Wollina U, Hansel G
Department of Dermatology and Allergology, Academic Teaching Hospital Dresden-Friedrichstadt, Dresden, Germany.
J Eur Acad Dermatol Venereol. 2008 Jan;22(1):1-6. doi: 10.1111/j.1468-3083.2007.02427.x. Epub 2007 Nov 12.
Lupus erythematosus (LE) shows a broad range of cutaneous symptoms, including acute, subacute and chronic lesions. The gold standard of established topical treatment consists of medium- to high-potency corticosteroids. Because face and neck are often involved, adverse effects of prolonged corticosteroid use are not uncommon. There is a need of steroid-free topical treatment in LE. With the development of topical calcineurin inhibitors, tacrolimus and pimecrolimus, there is an alternative available. The present study reviews the literature data on topical tacrolimus and pimecrolimus for malar rash, subacute lesions and discoid chronic lesions among others. The present data argue for an efficacy of these compounds in acute and subacute cutaneous LE manifestations with a rapid response and only minor side-effects when used as an adjunct to systemic treatment. In chronic discoid LE, hypertrophic plaques do not well respond because of limited penetration. The primary target seems to be the decrease or blocking of cytokine production by activated T lymphocytes.
红斑狼疮（LE）表现出广泛的皮肤症状，包括急性、亚急性和慢性病变。既定局部治疗的金标准包括中效至高效皮质类固醇。由于面部和颈部常受累，长期使用皮质类固醇的不良反应并不罕见。红斑狼疮需要无类固醇的局部治疗。随着局部钙调神经磷酸酶抑制剂他克莫司和吡美莫司的发展，有了一种替代方法。本研究回顾了关于局部使用他克莫司和吡美莫司治疗颧部皮疹、亚急性病变和盘状慢性病变等的文献数据。目前的数据表明，这些化合物在急性和亚急性皮肤红斑狼疮表现中有效，反应迅速，作为全身治疗的辅助用药时仅有轻微副作用。在慢性盘状红斑狼疮中，由于穿透有限，肥厚性斑块反应不佳。主要靶点似乎是减少或阻断活化T淋巴细胞产生细胞因子。
