and can compete with topical corticosteroids. In psoriasis, TCIs have shown clinical efficacy and safety in facial and intertriginous lesions. Further investigations into possible combinations of TCIs with other established treatments such as UVB irradiation in this disorder are necessary. Initial studies in cutaneous lupus erythematosus have been promising, whereas the response in rosacea and rosacea-like eruptions has been mixed. TCIs have been associated with good clinical responses in oral lichen planus and anogenital lichen sclerosus et atrophicus. In vitiligo, TCIs are associated with some degree of repigmentation, with better results being seen in children and in facial and neck areas. TCIs have a synergistic effect with UVB irradiation in vitiligo. There is a long list of small series and case reports documenting use of TCIs in various other skin conditions that warrant further validation. Although the established mode of action of TCIs is T-cell control, other effects also need to be considered. Specifically, TCIs reduce pruritus and erythema, which cannot be explained by T-cell interactions, and further investigations are needed in these fields.
外用钙调神经磷酸酶抑制剂（TCIs）吡美莫司和他克莫司已被批准用于特应性皮炎，但在其他炎症性皮肤病中还有其他潜在用途。本文综述了它们在非特应性皮炎疾病中的临床应用。在脂溢性皮炎、乏脂性湿疹和接触性皮炎中，TCIs非常有益，可与外用糖皮质激素相媲美。在银屑病中，TCIs在面部和间擦部位皮损中已显示出临床疗效和安全性。有必要进一步研究TCIs与其他既定治疗方法（如该疾病中的紫外线B照射）的可能联合应用。皮肤红斑狼疮的初步研究前景良好，而酒渣鼻和酒渣鼻样皮疹的反应则好坏参半。TCIs在口腔扁平苔藓和硬化性萎缩性苔藓中已显示出良好的临床反应。在白癜风中，TCIs与一定程度的色素再生有关，儿童以及面部和颈部区域的效果更好。在白癜风中，TCIs与紫外线B照射有协同作用。有一长串小型系列研究和病例报告记录了TCIs在各种其他皮肤疾病中的应用，这些应用有待进一步验证。尽管TCIs既定的作用模式是控制T细胞，但也需要考虑其他作用。具体而言，TCIs可减轻瘙痒和红斑，而这无法用T细胞相互作用来解释，因此在这些领域需要进一步研究。
