Calcineurin inhibitors for the treatment of atopic dermatitis

Expert Opinion on Pharmacotherapy

Volumn 9, Issue 17, 2008, Pages 3009-3023

  Ehrchen, Jan ^a   Sunderkötter, Cord ^a   Luger, Thomas ^a   Steinhoff, Martin ^a  

^a UNIVERSITY OF MÜNSTER   (Germany)

Author keywords

Atopic dermatitis (AD); Calcineurin inhibitor; Inflammatory skin disease; Pimecrolimus; T cells; Tacrolimus

Indexed keywords

BETAMETHASONE VALERATE; CALCINEURIN; CALCINEURIN INHIBITOR; CORTICOSTEROID; CYCLOSPORIN A; GLUCOCORTICOID; HYDROCORTISONE; HYDROCORTISONE ACETATE; HYDROCORTISONE BUTYRATE; HYDROCORTISONE VALERATE; ISA 247; PIMECROLIMUS; PLACEBO; TACROLIMUS; TRANSCRIPTION FACTOR NFAT; UNCLASSIFIED DRUG; VOCLOSPORIN;

ALCOHOL TOLERANCE; ANTIINFLAMMATORY ACTIVITY; ATOPIC DERMATITIS; BURNING SENSATION; CHEMOPROPHYLAXIS; CLINICAL TRIAL; CREAM; DRUG BLOOD LEVEL; DRUG DOSE COMPARISON; DRUG EFFICACY; DRUG INHIBITION; DRUG SAFETY; DRUG TARGETING; DRUG TOLERABILITY; ECZEMA; FACE RASH; GLOMERULUS FILTRATION RATE; HERPES SIMPLEX; HUMAN; HYPERTENSION; LONG TERM CARE; NEPHROTOXICITY; PHOTOTHERAPY; PRURITUS; REVIEW; SIDE EFFECT; SKIN ATROPHY; SKIN BURNING SENSATION; T LYMPHOCYTE ACTIVATION; VIRUS INFECTION;

ANIMALS; CALCINEURIN; DERMATITIS, ATOPIC; HUMANS; T-LYMPHOCYTES; VACCINATION;

EID: 57649106554     PISSN: 14656566     EISSN: None     Source Type: Journal    
DOI: 10.1517/14656560802498040     Document Type: Review

References (110)

