There seems to be a lot of controversy surrounding the safety of topical tacrolimus (Protopic) and pimecrolimus (Elidel) for the treatment of AD, in terms of whether there is a risk that they cause cancer. It all climaxed with the FDA sending out “black box warnings” on these products.
“Here’s an article”: that surveys several dermatologists to see whether their prescribing strategies have changed since the warnings were added.
There were a few several interesting points for me:
* Seems most dermatologists don’t think the warning is warranted. Particularly, it was interesting that one said that it was more the primary care physician that would take patients off the prescription instead of the dermatologist. But who knows how the dermatologists in this article were selected.
* The animal studies which lead to cancer claims were for the oral form of the drugs, not the topical form. Of course it’s going to get a lot more in your bloodstream if you eat it instead of rubbing it against your skin. It’s still unclear how much of it has to get into your bloodstream before it starts becoming dangerous.
* TCI’s have lots of studies about them (both orally and topically administered forms). Some of the topical corticosteroids don’t have as many studies. How do we know that they’re any better?

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