protopic for blepharitis

[peterdillon]

Hi all .just wondering if anyone has advised others to use protopic 0.1% for blepharitis  aka Topical FK 506 Ointment 0.1%. I have blepharitis many years and used many treatments most short lived and then back on the rollercoaser with red eyes + inflamed lids crusting etc .I also have had many chalzions removed (3 so far this year) I would twice daily hot compressfor 10-15 min and lid scrub switching between 1% tea-tree shampoo and baby shampoo  and lately started protopic ointment which has so far reduced redness and appearance of blepharitis is fading ,however I do get a slight burning or heat sensation on the surface of the eye lid for a day afterwards I only apply very small amount just enough to cover surface of eye lids and then skip a day I was warned by doc not to get into eyes or wash out straight away if it happens .I would like to give this treatment more time but the burning/heat sensation  although very slight does bother me. anyone tried protopic and had similar experience ?. Peter Dillon  Dublin,Ireland

[Flavius G Pernoud III, MD]

Been in practice 30 yrs Never heard of protopic. Blepharitis is a chronic low grade staph infection. You can benefit from scrubs of your eyelids but you must continue it. Sometimes low dose tetracycline by mouth is helpful but there can be side effects. There are various lid scrub foams and pads available that work fairly well. You can try one drop of baby shampoo in 1 oz. of tap water. Use a cotton swab or clean wash cloth with this dilute solution to gently clean the eyelid margins just where the eyelashes come out.

[peterdillon]

this is one of the reports that brought this treatment to my attention .I .do think its not a rock solid solution but for me it was worth trying  as the conclusion to report was promising.peter


Mayer K, Reinhard T, Reis A, Böhringer D, Sundmacher R.

Augenklinik, Heinrich-Heine-Universität, Düsseldorf.

BACKGROUND: Severe atopic blepharitis is difficult to treat, as topical steroids offer only a limited therapeutic benefit with increasing side effects by time. Topical FK 506 was found to be efficient and safe for treatment of atopic dermatitis in dermatologic studies. The use of topical FK 506 in atopic blepharitis has not been reported so far. PATIENTS AND METHODS: Fourteen patients with severe atopic blepharitis were treated with topical FK 506 0.1 %. The ointment was applied twice daily on the eye lids. Ophthalmologic examinations were scheduled at two weeks, two months and five months after onset of treatment. A score was defined for the skin of the lid (edema, erythema, lichenification, oozing, excoriation and crusting) and for the eye lid margin (erythema, thickening, crusting) respectively. Every patient graded pruritus on a visual analogue scale. RESULTS: The mean skin score prior to treatment was 25.6 +/- 5.8, after two weeks 7.9 +/- 4.8 (p < 0.001), after two months 5.8 +/- 5.0 (p < 0.001) and after five months 5.3 +/- 5.3 (p < 0.001). The mean score for the eye lid margin prior to treatment was 12.3 +/- 4.0, after two weeks 4.6 +/- 2.7 (p < 0.001), after two months 3.8 +/- 2.4 (p < 0.001) and after five months 4.3 +/- 2.6 (p < 0.001). The mean score for pruritus prior to treatment was 8.1 +/- 1.3, after two weeks 2.0 +/- 1.4 (p < 0.001), after two months 1.3 +/- 0.8 (p < 0.001) and after five months 0.8 +/- 0.7 (p < 0.001). All patients assessed the overall situation under therapy as markedly improved. CONCLUSIONS: Topical FK 506 0.1 % ointment turns out to be an excellent therapeutic option for treatment of severe atopic blepharitis. Long-term efficacy and safety have to be evaluated in long-term follow-up studies.

PMID: 11731901 [PubMed - indexed for MEDLINE]