1. Elias PM, Steinhoff M. "Outside-to-inside" (and now back to "outside") pathogenic mechanisms in atopic dermatitis. J Invest Dermatol 2008;128:1067-70
2. Bieber T. Atopic dermatitis. N Engl J Med 2008;358:1483-94
3. Singh S, Gupta A, Pandey SS, et al. Tachyphylaxis to histamine-induced wheal suppression by topical 0.05% clobetasol propionate in normal versus croton oil-induced dermatitic skin. Dermatol 1996;193:121-3
4. Schoepe S, Schacke H, May E, et al. Glucocorticoid therapy-induced skin atrophy. Exp Dermatol 2006;15:406-20
5. Griffiths CE, Katsambas A, Dijkmans BA, et al. Update on the use of ciclosporin in immune-mediated dermatoses. Br J Dermatol 2006;155(Suppl 2):1-16
6. Paul C, Graeber M, Stuetz A. Ascomycins: promising agents for the treatment of inflammatory skin diseases. Expert Opin Investig Drugs 2000;9:69-77
7. Reynolds NJ, Al-Daraji WJ. Calcineurin inhibitors and sirolimus: mechanisms of action and applications in dermatology. Clin Exp Dermatol 2002;27:555-61
8. Winiski A, Wang S, Schwendinger B, et al. Inhibition of T-cell activation in vitro in human peripheral blood mononuclear cells by pimecrolimus and glucocorticosteroids and combinations thereof. Exp Dermatol 2007;16:699-704
9. Kalthoff FS, Winiski A, Fichtinger P, et al. Differential inhibition of primary versus preactivated T cells by pimecrolimus but not by tacrolimus in vitro Int Arch Allergy Immunol 2007;142:255-64
10. Matsuda S, Shibasaki F, Takehana K, et al. Two distinct action mechanisms of immunophilin-ligand complexes for the blockade of T-cell activation. EMBO Rep 2000;1:428-34
11. Harrison CA, Bastan R, Peirce MJ, et al. Role of calcineurin in the regulation of human lung mast cell and basophil function by cyclosporine and FK506. Br J Pharmacol 2007;150:509-18
12. Stander S, Stander H, Seeliger S, et al. Topical pimecrolimus and tacrolimus transiently induce neuropeptide release and mast cell degranulation in murine skin. Br J Dermatol 2007;156:1020-6
13. Lee YH, Lee YR, Im SA, et al. Calcineurin inhibitors block MHC-restricted antigen presentation in vivo J Immunol 2007;179:5711-6
14. Al-Daraji WI, Grant KR, Ryan K, et al. Localization of calcineurin/NFAT in human skin and psoriasis and inhibition of calcineurin/NFAT activation in human keratinocytes by cyclosporin A. J Invest Dermatol 2002;118:779-88
15. Reynolds NJ, Voorhees JJ, Fisher GJ. Cyclosporin A inhibits 12-O-tetradecanoyl-phorbol-13-acetate-induced cutaneous inflammation in severe combined immunodeficient mice that lack functional lymphocytes. Br J Dermatol 1998;139:16-22
16. Krummen MB, Varga G, Steinert M, et al. Effect of pimecrolimus vs. corticosteroids on murine bone marrow-derived dendritic cell differentiation, maturation and function. Exp Dermatol 2006;15:43-50
17. Xhauflaire-Uhoda E, Thirion L, Pierard-Franchimont C, et al. Comparative effect of tacrolimus and betamethasone valerate on the passive sustainable hydration of the stratum corneum in atopic dermatitis. Dermatol 2007;214:328-32
18. Gollnick H, Luger T, Freytag S, et al. StabiEL: Stabilization of skin condition with Elidel - a patients' satisfaction observational study addressing the treatment, with pimecrolimus cream, of atopic dermatitis pretreated with topical corticosteroid. J Eur Acad Dermatol Venereol 2008
19. Proksch E, Jensen J, Braeutigam M, et al. Pimecrolimus but not corticosteroid improves the skin barrier in atopic dermatitis. J Invest Dermatol 2008;128:S104
20. Santini MP, Talora C, Seki T, et al. Cross talk among calcineurin, Sp1/ Sp3, and NFAT in control of p21(WAF1/CIP1) expression in keratinocyte differentiation. Proc Natl Acad Sci USA 2001;98:9575-80
21. Buchau AS, Schauber J, Hultsch T, et al. Pimecrolimus Enhances TLR2/ 6-Induced Expression of Antimicrobial Peptides in Keratinocytes. J Invest Dermatol 2008; May 22
22. Lan CC, Kao YH, Huang SM, et al. FK506 independently upregu]ates transforming growth factor beta and downregulates inducible nitric oxide synthase in cultured human keratinocytes: possible mechanisms of how tacrolimus ointment interacts with atopic skin. Br J Dermatol 2004;151:679-84
