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Atopic dermatitis is a chronic inflammatory skin disease that often begins in early infancy and runs a course of exacerbation and remission. Over the last decades topical corticosteroids have represented the therapy of choice for the treatment of flares. However, due to potential side effects, topical steroids are not generally accepted by the patients and physicians. The macrolides tacrolimus and pimecrolimus exert their immunomodulatory effects via inhibition of the phosphatase calcineurin, which normally dephosphorylates the transcription factor NF-AT in T-lymphocytes. This leads to a decreased transcription of several proinflammatory cytokines. Moreover, the immunomodulators have shown to influence also mast cells and antigen presenting cells. The proinflammatory effect of Tacrolimus and Pimecrolimus could be confirmed in various clinical studies on children and adult patients with atopic dermatitis. Various reports demonstrate a potential clinical effect also in other cutaneous skin diseases.

Topical immunomodulators in the treatment of atopic dermatitis / Topische Immunmodulatoren bei der Behandlung der atopischen Dermatitis