Tacrolimus ointment for the treatment of atopic dermatitis: clinical and pharmacologic effects.

The topical immunomodulator tacrolimus ointment has been shown to be safe and effective in the treatment of atopic dermatitis in clinical trials involving over 16,000 patients. Clinical trial results focusing on tacrolimus' safety and efficacy are summarized. Minimal systemic absorption results from topical application in patients with atopic dermatitis. Although the exact mechanism of action of tacrolimus ointment in atopic dermatitis is unknown, tacrolimus is known to inhibit up-regulation of cytokine production following T cell activation and to decrease Fc epsilon RI expression on dendritic antigen-presenting cells in skin. Additional mechanisms of action of tacrolimus relevant in the pathogenesis of inflammatory skin disorders are discussed.