23. Wolff K, Fleming C, Hanifin J, et al. Efficacy and tolerability of three different doses of oral pimecrolimus in the treatment of moderate-to-severe atopic dermatitis: a randomized controlled trial. Br J Dermatol 2005;152:1296-303
24. Aspeslet L, Freitag D, Trepanier D, et al. ISA(TX)247: a novel calcineurin inhibitor. Transplant Proc 2001;3:1048-51
25. Papp K, Bissonnette R, Rosoph L, et al. Efficacy of ISA247 in plaque psoriasis: a randomised, multicentre, double-blind, placebo-controlled Phase III study. Lancet 2008;371(19):1337-42
26. Korfitis C, Gregoriou S, Rallis E, Rigopoulos D. Pimecrolimus versus topical corticosteroids in dermatology. Expert Opin Pharmacother 2007;8:1565-73
27. Ruzicka T, Bieber T, Schopf E, et al. A short-term trial of tacrolimus ointment for atopic dermatitis. European Tacrolimus Multicenter Atopic Dermatitis Study Group. N Engl J Med 1997;337:816-21
28. Paller AS, Lebwohl M, Fleischer AB Jr, et al. Tacrolimus ointment is more effective than pimecrolimus cream with a similar safety profile in the treatment of atopic dermatitis: results from 3 randomized, comparative studies. J Am Acad Dermatol 2005;52:810-22
29. Ashcroft DM, Dimmock P, Garside R, et al. Efficacy and tolerability of topical pimecrolimus and tacrolimus in the treatment of atopic dermatitis: meta-analysis of randomised controlled trials. BMJ 2005;330:516
30. Yan J, Chen SL, Wang XL, et al. Meta-analysis of tacrolimus ointment for atopic dermatitis in pediatric patients. Pediatr Dermatol 2008;25:117-20
31. Hanifin JM, Ling MR, Langley R, et al. Tacrolimus ointment for the treatment of atopic dermatitis in adult patients: part I, efficacy. J Am Acad Dermatol 2001;44:S28-38
32. Reitamo S, Wollenberg A, Schopf E, et al. Safety and efficacy of 1 year of tacrolimus ointment monotherapy in adults with atopic dermatitis. The European Tacrolimus Ointment Study Group. Arch Dermatol 2000;136:999-1006
33. Reitamo S, Ortonne JP, Sand C, et al. A multicentre, randomized, double-blind, controlled study of long-term treatment with 0.1% tacrolimus ointment in adults with moderate-to-severe atopic dermatitis. Br J Dermatol 2005;152:1282-9
34. Reitamo S, Rustin M, Harper J, et al. A 4-year follow-up study of atopic dermatitis therapy with 0.1% tacrolimus ointment in children and adult patients. Br J Dermatol 2008
35. Kang S, Lucky AW, Pariser D, et al. Long-term safety and efficacy of tacrolimus ointment for the treatment of atopic dermatitis in children. J Am Acad Dermatol 2001;44:S58-64
36. Hanifin JM, Paller AS, Eichenfield L, et al. Efficacy and safety of tacrolimus ointment treatment for up to 4 years in patients with atopic dermatitis. J Am Acad Dermatol 2005;53:S186-94
37. Beck LA. The efficacy and safety of tacrolimus ointment: a clinical review. J Am Acad Dermatol 2005;53:S165-70
38. Reitamo S, Ortonne JR, Sand C, et al. Long-term treatment with 0.1% tacrolimus ointment in adults with atopic dermatitis: results of a two-year, multicentre, non-comparative study. Acta Derm Venereol 2007;87:406-12
39. Koo JY, Fleischer AB Jr, Abramovits W, et al. Tacrolimus ointment is safe and effective in the treatment of atopic dermatitis: results in 8000 patients. J Am Acad Dermatol 2005;53:S195-205
40. Wollenberg A, Reitamo S, Atzori F, et al. Proactive treatment of atopic dermatitis in adults with 0.1% tacrolimus ointment. Allergy 2008;63:742-50
41. Breneman D, Fleischer AB Jr, Abramovits W, et al. Intermittent therapy for flare prevention and long-term disease control in stabilized atopic dermatitis: a randomized comparison of 3-times-weekly applications of tacrolimus ointment versus vehicle. J Am Acad Dermatol 2008;58(6):990-9
42. Van Leent EJ, Graber M, Thurston M, et al. Effectiveness of the ascomycin macrolactam SDZ ASM 981 in the topical treatment of atopic dermatitis. Arch Dermatol 1998;134:805-9
43. Luger T, Van Leent EJ, Graeber M, et al. SDZ ASM 981: an emerging safe and effective treatment for atopic dermatitis. Br J Dermatol 2001;144:788-94
44. Eichenfield LF, Thaci D, de PY, et al. Clinical management of atopic eczema with pimecrolimus cream 1% (Elidel) in paediatric patients. Dermatology 2007;215(Suppl 1):3-17
