Tacrolimus 연고제로 호전을 보인 항문 주위 크론병 3례

Topical Tacrolimus Resulting in a Marked Resolution of Perianal Crohn's Disease

저자들은 기존의 크론병 치료에 호전이 없었던 항문 주위 병변에 0.3 mg/g의 저농도 tacrolimus 연고제를 1일 2회 환부에 도포하는 방법으로 약물에 의한 부작용 발생 없이 병변의 현저한 호전을 보인 3례를 경험하였기에 보고하는 바이다.

Crohn's disease of the perineum is notably resistant to treatment. We describe our experiences of tacrolimus ointment application in three patients with intractable perianal Crohn's disease. At the time of diagnosis patients showed anal fissure with ulcer, anal fistula, or perianal abscess, respectively. These lesions did not respond to steroid, metronidazole, mesalazine, or azathioprine, though the pediatric Crohn's disease activity index was markedly improved during the treatment period (4 to 12 months). Topical tacrolimus was applied and resulted in marked healing and a rapid granulation of cavity edges within 6 weeks to 3 months. Topical tacrolimus at a low dose shows a promise for the management of childhood perianal Crohn's disease. Further controlled studies are required to assess the efficacy and safety of this treatment.