Allergic contact dermatitis from tacrolimus - 24/08/11
Abstract |
A 9-year-old boy developed allergic contact dermatitis from tacrolimus ointment. Tacrolimus was proven to be the allergen by right-versus-left double-blinded provocative use testing of tacrolimus ointment 0.1% versus inactive vehicle applied twice daily to normal preauricular and antecubital skin. Facial dermatitis appeared after 1 week and antecubital dermatitis after 7 weeks. Furthermore, patch testing of each individual ingredient was positive only with tacrolimus; a concentration of 2.5% in ethanol was required. Forty control patients had negative patch tests with tacrolimus 5% in ethanol. We hypothesize that the unusually long time required to elicit a positive use test on the arm and the high patch test concentration required on the back are caused by low percutaneous absorption through normal extrafacial skin. This is likely to be caused in part by the high molecular weight of tacrolimus. A similar phenomenon may occur when patch testing with neomycin sulfate.
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Funding sources: Compensation of normal patch test controls was by personal funds of Howard Maibach. Patch testing of the initial patient was paid for by Fujisawa Healthcare. Disclosure: Dr Eichenfield has received funding from Fujisawa Healthcare and Novartis Pharmaceuticals for clinical studies. Dr Shaw received compensation from Fujisawa Healthcare for patch testing of the initial patient. Reprints not available from the authors. |
Vol 50 - N° 6
P. 962-965 - juin 2004 Retour au numéroBienvenue sur EM-consulte, la référence des professionnels de santé.
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