Off-Label Use of Topical Calcineurin Inhibitors in Dermatologic Disorders

Author:

Guenther Lyn1,Lynde Charles2,Poulin Yves3

Affiliation:

1. Western University, London, ON, Canada

2. Lynde Dermatology, Probity Medical Research, Markham, ON, and Department of Medicine, University of Toronto, ON, Canada

3. Laval University and Centre dermatologique du Québec métropolitain and Centre de Recherche Dermatologique du Québec métropolitain, Canada

Abstract

Off-label prescribing is a common practice in dermatology, particularly when uncommon dermatologic diseases have limited or no approved treatment options. Topical calcineurin inhibitors are approved for the treatment of eczema, and their anti-inflammatory, immunomodulatory, and steroid-sparing effects make them an attractive therapeutic option for a wide variety of other dermatologic diseases. This review summarizes and qualifies the available evidence supporting the clinical effectiveness of tacrolimus ointment and pimecrolimus cream in non-eczema indications. There is high-quality evidence supporting the effectiveness of topical calcineurin inhibitors in multiple dermatological disorders including vitiligo; psoriasis of the face, folds, and genitals; seborrheic dermatitis; chronic hand dermatitis; contact dermatitis; oral lichen planus; lichen sclerosus; morphea; and cutaneous lupus erythematosus. Lower-quality evidence suggests they may be considered as an option in many other cutaneous disorders.

Funder

leo pharma research foundation

Publisher

SAGE Publications

Subject

Dermatology,Surgery

Reference75 articles.

1. Topical Tacrolimus: A Review of Its Uses in Dermatology

2. Topical pimecrolimus for skin disease other than atopic dermatitis

3. Hengge UR, ed. Tacrolimus Ointment in Special Treatment Indications. Stuttgart, Germany: Thieme Verlag KG; 2018:1-84.

4. Going Off-label Without Venturing Off-Course

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