Feb 17, 2012
Hello. I recently visited a dermatologist who prescribed this cream to me for seborrheic dermatitis on my face/scalp. I had previously used corticosteroids; however, they do thin the skin, and the doctor suggested this instead. I did not realize it had immunosuppresant capabilities to it. Hmm...I thought I let the doctor know I had Hiv. Would using this cream further suppress my immune system? I have been on meds for several years and my virus is under control (undetectable and cd4 of 420 or 32%) This is usually as good as it gets with me in terms of labs. Should I not bother with this cream?
Response from Dr. Henry
I have not used Elidel-in general would not expect a major problem in HIV+ patients but recommend monitoring and making both your dermatoogist and HIV doctor aware of the situation. Found one relevant article:
An open-label efficacy pilot study with pimecrolimus cream 1% in adults with facial seborrhoeic dermatitis infected with HIV
AP De Moraes1,*, ÉÂG De Arruda1, MAV Vitoriano1, MO De Moraes Filho2, FÂF Bezerra2, E De Magalhes Holanda3, MEA De Moraes2
Article first published online: 22 MAR 2007
Background Seborrhoeic dermatitis (SD) is a common dermatosis in human immunodeficiency virus (HIV)-positive patients, many of whom do not respond satisfactorily to conventional topical treatments such as corticosteroids and antifungals.
Objective A pilot study to investigate the efficacy and tolerability of pimecrolimus cream 1% in HIV-positive patients with facial SD.
Methods In a single-centre study, 21 HIV-infected patients with mild to severe SD were treated twice daily with pimecrolimus cream 1% for 14 days. Thereafter, treatment was discontinued and patients followed up for 5 weeks. Skin involvement at baseline and on days 7, 14, 21, 35 and 49 was assessed using a four-point clinical score and digital photography.
Main outcome measures Efficacy and safety of pimecrolimus cream 1% treatment and incidence of relapse in the follow-up phase.
Results Marked improvement was seen in clinical parameters at day 7, with ≥ 90% patients clear of symptoms at day 14. Relapse was observed at day 35 but signs were milder than at baseline. All patients responded to therapy, despite their immunological status. Pimecrolimus did not alter CD4+ and CD8+ T-cell counts or viral load during the treatment period.
Conclusion Pimecrolimus cream represents a new, effective therapeutic option for facial SD in HIV patients.
If any reader knows of other references or has personal experience please post. KH
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