Tacrolimus Ointment for Atopic Dermatitis

To the Editor: Ruzicka et al. (Sept. 18, 1997, issue) 1 reported that tacrolimus (FK 506) ointment is beneficial in the treatment of atopic dermatitis. It is remarkable that an immunosuppressant agent produced a significant improvement in the symptoms of an inflammatory disease after three days of treatment. I suggest that in this disorder, which is characterized by the activation of skin mast cells and infiltrating basophils, 2 tacrolimus acts as an antiinflammatory agent by modulating the release of inflammatory mediators. Mast cells and basophils act as both immunoregulators and proinflammatory cells through the release of vasoactive mediators and cytokines (e.g., interleukin-4). . . .