Effect of Tacrolimus (FK506) in Dystrophic Epidermolysis Bullosa: Rationale and Preliminary Results

Progress has been made in understanding skin diseases such as epidermolysis bullosa (EB). Epidermolysis bullosa is characterized by abnormal skin fragility and the formation of blisters and erosions of the skin and mucous membranes in response to minor trauma. The disease manifests in infancy, and, by childhood, patients have cutaneous scarring and mucosal involvement that can be severe. Treatment is palliative. Tacrolimus (FK506) is a new immunosuppressive agent used in organ transplantation. This agent has a number of nonimmune effects, one of which is augmentation of cell regeneration and repair.1 With the rationale of stimulating wound healing, we administered tacrolimus to a 5-year-old boy with dystrophic EB. There were no toxic effects, and scabs could form and affected areas heal since disease onset and treatment dramatically shortened the time to heal new lesions. Report of a Case. Our patient was normal at birth. Blistering began at 2 months; at 4