Ann Dermatol.  2011 Aug;23(3):348-351. 10.5021/ad.2011.23.3.348.

Successful Treatment of Cutaneous Lesions of Dermatomyositis with Topical Pimecrolimus

• Kim JE
• Jeong MG
• Lee HE
• Ko JY
• Ro YS

• KMID: 2171927
• DOI: http://doi.org/10.5021/ad.2011.23.3.348

Abstract

Dermatomyositis (DM) is an idiopathic inflammatory process characterized by proximal muscle weakness and cutaneous lesions, such as the Gottron's sign, heliotrope rash, and erythematous photosensitive rash. Administration of systemic agents for the treatment of underlying systemic diseases leads to remission of the cutaneous lesions in many cases. However, cutaneous lesions may remain refractory to treatment. Pimecrolimus is a calcineurin inhibitor with combined anti-inflammatory and immunomodulatory activity. It has high affinity to the skin and low permeation potential, even in patients with acute skin inflammation and in those undergoing post-topical corticosteroid therapy. We herein report two DM patients whose cutaneous lesions were refractory to conventional treatment but showed dramatic response to topical pimecrolimus. The clinical outcomes suggest that topical pimecrolimus may be a good therapeutic alternative for the management of the cutaneous lesions of DM.

Keyword

Dermatomyositis; Pimecrolimus

MeSH Terms

Calcineurin
Dermatomyositis
Exanthema
Humans
Inflammation
Muscle Weakness
Skin
Tacrolimus
Calcineurin
Tacrolimus

Figure

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  Fig. 1 (A) Patient 1 with the shawl sign before treatment. (B) Gottron's sign before treatment. (C, D) Two months later after treatment with topical pimecrolimus. (E, F) Ten months later after treatment with topical pimecrolimus.

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  Fig. 2 (A) Patient 2 with the Gottron's sign before treatment. (B) Poikilodermatous erythematous patch on the nape and trunk before treatment. (C) Poikilodermatous erythematous patch on the right flank before treatment. (D, E, F) Three months after treatment with topical pimecrolimus. (G, H, I) One year later after stopping topical pimecrolimus treatment.

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