45. Kaufmann R, Folster-Holst R, Hoger P, et al. Onset of action of pimecrolimus cream 1% in the treatment of atopic eczema in infants. J Allergy Clin Immunol 2004;114:1183-8
46. Leo HL, Bender BG, Leung SB, et al. Effect of pimecrolimus cream 1% on skin condition and sleep disturbance in children with atopic dermatitis. J Allergy Clin Immunol 2004;114:691-3
47. Papp K, Staab D, Harper J, et al. Effect of pimecrolimus cream 1% on the long-term course of pediatric atopic dermatitis.Int J Dermatol 2004;43:978-83
48. Eichenfield LF, Lucky AW, Langley RG, et al. Use of pimecrolimus cream 1% (Elidel) in the treatment of atopic dermatitis in infants and children: the effects of ethnic origin and baseline disease severity on treatment outcome. Int J Dermatol 2005;44:70-5
49. Langley RG, Eichenfield LF, Lucky AW, et al. Sustained efficacy and safety of pimecrolimus cream 1% when used long-term (up to 26 weeks) to treat children with atopic dermatitis. Pediatr Dermatol 2008;25:301-7
50. Ashcroft DM, Chen LC, Garside R, et al. Topical pimecrolimus for eczema. Cochrane Database Syst Rev 2007 CD005500
51. Grassberger M, Steinhoff M, Schneider D, et al. Pimecrolimus - an anti-inflammatory drug targeting the skin. Exp Dermatol 2004;13:721-30
52. Meurer M, Lubbe J, Kapp A, Schneider D. The role of pimecrolimus cream 1% (Elidel)) in managing adult atopic eczema. Dermatol 2007;215(Suppl 1):18-26. Epub 2007 Dec 18
53. Meurer M, Folster-Holst R, Wozel G, et al. Pimecrolimus cream in the long-term management of atopic dermatitis in adults: a six-month study. Dermatol 2002;205:271-7
54. Wahn U, Bos JD, Goodfield M, et al. Efficacy and safety of pimecrolimus cream in the long-term management of atopic dermatitis in children. Pediatrics 2002;110:e2
55. Kapp A, Papp K, Bingham A, et al. Long-term management of atopic dermatitis in infants with topical pimecrolimus, a nonsteroid anti-inflammatory drug. J Allergy Clin Immunol 2002;110:277-84
56. Papp KA, Werfel T, Folster-Holst R, et al. Long-term control of atopic dermatitis with pimecrolimus cream 1% in infants and young children: a two-year study. J Am Acad Dermatol 2005;52:240-6
57. Sunderkotter C, Weiss JM, Bextermoller R, et al. [Post-marketing surveillance on treatment of 5,665 patients with atopic dermatitis using the calcineurin inhibitor pimecrolimus: positive effects on major symptoms of atopic dermatitis and on quality of life]. J Dtsch Dermatol Ges 2006;4:301-6
58. Eichenfield LF, Lucky AW, Boguniewicz M et al. Safety and efficacy of pimecrolimus (ASM 981) cream 1% in the treatment of mild and moderate atopic dermatitis in children and adolescents. J Am Acad Dermatol 2002;46:495-504
59. Murrell DF, Calvieri S, Ortonne JP, et al. A randomized controlled trial of pimecrolimus cream 1% in adolescents and adults with head and neck atopic dermatitis and intolerant of, or dependent on, topical corticosteroids. Br J Dermatol 2007;157:954-9
60. Zuberbier T, Heinzerling L, Bieber T, et al. Steroid-sparing effect of pimecrolimus cream 1% in children with severe atopic dermatitis. Dermatol 2007;215:325-30
61. Zuberbier T, Brautigam M. Long-term management of facial atopic eczema with pimecrolimus cream 1% in paediatric patients with mild to moderate disease. J Eur Acad Dermatol Venereol 2008;22(6):718-21
62. Gollnick H, Kaufmann R, Stough D, et al. Pimecrolimus cream 1% in the long-term management of adult atopic dermatitis: prevention of flare progression. A randomized controlled trial. Br J Dermatol 2008;158:1083-93
63. Simon D, Lubbe J, Wuthrich B, et al. Benefits from the use of a pimecrolimus-based treatment in the management of atopic dermatitis in clinical practice. Analysis of a Swiss cohort. Dermatol 2006;213:313-8
64. Luger TA, Gollnick H, Schwennesen T, et al. Safety and efficacy of pimecrolimus cream 1% in the daily practice: results of a patient self-observation study in patients with atopic dermatitis. J Dtsch Dermatol Ges 2007;5:908-14
65. Stuetz A, Grassberger M, Meingassner JG. Pimecrolimus (Elidel, SDZ ASM 981)-preclinical pharmacologic profile and skin selectivity. Semin Cutan Med Surg 2001;20:233-41
66. Paul C, Cork M, Rossi AB, et al. Safety and tolerability of 1% pimecrolimus cream among infants: experience with 1133 patients treated for up to 2 years. Pediatrics 2006;117:e118-28
