Tacrolimus for the management of psoriasis: clinical utility and place in therapy

Nina Malecic,1,2 Helen Young2 1Manchester Medical School, 2The Dermatology Research Centre, University of Manchester, Manchester Academic Health Science Centre, Manchester, UK Abstract: Psoriasis affects 1%–3% of the population in the United Kingdom and can convey significant detriment to...

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Autores principales:	Malecic N, Young H
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2016
Materias:	Tacrolimus psoriasis topical therapy oral treatment Dermatology RL1-803
Acceso en línea:	https://doaj.org/article/be6680819bf14dcdbe55d54dd2411f57
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spelling	oai:doaj.org-article:be6680819bf14dcdbe55d54dd2411f572021-12-02T03:11:51ZTacrolimus for the management of psoriasis: clinical utility and place in therapy2230-326Xhttps://doaj.org/article/be6680819bf14dcdbe55d54dd2411f572016-12-01T00:00:00Zhttps://www.dovepress.com/tacrolimus-for-the-management-of-psoriasis-clinical-utility-and-place--peer-reviewed-article-PTThttps://doaj.org/toc/2230-326XNina Malecic,1,2 Helen Young2 1Manchester Medical School, 2The Dermatology Research Centre, University of Manchester, Manchester Academic Health Science Centre, Manchester, UK Abstract: Psoriasis affects 1%–3% of the population in the United Kingdom and can convey significant detriment to the physical and mental health of sufferers. Plaques of psoriasis typically affect the extensor skin surfaces and scalp. Less frequently inverse psoriasis can affect more sensitive skin such as the face, genitals, and intertriginous areas. Psoriasis is incurable, but there are a range of treatment modalities that can be used to manage the condition. Treatment options include topical preparations, phototherapy, systemic therapy, and biological agents. Tacrolimus is a macrolide calcineurin inhibitor licensed for immunosuppression in transplant patients and topical administration in atopic dermatitis. Tacrolimus administered orally and in topical form has been shown to produce successful outcomes in patients with psoriasis. Topical tacrolimus is particularly effective for inverse psoriasis, which is likely to be due to the reduced level of induration seen in these psoriatic lesions, which allows greater skin penetrance, compared with hyperkeratotic plaques of psoriasis on the body. It is also notable that the areas affected by inverse psoriasis are more susceptible to adverse effects of topical corticosteroid therapy, and thus a topical preparation without the risk of skin atrophy, telangiectasia, and striae could be a valuable addition to current topical treatment options. Oral tacrolimus has shown efficacy in the treatment of severe, refractory psoriasis. Compared to ciclosporin, systemic tacrolimus may be more suited to a patient population with increased cardiovascular risk. This review will draw together the current literature on topical and oral tacrolimus for the treatment of psoriasis. Efficacy and safety have been evaluated by case reports and randomized controlled trials and comparisons have been made between tacrolimus therapy and standard treatment. Keywords: tacrolimus, psoriasis, topical therapy, oral treatmentMalecic NYoung HDove Medical PressarticleTacrolimuspsoriasistopical therapyoral treatmentDermatologyRL1-803ENPsoriasis: Targets and Therapy, Vol Volume 6, Pp 153-163 (2016)
institution	DOAJ
collection	DOAJ
language	EN
topic	Tacrolimus psoriasis topical therapy oral treatment Dermatology RL1-803
spellingShingle	Tacrolimus psoriasis topical therapy oral treatment Dermatology RL1-803 Malecic N Young H Tacrolimus for the management of psoriasis: clinical utility and place in therapy
description	Nina Malecic,1,2 Helen Young2 1Manchester Medical School, 2The Dermatology Research Centre, University of Manchester, Manchester Academic Health Science Centre, Manchester, UK Abstract: Psoriasis affects 1%–3% of the population in the United Kingdom and can convey significant detriment to the physical and mental health of sufferers. Plaques of psoriasis typically affect the extensor skin surfaces and scalp. Less frequently inverse psoriasis can affect more sensitive skin such as the face, genitals, and intertriginous areas. Psoriasis is incurable, but there are a range of treatment modalities that can be used to manage the condition. Treatment options include topical preparations, phototherapy, systemic therapy, and biological agents. Tacrolimus is a macrolide calcineurin inhibitor licensed for immunosuppression in transplant patients and topical administration in atopic dermatitis. Tacrolimus administered orally and in topical form has been shown to produce successful outcomes in patients with psoriasis. Topical tacrolimus is particularly effective for inverse psoriasis, which is likely to be due to the reduced level of induration seen in these psoriatic lesions, which allows greater skin penetrance, compared with hyperkeratotic plaques of psoriasis on the body. It is also notable that the areas affected by inverse psoriasis are more susceptible to adverse effects of topical corticosteroid therapy, and thus a topical preparation without the risk of skin atrophy, telangiectasia, and striae could be a valuable addition to current topical treatment options. Oral tacrolimus has shown efficacy in the treatment of severe, refractory psoriasis. Compared to ciclosporin, systemic tacrolimus may be more suited to a patient population with increased cardiovascular risk. This review will draw together the current literature on topical and oral tacrolimus for the treatment of psoriasis. Efficacy and safety have been evaluated by case reports and randomized controlled trials and comparisons have been made between tacrolimus therapy and standard treatment. Keywords: tacrolimus, psoriasis, topical therapy, oral treatment
format	article
author	Malecic N Young H
author_facet	Malecic N Young H
author_sort	Malecic N
title	Tacrolimus for the management of psoriasis: clinical utility and place in therapy
title_short	Tacrolimus for the management of psoriasis: clinical utility and place in therapy
title_full	Tacrolimus for the management of psoriasis: clinical utility and place in therapy
title_fullStr	Tacrolimus for the management of psoriasis: clinical utility and place in therapy
title_full_unstemmed	Tacrolimus for the management of psoriasis: clinical utility and place in therapy
title_sort	tacrolimus for the management of psoriasis: clinical utility and place in therapy
publisher	Dove Medical Press
publishDate	2016
url	https://doaj.org/article/be6680819bf14dcdbe55d54dd2411f57
work_keys_str_mv	AT malecicn tacrolimusforthemanagementofpsoriasisclinicalutilityandplaceintherapy AT youngh tacrolimusforthemanagementofpsoriasisclinicalutilityandplaceintherapy
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Tacrolimus for the management of psoriasis: clinical utility and place in therapy

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