OC10 Topical pimecrolimus for the treatment of erosive oral lichen planus

Abstract

Introduction A wide variety of topical and systemic therapies are proposed for the treatment of symptomatic erosive or ulcerative oral lichen planus (OLP). The calcineurin inhibitor tacrolimus has been shown to be an effective means of treating OLP recalcitrant to other therapies. More recently, pimecrolimus has also been suggested to be of benefit in the treatment of such disease.Case Summary A 50‐year‐old male with a 7‐year history of histopathologically proven erosive OLP had been treated with a wide variety of topical and systemic therapies, including tacrolimus ointment. Despite this his condition remained problematic with frequent episodes of severe erosive disease predominantly affecting the buccal mucosa bilaterally. Clinical examination revealed extensive intra‐oral erosive disease, particularly affecting the right buccal mucosa. Twice daily topical application of 1% pimecrolimus ointment (Elidel®) was instituted. This resulted in resolution of his symptoms and a significant improvement in the clinical appearance of his oral lesions within a 2‐month period.Conclusion Topical pimecrolimus may be an effective therapy for symptomatic erosive or ulcerative OLP recalcitrant to other topical and systemic therapies, including topical tacrolimus. There is a need for appropriate studies to establish the efficacy of pimecrolimus for the treatment of OLP and to ascertain whether topical calcineurin inhibitors increase the malignant potential of OLP.