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Am Fam Physician. 2003;67(9):1874

to the editor: I read with interest the article, “Topical Tacrolimus: A New Therapy for Atopic Dermatitis,”1 because I recently saw a patient who experienced therapeutic failure with a $100 tube of tacrolimus for atopic dermatitis.

Because the response rate with tacrolimus is 27 to 36 percent compared with a 6 percent response rate for the vehicle alone, there is little doubt that tacrolimus works better than its vehicle alone. However, practicing physicians need to know whether tacrolimus works better than other available therapies, such as oral antihistamines, topical emollients, topical doxepin, and topical corticosteroids. This information would help physicians decide whether to order such an expensive new treatment or stay with the available remedies.

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This series is coordinated by Kenny Lin, MD, MPH, deputy editor.

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