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Behandlung des atopischen Ekzems bei Erwachsenen mit topischen Calcineurininhibitoren

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Zusammenfassung

In bis zu 60% der Fälle kann ein atopisches Ekzem bis in das Erwachsenenalter persistieren und durch besondere klinische Manifestationen und Verlaufsformen gekennzeichnet sein. Die Einführung der topischen Calcineurininhibitoren Pimecrolimus-1%-Creme und Tacrolimus-0,03%- und -0,1%-Salbe wird, wie umfangreiche klinische Studien und die zunehmende praktische Erfahrung zeigen, das Langzeitmanagement des atopischen Ekzems mittelschwerer Ausprägung bei Erwachsenen deutlich verbessern. Die topischen Calcineurininhibitoren sind auch bei Anwendung über Wochen und Monate sicher, verträglich und wirksam, bessern rasch den Juckreiz und ermöglichen—wie vor allem Studien mit der Pimecrolimus-1%-Creme gezeigt haben—eine signifikante Verlängerung der schubfreien Zeit mit Reduktion oder weitgehender Vermeidung einer zusätzlichen Anwendung von topischen Kortikosteroiden.

Abstract

In about 60% of cases, atopic eczema can persist in adulthood with distinctive clinical features and disease course. The introduction of the topical calcineurin inhibitors pimecrolimus 1% cream and tacrolimus 0,03 and 0,1% ointment clearly improves the long-term management of atopic eczema in adult patients; this has been shown in several large clinical studies and is confirmed by the growing practical experience with these substances. Topical calcineurin inhibitors are, even when applied for weeks and months, safe, well tolerated and efficient; they have a rapid and positive effect on pruritus and the potential—as shown in clinical studies with pimecrolimus 1% cream—to reduce the number of eczema flares, to significantly prolong the time to a first flare and to reduce or even eliminate the need for topical corticosteroids.

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Literatur

  1. Hill CH, Sulzberger MB (1935) Evolution of atopic dermatitis. Arch Dermatol Syph 32:451–463

    Google Scholar 

  2. Kissling S, Wütherich B (1993) Verlauf der atopischen Dermatitis nach dem Kindesalter. Hautarzt 44:569–573

    Google Scholar 

  3. Rystedt I (1985) Hand eczema and long-term prognosis in atopic dermatitis. Acta Derm Venereol Suppl (Stockh) 117:1–59

    Google Scholar 

  4. Kissling S, Wüthrich B (1994) Lokalisationen, Manifestationstypen sowie Mikromanifestationen der atopischen Dermatitis bei jungen Erwachsenen. Eine persönliche Nachkontrolle 20 Jahre nach Diagnosestellung im Kindesalter. Hautarzt 45:368–371

    Google Scholar 

  5. Herzberg J (1973) Wenig bekannte Formen der Neurodermitis. Hautarzt 24:47–51

    Google Scholar 

  6. Vickers CFH (1980) The natural history of atopic eczema. Acta Derm Venereol Suppl 92:113–115

    Google Scholar 

  7. Burrows D, Penman RWB (1960) Prognosis of the eczema-asthma syndrome. Br J Med 2:825–828

    Google Scholar 

  8. Kay J, Gawkrodger DJ, Mortimer MJ, Jaron AG (1994) The prevalence of childhood atopic eczema in a general population. J Am Acad Dermatol 30:35–39

    Google Scholar 

  9. Leent EJM van, Gräber M, Thurston M et al. (1998) Effectiveness of the Ascomycin Macrolactam SDZ ASM 981 in the topical treatment of atopic dermatitis. Arch Dermatol 134:805–809

    Google Scholar 

  10. Luger T, Leent EJM van, Graeber M et al. (2001) SDZ ASM 981: an emerging safe and effective treatment for atopic dermatitis. Br J Dermatol 144:788–794

    Google Scholar 

  11. Meurer M, Fölster-Holst R, Wozel G et al. (2002) Pimecrolimus cream in the long-term management of atopic dermatitis in adults: a six-month study. Dermatology 205:271–277

    Google Scholar 

  12. Wahn U, Bos JD, Goodfield M et al. (2002) Efficacy and safety of pimecrolimus cream in the long-term management of atopic dermatitis in children. Pediatrics 110:e2

    Google Scholar 

  13. Kapp A, Papp K, Bingham A et al. (2002) Long-term management of atopic dermatitis in infants with topical pimecrolimus, a non-steroid anti-inflammatory drug. J Allergy Clin Immunol 110:277–284

    Google Scholar 

  14. Meingassner JG, Stütz A (1992) Immunosuppressive macrolides of the type FK506: a novel class of topical agents for treatment of skin diseases? J Invest Dermatol 98:851–855

    Google Scholar 

  15. Bekersky I, Fitzsimmons W, Tanase A et al. (2001) Nonclinical and early clinical development of tacrolimus ointment for the treatment of atopic dermatitis. J Am Acad Dermatol 44:7–27

    Google Scholar 

  16. Ruzicka T, Bieber T, Schopf E et al. (1997) A short-term trial of tacrolimus ointment for atopic dermatitis. European Tacrolimus Multicenter Atopic Dermatitis Study Group. N Engl J Med 337:816–821

    Google Scholar 

  17. Wollenberg A, Sharma S, Bubnoff D von et al. (2001) Topical tacrolimus (FK506) leads to profound phenotypic and functional alterations of epidermal antigen-presenting dendritic cells in atopic dematitis. J Allergy Clin Immunol 107:519–525

    Google Scholar 

  18. Remitz A, Kyllönen H, Granlund H, Reitamo S (2001) Tacrolimus ointment reduces staphylococcal colonization of atopic dermatitis lesions. J Allergy Clin Immunol 107:196–197

    Google Scholar 

  19. Queille-Roussel C, Paul C, Duteil L et al. (2001) The new topical ascomycin derivative SDZ ASM 981 does not induce skin atrophy when applied to normal skin for 4 weeks: a randomized, double-blind controlled study. Br J Dermatol 144:507–513

    Google Scholar 

  20. Reitamo S, Rissanen J, Remitz A et al. (1998) Tacrolimus ointment does not affect collagen synthesis: results of a single-center randomized trial. J Invest Dermatol 111:396–398

    Google Scholar 

  21. Reitamo S, Wollenberg A, Schopf E et al. (2000) Safety and efficacy of 1 year of tacrolimus ointment monotherapy in adults with atopic dermatitis. The European Tacrolimus Study Group. Arch Dermatol 136:999–1006

    Google Scholar 

  22. Reitamo S, Rustin M, Ruzicka T et al. (2002) Efficacy and safety of tacrolimus ointment compared with hydrocortisone butyrate ointment in adult patients with atopic dermatitis. J Allergy Clin Immunol 109:547–555

    Google Scholar 

  23. Sugiura H, Uehara M, Hoshino N, Yamaji A (2002) Long-term efficacy of tacrolimus (FK506) ointment for facial erythema in atopic dermatitis patients: an analysis of their backgrounds compared with response to tacrolimus ointment. In: Tsambaos D, Merk H (eds) Modern trends in skin pharmacology. Parissianos Medical Publications, pp 329–335

  24. Caro I, Gordon KB, Sheehan M et al. (2002) Long-term safety of topically applied tacrolimus ointment in adult patients with atopic dermatitis. Poster presentation. 60th Annual Meeting Am Acad Dermatol, New Orleans, Febr 22–27

  25. Allen A, Siegfried E, Silverman R et al. (2001) Significant absorption of topical tacrolimus in 3 patients with Netherton syndrome. Arch Dermatol 137:747–750

    Google Scholar 

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Meurer, M., Wozel, G. Behandlung des atopischen Ekzems bei Erwachsenen mit topischen Calcineurininhibitoren. Hautarzt 54, 424–431 (2003). https://doi.org/10.1007/s00105-003-0526-1

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