Challenges in using topical calcineurin inhibitors as a treatment for recalcitrant oral lichen planus

2019 ◽  
Vol 181 (6) ◽  
pp. 1120-1120 ◽  
Author(s):  
K. Thongprasom
Keyword(s):  
Lichen Planus ◽  
Oral Lichen Planus ◽  
Calcineurin Inhibitors ◽  
Topical Calcineurin Inhibitors ◽  
Oral Lichen

Efficacy of Topical Calcineurin Inhibitors in Lichen Planus

2012 ◽  
Vol 16 (4) ◽  
pp. 221-229 ◽  
Author(s):  
Michael Samycia ◽  
Andrew N. Lin
Keyword(s):  
Lichen Planus ◽  
Strong Evidence ◽  
Oral Lichen Planus ◽  
Case Reports ◽  
Calcineurin Inhibitors ◽  
Double Blind ◽  
Tacrolimus Ointment ◽  
Topical Tacrolimus ◽  
Topical Calcineurin Inhibitors ◽  
Oral Lichen

Background: Topical calcineurin inhibitors have been studied in many skin disorders, including lichen planus. Objective: To evaluate published reports of the use of topical calcineurin inhibitors in lichen planus. Methods: We searched PubMed, Ovid/Cochrane, and Embase using the keywords “tacrolimus,” “pimecrolimus,” “topical calcineurin inhibitors,” and “lichen planus.” Results: We examined 5 double-blind studies, 1 investigator-blinded study, 10 open prospective studies, 6 retrospective studies, and 28 case reports evaluating tacrolimus or pimecrolimus for oral, vulvovaginal, and cutaneous lichen planus. Conclusions: Strong evidence (double-blind and open studies) supports the use of topical tacrolimus ointment in oral lichen planus, with efficacy at least equal to topical clobetasol propionate 0.05% ointment. Treatment of oral lichen planus with topical tacrolimus ointment can result in demonstrable blood tacrolimus levels, but without clinically significant adverse events. Strong evidence (double-blind and open studies) supports the use of topical pimecrolimus 1% cream in oral lichen planus, with efficacy equal to that of topical triamcinolone acetonide 0.1% paste. For vulvovaginal lichen planus, pimecrolimus was superior to placebo in one double-blind study, and tacrolimus was effective in open studies. Only case reports support the efficacy of topical calcineurin inhibitors in cutaneous lichen planus.

Topical calcineurin inhibitors in the treatment of oral lichen planus: a systematic review and meta‐analysis

2019 ◽  
Vol 181 (6) ◽  
pp. 1166-1176 ◽  
Author(s):  
S.‐L. Sun ◽  
J.‐J. Liu ◽  
B. Zhong ◽  
J.‐K. Wang ◽  
X. Jin ◽  
...  
Keyword(s):  
Systematic Review ◽  
Lichen Planus ◽  
Oral Lichen Planus ◽  
Meta Analysis ◽  
Calcineurin Inhibitors ◽  
Topical Calcineurin Inhibitors ◽  
Oral Lichen

Efficacy of Topical Calcineurin Inhibitors in Oral Lichen Planus

2015 ◽  
Vol 19 (6) ◽  
pp. 539-545 ◽  
Author(s):  
Bahman Sotoodian ◽  
Jacky Lo ◽  
Andrew Lin
Keyword(s):  
Lichen Planus ◽  
Oral Lichen Planus ◽  
Calcineurin Inhibitor ◽  
Case Reports ◽  
Calcineurin Inhibitors ◽  
Double Blind ◽  
Topical Calcineurin Inhibitors ◽  
Cochrane Database ◽  
Significant Impairment ◽  
Oral Lichen

Background: Oral lichen planus (OLP) is associated with severe pain and significant impairment for patients. Objective: To evaluate the safety and efficacy of topical calcineurin inhibitors (TCI) in the treatment of OLP. Methods: Medline and the Cochrane Database were searched using the keywords “calcineurin inhibitor OR tacrolimus OR pimecrolimus” AND “oral lichen planus.” Results: Four retrospective studies that looked at the effects of tacrolimus on OLP; 4 randomized, double-blind clinical trials (RDBCT) comparing tacrolimus with topical corticosteroids; and 5 RDBCT comparing pimecrolimus with placebo or triamcinolone were noted. Six open prospective and multiple case reports assessing the efficacy of calcineurin inhibitor for treatment of diverse types of OLP were found. Conclusion: There is strong evidence to suggest that the use of tacrolimus 0.1% ointment and pimecrolimus 1% cream is superior or equally efficacious as traditional therapies for OLP. Topical calcineurin inhibitors are well tolerated, with no significant systemic adverse effects.

scholarly journals Oral Lichen Planus – Known and Unknown: a Review

Folia Medica ◽  
2018 ◽  
Vol 60 (4) ◽  
pp. 528-535 ◽  
Author(s):  
Maria Z. Mutafchieva ◽  
Milena N. Draganova-Filipova ◽  
Plamen I. Zagorchev ◽  
George T. Tomov
Keyword(s):  
Lichen Planus ◽  
Oral Lichen Planus ◽  
Calcineurin Inhibitors ◽  
Autoimmune Disorder ◽  
Disease Diagnosis ◽  
Trigger Factors ◽  
Ongoing Controversy ◽  
Therapeutic Modalities ◽  
External Agents ◽  
Oral Lichen

Abstract Lichen planus is a chronic mucocutaneous inflammatory disease aff ecting 1-2% of the general population with maximum prevalence of the disease in women above the age of 40. Its aetiology remains unclear and the pathogenesis is still the object of much speculation. It is considered to be an autoimmune disorder mediated mainly by the T-lymphocytes. The present paper presents the most well-known external agents (viruses in particular), internal agents like stress, and the heat shock protein thought to be trigger factors and describes the action of diff erent cells and proteins associated with the development of that disease. Diagnosis is based on clinical and histopathologic evidence; direct and indirect immunofluorescence techniques can also be of use. Despite the wide variety of therapeutic modalities, treatment outcomes are often insufficient. Currently, topical corticosteroids are widely accepted as a standard therapy, but also retinoids, calcineurin inhibitors and other immunosuppressants can be administered. Because of the aspect relevant to these drugs, priority is given to alternative harmless methods such as LLLT and PDLT. There is an ongoing controversy in the literature about the possible premalignant character of oral lichen planus, however, periodic followup is recommended.

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