Corticosteroid-induced skin damage improved with pimecrolimus cream 1% treatment: a 1-year study in adults with mild to moderate atopic dermatitis

Abstract

Background and objectives: Long-term treatment with topical corticosteroids (TCS) can lead to skin atrophy and telangiectasia at the application site. The objective of this study was to investigate if reversal of TCS-induced skin damage in patients with atopic dermatitis (AD) can be achieved by treatment with pimecrolimus cream 1%, especially in sensitive skin areas like the face.

Methods: Forty-one adult patients with mild to moderate atopic dermatitis and preexisting moderate TCS-induced skin damage on the face and cubital areas were intermittently treated for 48-52 weeks with pimecrolimus cream 1%. Skin atrophy and telangiectasia were evaluated by a dermatoscope connected to a digital camera (Dermatophot). In 11 patients skin thickness was measured by ultrasound.

Results: Compared with baseline, the Dermatophot score improved by 30.5% (p < .0001; 95% CI: 20.8%-40.1%) on the face and by 38.6% (p < .0001; 95% CI: 28.2%-49.0%) on the cubital areas. In parallel, skin thickness increased by 64.4% (p = .002) on the face and by 19.9% (p = .016) on the cubital areas. During the study clinical symptoms improved in almost 60% of the patients.

Conclusion: Reversal of TCS-induced skin atrophy/telangiectasia was observed in approximately 1/2 of patients using chronic intermittent treatment with pimecrolimus cream 1%.

Keywords: Atopic dermatitis; pimecrolimus; skin atrophy; topical corticosteroids.