tailieunhanh - Mild-to-Moderate Psoriasis - part 10

Tacrolimus tại chỗ cung cấp tiềm năng cho một tác dụng chống viêm, trong khi tránh teo và phun trào acneiform thường liên quan với việc sử dụng corticosteroids tại chỗ (48). Một số nghiên cứu đã chỉ ra những lợi ích của tacrolimus cho bệnh vẩy nến trên khuôn mặt và intertriginous | 254 Berthelot et al. and facial areas their side effects may mitigate use in these areas. Topical tacrolimus offers the potential for an anti-inflammatory effect while avoiding the atrophy and acneiform eruptions commonly associated with the use of topical corticosteroids 48 . Several studies have shown the benefits of tacrolimus for facial and intertriginous psoriasis 49 50 . One study showed excellent improvement at the end of an eight-week treatment period with of the tacrolimus ointment group versus of the vehicle group giving a clear or almost clear response 50 . Adverse events were similar in the tacrolimus ointment and vehicle groups. In a study of pimecroli-mus in 57 patients with moderate to severe inverse psoriasis 54 of the pimecrolimus group versus 21 of the placebo group had an Investigator s Global Assessment score of 0 or 1 clear or almost clear at week 2 51 . By week 8 71 of the pimecrolimus group had an Investigator s Global Assessment score of 0 or 1. Pimecrolimus was safe and well-tolerated with adverse events similar between groups. Topical tacrolimus and pimecrolimus are ineffective for standard plaque psoriasis. Safety Recently concern has been raised due to the development of tumors associated with these agents. Nine cases of tumor adverse events and 21 cases of tumor adverse events with pimecrolimus and tacrolimus respectively have been reported to the . Food and Drug Administration s Adverse Event Reporting System 52 . Although systemic tacrolimus used during pregnancy may result in fetal malformations and preterm deliveries the bioavailability of topical tacrolimus is less than 5 of the orally administered form making the potential for tumors with standard topical therapy extremely low indeed 53-55 . Both topical and systemic tacrolimus preparations are pregnancy category C 56 . Coal Tar This agent is messy malodorous and stains clothing and other fabrics leading to poor patient compliance despite being inexpensive. Liquor

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