Tacrolimus Ointment, Alcohol, and Facial Flushing
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《新英格兰医药杂志》
A 56-year-old patient was treated with 0.1 percent tacrolimus ointment because of rosacea that had been aggravated by prolonged use of topical corticosteroids. After two weeks of treatment, she had an unprecedented episode of facial flushing during an evening reception where alcoholic beverages were served. The patient agreed to undergo a test to see whether the reaction could be reproduced in a clinical setting. After one week of twice-daily application of 0.5 g of 0.1 percent tacrolimus ointment on the face, she ingested 0.05 liter of white wine. The images show the patient before exposure to alcohol (Panel A) and 12 minutes after exposure (Panel B). The erythema faded after 45 minutes. One month after the discontinuation of treatment with tacrolimus, the patient's tolerance of alcohol was normal. Intolerance to alcohol occurs in up to 7 percent of adult patients who are treated with topical tacrolimus and has also been reported with pimecrolimus cream.
Jann Lübbe, M.D.
Maria Milingou, M.D.
Geneva University Hospital
1211 Geneva 14, Switzerland
Jann Lübbe, M.D.
Maria Milingou, M.D.
Geneva University Hospital
1211 Geneva 14, Switzerland