Emerging role of tacrolimus in the treatment of atopic dermatitis: Recent advances

More than fifteen years have passed since the approval of clinical use of tacrolimus ointment for atopic dermatitis. Its efficacy and safety have been demonstrated clearly in many global and domestic short-term and long-term administration trials. Although prolonged external application of steroid causes adverse reactions including cutaneous atrophy, tacrolimus ointment does not cause such adverse reaction. Therefore, tacrolimus has been positioned as a drug that exerts therapeutic effects of external steroid but causes none of its unwanted side-effects. The pathological condition of atopic dermatitis has not been fully understood. However, the genetic, physiological and immunological findings and the therapeutic findings based on the use of new drugs have been accumulating and many scientific advancements have been achieved. With progress in understanding of the pathological condition, the possibility has been suggested that tacrolimus, which was clinically applied originally as an immunosuppressant for control of T cell activation, may control various aspects of the development/pathological condition of atopic dermatitis. In this paper, we summarized the recent findings on tacrolimus including control of itching, inhibition of allergic inflammation and improvement of skin barrier function and addressed the new possibility of treatment of atopic dermatitis with tacrolimus ointment.