Abstract
BackgroundLichen sclerosus is a chronic inflammatory disease with a predilection of the anogenital region. Because of the potential side effects of repeated local application of potent glucocorticosteroids, equally-effective, safer therapeutic options are required, especially in the treatment of children.Case presentationsWe report on the efficacy of twice-daily application of pimecrolimus 1% cream in four prepubertal girls (range of age: 4 to 9 years) who suffered from anogenital lichen sclerosus. After three to four-month treatment, all patients had almost complete clinical remission including relief from itch, pain and inflammation. Only minor improvement was observed for the white sclerotic lesions. No significant side effects have been observed.ConclusionsTopical pimecrolimus appears to be an effective and safe treatment for children with anogenital lichen sclerosus. The clinical benefits observed in the four patient presented particularly include relief of pruritus, pain and inflammation. Vehicle-controlled studies on a larger number of patients are now warranted to substantiate our promising findings, and to investigate long-term efficacy and safety of topical pimecrolimus in anogenital lichen sclerosus.
Highlights
Lichen sclerosus is a chronic inflammatory disease with a predilection of the anogenital region
We describe four prepubertal girls between the age of 4 and 9 years who suffered from Lichen sclerosus (LS) of the anogenital region (Tab. 1)
Pimecrolimus belongs to the ascomycin class of macrolactam immunosuppressives, acting by the inhibition of Tcell activation via the calcineurin pathway and inhibition of the release of numerous inflammatory cytokines, thereby preventing the cascade of immune and inflammatory signals
Summary
Pimecrolimus belongs to the ascomycin class of macrolactam immunosuppressives, acting by the inhibition of Tcell activation via the calcineurin pathway and inhibition of the release of numerous inflammatory cytokines, thereby preventing the cascade of immune and inflammatory signals. At the end of therapy, almost complete remission of symptoms was achieved in Successful treatment of genital LS with calcineurin inhibitors has been reported recently. 1) Vulvar region before (a) and after (b) 12 weeks of pimecrolimus 1% cream twice daily We observed that subjective symptoms such as pruritus and pain completely resolved after a few weeks of treatment and clinical features such as fissuring, purpura, inflammatory erythema and genital bleeding almost completely resolved at the end of therapy (Table 1). As the recurrence rate of active LS in prepuberty is relatively high and many of the patients have continuing symptoms after menarche as well, a long-term treatment regime not based on GCS is needed to avoid the well-known side effects linked to. Vehicle-controlled studies on a larger number of patients are warranted to substantiate our promising findings, and to investigate long-term efficacy and safety of topical pimecrolimus in anogenital LS
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
