Treatment of erosive oral lichen planus with topical tacrolimus

Abstract

BACKGROUND: Erosive oral lichen planus (LP) is a painful chronic inflammatory condition that is frequently resistant to immunosuppressive agents. Topical tacrolimus has been reported as a safe and effective treatment.OBJECTIVE: To evaluate the efficacy and safety of topical tacrolimus in the treatment of symptomatic erosive oral LP.METHODS: A retrospective review of consecutive patients with oral LP treated with topical tacrolimus between June 1999 and November 2003 was performed. Clinical improvement and adverse events were recorded by the physician. Patients were asked retrospectively to rate their symptoms immediately prior to and after tacrolimus therapy using a visual analogue scale.RESULTS: Physician‐observed clinical improvement was found in 21 of 23 patients (91.3%) within 6 weeks. Six patients (26.1%) remained asymptomatic after stopping treatment and 15 patients (65.2%) required maintenance therapy to prevent subsequent flares. Patients' self‐reported symptom scores were significantly better (p<0.001) with tacrolimus treatment, which supported physician‐observed clinical improvement. There was no evidence of systemic absorption and only minor local side effects were noted.CONCLUSIONS: Topical tacrolimus is an effective treatment for erosive oral LP. The majority of patients require long‐term therapy to maintain remission.