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June 12, 2020
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Topical calcineurin inhibitors may be effective in pediatric periorificial dermatitis

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Nearly 70% of pediatric patients with periorificial dermatitis who underwent topical calcineurin inhibitor monotherapy showed a complete response, according to a study.

“Data regarding the treatment of periorificial dermatitis with topical calcineurin inhibitors in the pediatric population are limited,” Ayelet Ollech, MD, of the division of dermatology at Ann & Robert H. Lurie Children’s Hospital of Chicago, and colleagues wrote.

Nearly 70% of pediatric patients with periorificial dermatitis who underwent topical calcineurin inhibitor monotherapy showed a complete response, according to a study.

The group conducted a retrospective medical record review of pediatric patients to evaluate the clinical utility of these drugs. In cases in which medical records failed to provide complete and accurate data, clinicians followed up via telephone.

The analysis included 132 patients who had a median age of 4.2 years (interquartile range, 2.3-8.2 years). Patients were followed for a median of 5.2 months (IQR, 2.1-11.7 months).

Among 72 patients with evaluable follow-up information, 66.7% underwent topical calcineurin inhibitor monotherapy, 16.7% were treated with a combination of topical calcineurin inhibitors plus metronidazole, 12.5% were treated with a combination of topical calcineurin inhibitors and systemic antibiotic, and 4.2% were treated with topical calcineurin inhibitors, metronidazole and systemic antibiotic.

The complete response rate in the calcineurin inhibitor monotherapy group was 68.8%, while 75% of those treated with concomitant metronidazole and 77.8% of those treated with a concomitant antibiotic reached this result. The triple therapy resulted in a complete response in 66.7% of patients.

Other findings showed that patients were treated for a median of 60 days (IQR, 30-90 days). Recurrence of disease was reported in 18% of the cohort.

Seventeen patients demonstrated a partial response to treatment with topical calcineurin inhibitors. Among patients who showed a complete or partial response, the time to that result was 14 days (IQR, 7-60 days).

Turning to the safety profile, the researchers described adverse events as “rare and mild in severity.”

“Topical calcineurin inhibitors are an effective therapeutic option for pediatric patients with periorificial dermatitis and were well tolerated in this cohort,” the researchers wrote.