67. Allen BR, Lakhanpaul M, Morris A, et al. Systemic exposure, tolerability, and efficacy of pimecrolimus cream 1% in atopic dermatitis patients. Arch Dis Child 2003;88:969-73
68. Lakhanpaul M, Davies T, Allen BR, et al. Low systemic exposure in infants with atopic dermatitis in a 1-year pharmacokinetic study with pimecrolimus cream 1%*. Exp Dermatol 2006;15:138-41
69. Van Leent EJ, De Vries HJ, Ebelin ME, et al. Blood concentrations of pimecrolimus in adult patients with atopic dermatitis following intermittent administration of pimecrolimus cream 1% (Elidel) for up to 1 year. J Dermatol Treat 2007;18:19-22
70. Staab D, Pariser D, Gottlieb AB, et al. Low systemic absorption and good tolerability of pimecrolimus, administered as 1% cream (Elidel) in infants with atopic dermatitis - a multicenter, 3-week, open-label study. Pediatr Dermatol 2005;22:465-71
71. Thaci D, Steinmeyer K, Ebelin ME, et al. Occlusive treatment of chronic hand dermatitis with pimecrolimus cream 1% results in low systemic exposure, is well tolerated, safe, and effective. An open study. Dermatol 2003;207:37-42
72. Oji V, Beljan G, Beier K, et al. Topical pimecrolimus: a novel therapeutic option for Netherton syndrome. Br J Dermatol 2005;153:1067-8
73. Rubins A, Gutmane R, Valdmane N, et al. Pharmacokinetics of 0.1% tacrolimus ointment after first and repeated application to adults with moderate to severe atopic dermatitis. J Invest Dermatol 2005;125:68-71
74. Harper J, Smith C, Rubins A, et al. A multicenter study of the pharmacokinetics of tacrolimus ointment after first and repeated application to children with atopic dermatitis. J Invest Dermatol 2005;124:695-9
75. Soter NA, Fleischer AB Jr, Webster GF, et al. Tacrolimus ointment for the treatment of atopic dermatitis in adult patients: part II, safety. J Am Acad Dermatol 2001;44:S39-46
76. Paller A, Eichenfield LF, Leung DY, et al. A 12-week study of tacrolimus ointment for the treatment of atopic dermatitis in pediatric patients. J Am Acad Dermatol 2001;44:S47-57
77. Beljan G, Traupe H, Metze D, et al. [Comel-Netherton syndrome with bacterial superinfection]. Hautarzt 2003;54:1198-202
78. Allen A, Siegfried E, Silverman R, et al. Significant absorption of topical tacrolimus in 3 patients with Netherton syndrome. Arch Dermatol 2001;137:747-50
79. Beyerler M, Schmid-Grendelmeier P, Hafner J. Significantly elevated systemic levels after occlusive application of topical tacrolimus in atopic dermatitis. Dermatol 2006;212:260-1
80. Drake L, Prendergast M, Maher R, et al. The impact of tacrolimus ointment on health-related quality of life of adult and pediatric patients with atopic dermatitis. J Am Acad Dermatol 2001;44:S65-72
81. Milingou M, Antille C, Sorg O, et al. Alcohol intolerance and facial flushing in patients treated with topical tacrolimus. Arch Dermatol 2004;140:1542-4
82. Ogunleye T, James WD. Ethanol-induced flushing with topical pimecrolimus use. Dermatitis 2008;19:E1-2
83. Tomi NS, Luger TA. The treatment of atopic dermatitis with topical immunomodulators. Clin Dermatol 2003;21:215-24
84. Remitz A, Kyllonen H, Granlund H, et al. Tacrolimus ointment reduces staphylococcal colonization of atopic dermatitis lesions. J Allergy Clin Immunol 2001;107:196-7
85. Hofman T, Cranswick N, Kuna P, et al. Tacrolimus ointment does not affect the immediate response to vaccination, the generation of immune memory, or humoral and cell-mediated immunity in children. Arch Dis Child 2006;91:905-10
86. Stiehm ER, Roberts RL, Kaplan MS, et al. Pneumococcal seroconversion after vaccination for children with atopic dermatitis treated with tacrolimus ointment. J Am Acad Dermatol 2005;53:S206-13
87. Papp KA, Breuer K, Meurer M, et al. Long-term treatment of atopic dermatitis with pimecrolimus cream 1% in infants does not interfere with the development of protective antibodies after vaccination. J Am Acad Dermatol 2005;52:247-53
88. Gradman J, Wolthers OD. Suppressive effects of topical mometasone furoate and tacrolimus on skin prick testing in children. Pediatr Dermatol 2008;25:269-70
