Topical pimecrolimus for paediatric cutaneous mastocytosis

• Published in: Clinical and experimental dermatology Vol. 43; no. 5; pp. 559 - 565
• Main Authors: Mashiah, J., Harel, A., Bodemer, C., Hadj‐Rabia, S., Goldberg, I., Sprecher, E., Kutz, A.
• Format: Journal Article
• Language: English
• Published: England Oxford University Press 01.07.2018
• Subjects: Administration, Cutaneous; Calcineurin; Calcineurin inhibitors; Calcineurin Inhibitors - administration & dosage; Calcineurin Inhibitors - therapeutic use; Child, Preschool; Children; Cream; Epidemiology; Female; Humans; Hyperpigmentation; Infant; Male; Mastocytosis; Mastocytosis, Cutaneous - drug therapy; Patients; Retrospective Studies; Skin cancer; Tacrolimus - administration & dosage; Tacrolimus - analogs & derivatives; Tacrolimus - therapeutic use; Treatment Outcome
• ISSN: 0307-6938; 1365-2230
• DOI: 10.1111/ced.13391

Summary 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.