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Dermatology · Therapeutics: topical calcineurin inhibitors
Sample itemA mother is worried about the burning sensation and the boxed warning on topical tacrolimus for her child's facial eczema. What is the correct counselling?
Original practice item, not a recalled exam question. Nothing here is recorded.
The answer and the reasoning
C. Burning is common in the first few days and usually settles; sun protection is advised and long-term safety data are reassuring
Topical calcineurin inhibitors such as tacrolimus and pimecrolimus commonly cause transient burning that settles with continued use. The boxed warning for lymphoma and skin cancer is theoretical, and large studies have not confirmed increased risk. They are steroid-sparing for the face and flexures, with sun protection advised.
Option by option
A. It should be applied under occlusion for faster action
Occlusion is discouraged because it increases absorption.
B. The drug must never be used in children
Use in children is approved from age 2 for tacrolimus.
C. Burning is common in the first few days and usually settles; sun protection is advised and long-term safety data are reassuring (correct)
Correct. Transient burning is common and long-term data are reassuring.
D. Burning means a true allergy and treatment must stop forever
Early burning is not true allergy.
Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.
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