Emollients have long been used to maintain the skin barrier function in
patients with atopic dermatitis. For many years, topical corticosteroids have been
mainstay for atopic dermatitis (AD) treatment. The introduction of topical calcineurin
inhibitors represented the first new class of medication approved for the treatment of
AD since topical corticosteroids. Topical calcineurin inhibitors, pimecrolimus and
tacrolimus, were developed to provide an effective and safe alternative therapy for longterm
control of the disease. They provide targeted anti-inflammatory activity without
local or systemic side-effects seen with topical corticosteroids. They have been used not
only in AD, but also in other inflammatory skin diseases such as psoriasis, lichen
planus, seborrheic dermatitis, contact dermatitis, alopecia areata, acne rosacea,
pyoderma gangrenosum and vitiligo.
In this chapter, mechanism of action, the efficacy, safety, adverse effects of topical
calcineurin inhibitors and their innovative use in dermatology will be reviewed.
Keywords: Topical therapy, topical macrolide immunomodulator, calcineurin
inhibitor, pimecrolimus, tacrolimus, atopic dermatitis, mechanism of calcineurin
inhibitors, immunology of the skin.