Schliemann Sibylle, Kelterer Daniela, Bauer Andrea, John Swen M, Skudlik Christoph, Schindera Ingo, Wehrmann Wolfgang, Elsner Peter
Department of Dermatology, Friedrich-Schiller-University, D-07740 Jena, Germany.
Contact Dermatitis. 2008 May;58(5):299-306. doi: 10.1111/j.1600-0536.2007.01314.x.
Occupational hand dermatitis (OHD) is a common and often chronic condition. Usage of topical corticosteroids is limited in long-term therapy because of potential side-effects. New treatment options are highly appreciated.
To study efficacy and safety of tacrolimus in patients suffering from OHD.
In a prospective, open, multicentre study, 29 patients with OHD of predominantly mild-to-moderate severity were treated with tacrolimus ointment (Protopic 0.1%) during a 4-week active treatment period with twice daily application followed by a 2-month optional treatment period. Efficacy was evaluated by the use of a standardized hand eczema score and by clinical severity rating, conducted on all study visits (screening, baseline and weeks 2, 4, 6, and 12). Adverse events were recorded for safety evaluation.
The hand eczema score declined significantly after 2 weeks of treatment compared with baseline and further declined until the end of the study. Finally, 12 (44%) patients were clear of hand eczema. Worsening of the dermatitis occurred in 2 patients (7%). Clinical grading indicated improvement too. Overall tolerability was good.
Topical tacrolimus might be an efficacious treatment option for chronic OHD. Blinded and randomized controlled studies are necessary to confirm the results of this pilot study.
职业性手部皮炎(OHD)是一种常见且通常为慢性的病症。由于存在潜在副作用,局部使用皮质类固醇在长期治疗中的应用受到限制。新的治疗选择备受期待。
研究他克莫司治疗职业性手部皮炎患者的疗效和安全性。
在一项前瞻性、开放性、多中心研究中,29例主要为轻至中度严重程度的职业性手部皮炎患者在为期4周的积极治疗期内,每日两次外用他克莫司软膏(普特彼0.1%),随后为2个月的可选治疗期。在所有研究访视(筛查、基线以及第2、4、6和12周)时,通过使用标准化手部湿疹评分和临床严重程度评级来评估疗效。记录不良事件以进行安全性评估。
与基线相比,治疗2周后手部湿疹评分显著下降,并持续下降直至研究结束。最终,12例(44%)患者手部湿疹痊愈。2例(7%)患者出现皮炎加重。临床分级也显示有改善。总体耐受性良好。
外用他克莫司可能是慢性职业性手部皮炎的一种有效治疗选择。需要进行盲法和随机对照研究以证实本初步研究的结果。