Pimecrolimus perioral dermatitis

2019 Sep/Oct;23(4_suppl):19S-26S. 2018 Sep;31(5):e12697. [PMC free article: PMC3162265] [PubMed: 21909206]

15.

Wollina U, Hansel G. The use of topical calcineurin inhibitors in lupus erythematosus: an overview. [PubMed: 21353334]

9.

Zhao J, Sun W, Zhang C, Wu J, Le Y, Huang C, Liu Y, Xiang L. Comparison of different regimens of pimecrolimus 1% cream in the treatment of facial seborrheic dermatitis.

[PubMed: 17935515]

4.

Lee GR, Maarouf M, Hendricks AK, Lee DE, Shi VY. Current and emerging therapies for hand eczema. [PubMed: 30903622]

7.

Lonsdale-Eccles AA, Velangi S. Topical pimecrolimus in the treatment of genital lichen planus: a prospective case series. There is a growing body of evidence for the use of pimecrolimus cream in other skin conditions, on the specialist advice of a dermatologist.

How does pimecrolimus work?

The following immune-modulating effects have been noticed:

  • Pimecrolimus at very small concentrations binds with high affinity to the proteinreceptor macrophilin-12 (FKBP-12).
  • This resulting drug-protein complex inhibits calcineurin (a calcium-dependentphosphatase-transmitting chemical) which results in the blockage of signal transduction in target cells.
  • As a consequence, the release of cytokines (chemicals in the body's immune system that can cause inflammation, redness, and itching) from T-cells and mast cells is blocked.

What are the contraindications of pimecrolimus?

Contraindications

  • Known hypersensitivity to pimecrolimus or other macrolactams.

Precautions

  • Increased risk of local skin infections — if infection develops, consider antimicrobials and stop pimecrolimus until the infection has resolved.
  • UV light exposure — avoid excessive exposure to sunlight and sunlamps.
  • Alcohol consumption — may cause facial flushing and skin irritation.
  • Avoid use in areas affected by active cutaneous viral infections such as herpes simplex, molluscum contagiosum, or viral warts.
  • Should not be applied to potentially malignant or premalignant skin lesions.
  • Not recommended in patients with Netherton syndrome or severely inflamed or damaged skin (eg, erythroderma).
  • Not recommended in immunocompromised patients, as the use of pimecrolimus in these patients has not been studied.

Pregnancy and breastfeeding

  • Manufacturer advises avoid in pregnancy due to limited data in humans.

    2011 Sep;165(3):465-73. [PMC free article: PMC4326095] [PubMed: 24813302]

2.

El-Batawy MM, Bosseila MA, Mashaly HM, Hafez VS. Topical calcineurin inhibitors in atopic dermatitis: a systematic review and meta-analysis.

Pimecrolimus

Pimecrolimus — extra information

TreatmentsEczemas


Last reviewed: February 2024

Author(s): Dr Michael Barrett, West Suffolk Hospital, Bury St Edmunds, Suffolk, United Kingdom (2024)

Previous contributors: Vanessa Ngan, Staff Writer, 2004

Reviewing dermatologist: Dr Ian Coulson

Edited by the DermNet content department

Introduction
How it works
Uses
How to use
Precautions
Side effects

What is pimecrolimus?

Pimecrolimus is a topical steroid-free medication with immune-modulating and anti-inflammatory properties, used to treat atopicdermatitis.

It is classified as a calcineurin inhibitor and an ascomycin macrolactam derivative; ascomycin is produced by Streptomyces hygroscopicus.

A tube of pimecrolimus cream

What is pimecrolimus used for?

Pimecrolimus is approved for the short-term and intermittent long-term treatment of atopic dermatitis in patients who are over 3 months of age where topical corticosteroids are deemed inappropriate.

Bone Marrow Transplant. 2008 Jul;59(1):34-40. N Engl J Med. 1982 Nov 25;307(22):1384-8. Dermatol Ther. J Dermatol. Br J Dermatol. If dermatitis does not respond within that time frame, the patient should seek re-evaluation. Check the individual datasheet in your country for information about medicines.

We suggest you refer to your national drug approval agency such as the Australian Therapeutic Goods Administration (TGA), US Food and Drug Administration (FDA), UK Medicines and Healthcare products regulatory agency (MHRA) / emc, and NZ Medsafe, or a national or state-approved formulary eg, the New Zealand Formulary (NZF) and New Zealand Formulary for Children (NZFC) and the British National Formulary (BNF) and British National Formulary for Children (BNFC).

Bibliography

  • Ahn D, Robison CA.

    Pimecrolimus. [PubMed: 28589618]

10.

Schwarz T, Kreiselmaier I, Bieber T, Thaci D, Simon JC, Meurer M, Werfel T, Zuberbier T, Luger TA, Wollenberg A, Bräutigam M. A randomized, double-blind, vehicle-controlled study of 1% pimecrolimus cream in adult patients with perioral dermatitis.