Long-term safety of topical pimecrolimus and topical tacrolimus in atopic blepharoconjunctivitis.

Long-term Safety of Topical Pimecrolimus and Topical Tacrolimus in Atopic Blepharoconjunctivitis Atopic blepharoconjunctivitis (ABC) is an ocular manifestation of atopy with a course similar to that of atopic dermatitis: chronic with exacerbations. Topical corticosteroids are widely used for ABC, but longtermuse has awell-established risk of adverse effects: increase of intraocular pressure (IOP) or glaucoma, subcapsular cataract, reactivation of herpes simplexvirus, andskinatrophy.1,2 Someof theadverseeffectsmay manifest in amatter of days in susceptible individuals (IOP increase), while some are relevant in prolonged use (skin atrophy and subcapsular cataract). Topical calcineurin inhibitors pimecrolimus and tacrolimus have shown good long-term safety in the treatment of atopic dermatitis,3 and previous smaller studies of the use of tacrolimus on the eyelids have showngood safety, efficacy, improvement of conjunctival cytology, and a positive effect on IOP.4-6