In the May issue of the ARCHIVES, Ruzicka et al1 presented a scholarly review of the possible applications of the immunosuppressive drug tacrolimus in the treatment of dermatologic diseases. As they appropriately cautioned, the knowledge base of articles discussing topical uses of this drug is quite small, and much needs to be learned. Often, before the completion of large-scale, blinded, placebo-controlled trials, physicians will report the results of single-patient experiences. Not surprisingly, positive results are much more likely to be written up for publication than are negative results. Hence, the following brief case report should caution against being overly optimistic about expectations for tacrolimus or any other new drug until the appropriate multicenter studies are completed.
Thiers BH. Topical Tacrolimus: Treatment Failure in a Patient With Alopecia Areata. Arch Dermatol. 2000;136(1):124. doi: