Topical pimecrolimus for paediatric cutaneous mastocytosis

Clin Exp Dermatol. 2018 Jul;43(5):559-565. doi: 10.1111/ced.13391. Epub 2018 Feb 20.

Abstract

Background: Most cases of paediatric cutaneous mastocytosis (CM) occur before the age of 2 years, and regression occurs in only 67% of children. Given the absence of any specific therapy, CM is usually treated symptomatically. A few publications have reported the beneficial effect of calcineurin inhibitors for CM.

Aim: We sought to evaluate the clinical effectiveness and safety profile of topical pimecrolimus cream for the treatment of CM.

Methods: We performed a retrospective study of all diagnosed cases of CM treated with topical pimecrolimus 1% cream between 2013 and 2015. All patients were evaluated in a paediatric dermatology unit of a tertiary medical centre. Epidemiological, clinical and treatment data, including effectiveness and safety, were reviewed.

Results: In total, 18 children (11 male, 7 female; age range 3-42 months) with CM were evaluated. Of the 146 treated lesions, 39 (26.7%) disappeared and 98 (67%) faded or developed postinflammatory hyperpigmentation. Of the 119 papular lesions, 24 (16.4%) showed partial flattening and 56 (47%) became macular. Darier sign became negative in 14 (82%) of 17 patients. No topical or systemic complications were observed.

Conclusions: Topical therapy with pimecrolimus 1% cream should be considered in the treatment of CM.

MeSH terms

  • Administration, Cutaneous
  • Calcineurin Inhibitors / administration & dosage
  • Calcineurin Inhibitors / therapeutic use*
  • Child, Preschool
  • Female
  • Humans
  • Infant
  • Male
  • Mastocytosis, Cutaneous / drug therapy*
  • Retrospective Studies
  • Tacrolimus / administration & dosage
  • Tacrolimus / analogs & derivatives*
  • Tacrolimus / therapeutic use
  • Treatment Outcome

Substances

  • Calcineurin Inhibitors
  • pimecrolimus
  • Tacrolimus