Objective To evaluate efficacy and safety of topical tacrolimus（FK506）for atopic dermatitis. Methods Randomized controlled trials (RCTs) were identified from specialized trials registered in Cochrane Skin Group (July, 2003), the Cochrane Library (issue 2, 2003), Medline (1996-2003), Embase (1984-2003) and CBM (1978-2003). We handsearched the published and unpublished data and Cochrane Skin Group 8th Annual Meeting. RCTs comparing tacrolimus with placebo or hormone were included. Data were extracted and evaluated by two reviewers independently. Results Eight randomized controlled trials involving 4 122 patients were included, with all trials of high methodological quality. Meta-analysis indicated that 0.03% tacrolimus was more effective than placebo, 1% hydrocortisone acetate and 0.1% hydrocortisone butyrate with odds ratio of 3.03 [95%CI (1.05, 8.73), P=0.04], 0.1% tacrolimus was more effective than placebo, 1% hydrocortisone acetate and 0.1% hydrocortisone butyrate with odds ratio of 3.84 [95%CI (1.43, 10.32), P=0.008], 0.3% tacrolimus was more effective than placebo with odds ratio of 3.20 [95%CI (1.31, 7.79), P=0.01], the odds ratio of 0.1% tacrolimus vs 0.03% tacrolimus was 1.40 [95%CI (1.13, 1.72), P=0.002]. No serious adverse effects were identified. Conclusions Topical tacrolimus for atopic dermatitis is more effective than placebo and 1% hydrocortisone acetate. 0.1% tacrolimus is more effective than 0.03% tacrolimus. No conclusion could be drawn when tacrolimus is compared with 0.1% hydrocortisone butyrate. Tacrolimus tends to improve EASI scores, head and neck scores as well as HRQL scores, but more randomized controlled trials are necessary to draw definite conclusions.
目的:探讨慢性湿疹和皮炎患者接触性致敏原及其特点。方法:应用斑贴试验分析178例慢性湿疹和皮炎患者接触性致敏原。结果:列前的致敏原分别是硫酸镍、甲醛、香料、对苯二胺、重铬酸钾、松香、橡胶、白降汞、乙二胺;引起手部湿疹和皮炎患者的致敏原主要是香料和重铬酸钾、躯干和四肢湿疹和皮炎患者的致敏原主要为硫酸镍和松香、头面部湿疹和皮炎患者的主要致敏原为甲醛和香料,脐周皮炎和系统性接触性皮炎患者的致敏原主要为硫酸镍。结论:斑贴试验有助于明确慢性湿疹和皮炎患者的接触性致敏原及其性质。
目的:探讨慢性湿疹和皮炎患者接触性致敏原及其特点。方法:应用斑贴试验分析178例慢性湿疹和皮炎患者接触性致敏原。结果:列前的致敏原分别是硫酸镍、甲醛、香料、对苯二胺、重铬酸钾、松香、橡胶、白降汞、乙二胺;引起手部湿疹和皮炎患者的致敏原主要是香料和重铬酸钾;躯干和四肢湿疹和皮炎患者的致敏原主要为硫酸镍和松香;头面部湿疹和皮炎患者的主要致敏原为甲醛和香料;脐周皮炎和系统性接触性皮炎患者的致敏原主要为硫酸镍。结论:斑贴试验有助于明确慢性湿疹和皮炎患者的接触性致敏原及其性质。
ObjectiveTo assess the efficacy and safety of compound flumetasone ointment for neurodermatitis and chronic eczema. MethodsWe searched the Medline, Cochrane Central Register of Controlled Trials, EMbase, CBM, CNKI and Wanfang Data to collect randomized controlled trials (RCTs) of compound flumetasone ointment for neurodermatitis and chronic eczema; the retrieval time started from founded date to December 2012. The language was confined to English and Chinese. We performed meta-analyses using the Cochrane Collaboration's RevMan 5.0 Software. ResultsA total of 22 RCTs involving 2 049 patients with neurodermatitis and chronic eczema were included and assessed. At the end of the 2nd, 3rd and 4th week, the efficacy of topical compound flumetasone ointment (or combined with oral antihistamines) was obviously higher than that of other topical corticosteroid preparations[RR=1.39, 95%CI(1.30, 1.50), P<0.000 01; RR=1.25, 95%CI(1.15, 1.37), P<0.000 01; RR=1.21, 95%CI(1.11, 1.33), P<0.000 1]. Only temporary and slight adverse effects, such as erythema, desquamation, burning and tingling were observed, whereas no serious adverse effects were reported. ConclusionThe limited evidence demonstrates that topical compound flumetasone ointment (or combined with oral antihistamines) is safe and efficient. More large sampled and multiple central RCTs are required to verify these conclusions owing to the limitations of the present study.