Five studies were included in the review (n was unclear but appeared to be 60): one randomised controlled trial (RCT) (n was unclear, but appeared to be 20); and four uncontrolled studies (n=40).
There was no significant difference between tacrolimus and clobetasol (one RCT), but there was a significantly higher occurrence of telangiectasia with clobetasol compared with tacrolimus (p<0.05).
Tacrolimus was effective for the initial skin lesions of systemic lupus erythematous lesions with edematous or telangiectatic changes within two weeks of initiation of treatment (one uncontrolled study) and extensive photosensitive rash in systemic lupus erythematous (one uncontrolled study). Pimecrolimus treatment was associated with significant improvement in skin lesions in systemic lupus erythematous (one uncontrolled study).
Tacrolimus and pimecrolimus were reported to be efficacious for subacute cutaneous lupus erythematous to a lesser extent than for systemic lupus erythematous (two uncontrolled studies, one RCT).
Pimecrolimus (two uncontrolled studies) and tacrolimus (one RCT and one uncontrolled study) were associated with with improvement in discoid lupus erythematous patients. Pimecrolimus-treated patients showed significant improvement in quality of life scores in two uncontrolled studies. The authors reported that patients with hyperkeratotic discoid lupus erythematous did not respond well to tacrolimus treatment (one uncontrolled study).