Johanna Mandelin

Effects of 1-year intermittent treatment with topical tacrolimus monotherapy on skin collagen synthesis in patients with atopic dermatitis

Background  Topical corticosteroids decrease collagen synthesis during short‐term treatment and can induce skin atrophy when applied over the long term. In contrast, short‐term tacrolimus ointment therapy does not affect collagen synthesis.

One-year Treatment with 0.1% Tacrolimus Ointment versus a Corticosteroid Regimen in Adults with Moderate to Severe Atopic Dermatitis: A Randomized, Double-blind, Comparative Trial

A one-year, randomized, double-blind study was conducted in 80 patients with atopic dermatitis treated with tacrolimus ointment or a corticosteroid regimen (hydrocortisone acetate 1% ointment for head and neck, hydrocortisone butyrate 0.1% ointment for trunk and limbs) to compare efficacy and safety, and effects on Th2-reactivity. The study was completed by 36/40 patients in the tacrolimus group, and 31/40 patients in the corticosteroid group. In both groups affected body surface area, eczema area and severity index, and transepidermal water loss decreased at months 6 and 12. Tacrolimus was superior for all efficacy scores at month 6, and in the head and neck area at month 12. Recall antigen reactivity increased at month 12 in both groups. Adverse events were reported by 40/40 patients in the tacrolimus, and by 34/40 patients in the corticosteroid group. Long-term treatment with topical tacrolimus or a corticosteroid regimen improves atopic dermatitis and recall antigen reactivity, suggesting an improvement in the Th1/Th2-balance.

Long‐term efficacy and tolerability of tacrolimus 0.03% ointment in infants:* a two‐year open‐label study

Background  Tacrolimus ointment is effective for treatment of moderate to severe atopic dermatitis (AD) in children aged ≥2 years (Br J Dermatol, 2004; 150: 554). Here, efficacy and tolerability of tacrolimus 0.03% ointment were evaluated in 50 infants aged <2 years at start of treatment.

The pharmacokinetics of tacrolimus after first and repeated dosing with 0.03% ointment in infants with atopic dermatitis*

Background  In adults and children aged > 2 years, systemic absorption of tacrolimus from tacrolimus ointment is very low. In this study, the pharmacokinetics of tacrolimus 0.03% ointment were investigated in infants aged 3–24 months.

Effect of Oral Acetylsalicylic Acid on Burning Caused by Tacrolimus Ointment in Patients With Atopic Dermatitis

poorer prognosis when diagnosed as having melanoma. Lack of knowledge of skin cancer type was not associated with elapsed time since diagnosis, suggesting that poor memory over time is not a relevant factor. Some participants who did not know whether they were diagnosed as having melanoma or NMSC may have known that they were diagnosed with basal or squamous cell carcinoma, and these terms should be added to populationbased surveys such as the NHIS. Health care providers should also educate patients with skin cancer about their disease and verify their knowledge of the type of skin cancer diagnosed and the importance of subsequent preventive behaviors. Accepted for Publication: May 18, 2010. Author Affiliations: The Cancer Institute of New Jersey and Department of Medicine, University of Medicine and Dentistry of New Jersey (UMDNJ) Robert Wood Johnson Medical School, New Brunswick; and Department of Health Education and Behavioral Science, UMDNJ School of Public Health, Piscataway. Correspondence: Dr Coups, The Cancer Institute of New Jersey, 195 Little Albany St, Room 5567, New Brunswick, NJ 08901 (coupsej@umdnj.edu). Financial Disclosure: None reported. Funding/Support: Dr Coups receives support from National Cancer Institute grant 1K07CA133100. Disclaimer: The sponsor had no role in the design and conduct of the study; in the collection, analysis, and interpretation of data; in the preparation of the manuscript; or in the review or approval of the manuscript.

The Value of FLG Null Mutations in Predicting Treatment Response in Atopic Dermatitis: An Observational Study in Finnish Patients

The contribution of filaggrin null mutations to predicting atopic dermatitis (AD) treatment response is not clear, nor have such mutations been studied in the Finnish population. This study tested the association of the 4 most prevalent European FLG null mutations, the 2 Finnish enriched FLG null mutations, the FLG 12-repeat allele, and 50 additional epidermal barrier gene variants, with risk of AD, disease severity, clinical features, risk of other atopic diseases, age of onset, and treatment response in 501 patients with AD and 1,710 controls. AD, early-onset AD, palmar hyperlinearity, and asthma showed significant associations with the combined FLG null genotype. Disease severity and treatment response were independent of patient FLG status. Carrier frequencies of R501X, 2282del4, and S3247X were notably lower in Finns compared with reported frequencies in other populations. This data confirms FLG mutations as risk factors for AD in Finns, but also questions their feasibility as biomarkers in predicting treatment response.

Bullous pemphigoid triggered by radiotherapy for breast cancer

Bullous pemphigoid (BP) is the most common autoimmune subepidermal blistering disease of the skin and mucous membranes. It is characterized by autoantibodies against structural proteins of the dermal–epidermal jonction and responsible for itch, localized or generalized bullous lesions followed by skin erosions. It is usually an idiopathic condition affectingmainly the elderly [1]. However, various exogenous factors have been implicated in the pathogenesis of the disease, such as medications, trauma, surgery, UV phototherapy [2] or percutaneous ionizing radiation (radiotherapy, RT) [3,4]. We report on a case of BP that was triggered within a month after RT for breast cancer. Observation A 68-year Finnish woman was referred for the management of a recent blistering disease. Her medical history was notable for a ductal adenocarcinoma of the right breast diagnosed in November 2015. The tumor was strictly localized to the right breast with no lymph node or metastatic dissemination. It was 10 mm, staged grade II, expressed estrogen receptor (100%), but was progesterone receptor and HER-2 negative. After tumor resection,