Pilot Study Of Course And Efficacy Of Pimecrolimus Cream 1% For The Treatment Of Facial Seborrheic Dermatitis And Steroid-induced Rosacea And The Effect Of Pimecrolimus On The Skin Barrier Function In Patients With Steroid-induced Rosacea

BackgroundFacial seborrheic dermatitis and steroid-induced rosacea are common diseases at dermatology clinic. The current treatment is not satisfactory. Relapse and recurrence always happen. So there is a strong need for safe and effective alternatives for the treatment. The development of topical immunomodulatory medications has provided an alternative therapy for chronic inflammatory skin disorders. Now there are not so many clinical trials for pimecrolimus cream in the treatment of those two kinds of diseases and no treatment regimen is generally acknowledged. No study has been made to compare the efficacy of pimecrolimus cream for the treatment of facial seborrheic dermatitis and steroid-induced rosacea by different courses, the efficacy after discontinuation with extenuation and the variance of skin barrier function before and after the therapy.ObjectiveTo investigate the treatment regimen of pimecrolimus cream 1% for facial seborrheic dermatitis and steroid-induced rosacea. To observe the variance of skin barrier function before and after the therapy.MethodsThe patients of facial seborrheic dermatitis and steroid-induced rosacea were randomly devived to three groups. Group 1:pimecrolimus cream 1% ext bid*2w + 6101 cream ext bid*2w. Group 2:pimecrolimus cream 1% ext bid*2w + pimecrolimus cream 1% ext qd*2w. Group 3:pimecrolimus cream 1% ext bid*4w. Objective symtoms, subjective symptoms and dermatology life quality index (DLQI) were mearsured at week 0,2,4,6. Nine patients of steroid-induced rosacea were selected randomly. The transepidermal water loss (TEWL), pH and stratum corneum hydration values were measured at week 0 and week 4 on left cheek.Results For the seborrheic dermatitis patients, after 4-week treatment, the clinical severity scores of three different regimens all decreased. There was no statistical difference between the scores of Group 1 and 2, while the scores of group 3 decreased more apparently. After discontinuation there was no statistical difference of the severity scores variance among the three groups. There was no statistical difference of the improvement in quality of life among the three groups. For the steroid-induced rosacea patients, after 4-week treatment, the clinical severity scores of three different regimens all decreased. The scores of group 2 and 3 decreased more apparently than group 1, while there was no statistical difference between the two groups. After discontinuation there was no statistical difference of the severity scores variance among the three groups. There was no statistical difference of the improvement in quality of life among the three groups.ConclusionsWe recommend the regimen of seborrheic dermatitis could be twice per day for four weeks. The regimen of steroid-induced rosacea could be twice per day for two weeks and then once per day for another two weeks. The skin barrier function of steroid-induced rosacea patients improved after 4-week treatment, and the improvement rate of TEWL appeared most notable.