AND THE ANSWER IS . . . 3 Discussion Tac is an immunosuppressive and anti-inflammatory agent based on its inhibition of intracellular calcineurin-related pathways (1). When applied topically to inflamed lesions such as present in AD, there is extensive local absorption into the skin but little or no systemic absorption of biologically active Tac. Therefore, there have been no adverse systemic effects of Tac ointment therapy, even after extended periods of treatment. Thus, monitoring of serum Tac levels is not necessary. Topical Tac therapy is as effective or perhaps more effective than 1% hydrocortisone ointment, a commonly used agent in the treatment of AD (3,4). It is not yet defined how the efficacy of Tac compares with that of more potent typical corticosteroids. An advantage of Tac over topical steroids is that thinning of the skin seen with the prolonged use of topical steroids does not occur with chronic topical Tac treatment. Therefore, Tac ointment can be used chronically on the face where prolonged topical steroid therapy is generally avoided. Stinging and burning at the Tac application sites does occur in about 20-30% of AD patients but this is generally transient. References 1 ) J Eur Acad Dermatol Venereol 2002; 16:100-114 2) J Am Acad Derm 2002; 46:228-41 3) Br J Dermatol 2004;150:554-62 4) Am J Clin Dermatol 3004;5:267-79   Please tell us what you think of this site. © Copyright 1997-2008 American Academy of Allergy, Asthma & Immunology All rights reserved