89. Mandelin J, Remitz A, Virtanen H, et al. Recall antigen reactions in patients with atopic dermatitis treated with tacrolimus ointment for 1 year. J Allergy Clin Immunol 2008;121:777-9
90. Reitamo S, Rissanen J, Remitz A, et al. Tacrolimus ointment does not affect collagen synthesis: results of a single-center randomized trial. J Invest Dermatol 1998;111:396-8
91. Kyllonen H, Remitz A, Mandelin JM, et al. Effects of 1-year intermittent treatment with topical tacrolimus monotherapy on skin collagen synthesis in patients with atopic dermatitis. Br J Dermatol 2004;150:1174-81
92. Queille-Roussel C, Paul C, Duteil L, et al. The new topical ascomycin derivative SDZ ASM 981 does not induce skin atrophy when applied to normal skin for 4 weeks: a randomized, double-blind controlled study. Br J Dermatol 2001;144:507-13
93. Ellis D, Jaffe R, Green M, et al. Epstein-Barr virus-related disorders in children undergoing renal transplantation with tacrolimus-based immunosuppression. Transplantation 1999;68:997-1003
94. Parrish JA. Immunosuppression, skin cancer, and ultraviolet A radiation. N Engl J Med 2005;353:2712-3
95. Margolis DJ, Hoffstad O, Bilker W. Lack of association between exposure to topical calcineurin inhibitors and skin cancer in adults. Dermatol 2007;214:289-95
96. Bieber T, Cork M, Ellis C, et al. Consensus statement on the safety profile of topical calcineurin inhibitors. Dermatol 2005;211:77-8
97. McNeill AM, Koo JY. "Unknown Risks" of non-steroid topical medications for atopic dermatitis. Int J Dermatol 2007;46:656-8
98. Langley RG, Luger TA, Cork MJ, et al. An update on the safety and tolerability of pimecrolimus cream 1%: evidence from clinical trials and post-marketing surveillance. Dermatol 2007215(Suppl 1):27-44. Epub;%2007 Dec 18.
99. Arellano FM, Wentworth CE, Arana A, et al. Risk of lymphoma following exposure to calcineurin inhibitors and topical steroids in patients with atopic dermatitis. J Invest Dermatol 2007;127:808-16
100. Lerche CM, Philipsen PA, Poulsen T, et al. Topical tacrolimus in combination with simulated solar radiation does not enhance photocarcinogenesis in hairless mice. Exp Dermatol 2008;17:57-62
101. Weischer M, Rocken M, Berneburg M. Calcineurin inhibitors and rapamycin: cancer protection or promotion? Exp Dermatol 2007;16:385-93
102. Ring J, Barker J, Behrendt H, et al. Review of the potential photo-cocarcinogenicity of topical calcineurin inhibitors: position statement of the European Dermatology Forum. J Eur Acad Dermatol Venereol 2005;19:663-71
103. Doelker L, Tran C, Gkomouzas A, et al. Production and clearance of cyclobutane dipyrimidine dimers in UV-irradiated skin pretreated with 1% pimecrolimus or 0.1% triamcinolone acetonide creams in normal and atopic patients. Exp Dermatol 2006;15:342-6
104. US National Institutes for Health. Clinical Trials.gov. Online. Available at: http://clinicaltrials.gov/ct2/home
105. Virtanen H, Remitz A, Malmberg P, et al. Topical tacrolimus in the treatment of atopic dermatitis-does it benefit the airways? A 4-year open follow-up. J Allergy Clin Immunol 2007;120:1464-6
106. Hjelmgren J, Svensson A, Jorgensen ET, et al. Cost-effectiveness of tacrolimus ointment vs. standard treatment in patients with moderate and severe atopic dermatitis: a health-economic model simulation based on a patient survey and clinical trial data. Br J Dermatol 2007;156:913-21
107. Ellis CN, Drake LA, Prendergast MM, et al. Cost-effectiveness analysis of tacrolimus ointment versus high-potency topical corticosteroids in adults with moderate to severe atopic dermatitis. J Am Acad Dermatol 2003;48:553-63
108. Ellis C, Luger T, Abeck D, et al. International Consensus Conference on Atopic Dermatitis II (ICCAD II): clinical update and current treatment strategies. Br J Dermatol 2003;148(Suppl 63):3-10
109. Peserico A, Stadtler G, Sebastian M, et al. Reduction of relapses of atopic dermatitis with methylprednisolone aceponate cream twice weekly in addition to maintenance treatment with emollient: a multicentre, randomized, double-blind, controlled study. Br J Dermatol 2008;158:801-7
110. Zenz R, Eferl R, Kenner L, et al. Psoriasis-like skin disease and arthritis caused by inducible epidermal deletion of Jun proteins. Nature 2005;437:369-75