Effect of topical cyclosporine rinse on oral lichen planus. A double-blind analysis.
BACKGROUND
Oral lichen planus is a relatively common disorder of the mouth that can be debilitating. It is frequently palliated with topical or systemic corticosteroids and retinoids. These treatments require prolonged use, however, and are not always effective.


METHODS
In a double-blind trial, 16 patients with symptomatic oral lichen planus were randomly assigned to receive either topical cyclosporine or its vehicle. The patients swished and expectorated 5 ml of medication (containing 100 mg of cyclosporine per milliliter) three times daily.


RESULTS
After eight weeks, the eight recipients of cyclosporine had marked improvement in erythema (P = 0.003), erosion (P = 0.02), reticulation (presence of white lacelike lesions; P = 0.007), and pain (P = 0.002), whereas the eight recipients of vehicle had no change or minimal improvement. After a switch to cyclosporine for eight weeks, the vehicle-treated patients had improvement similar to that seen in the patients who initially received cyclosporine. There were no systemic side effects. In most cases blood cyclosporine levels were low or undertectable. Cyclosporine levels present in specimens of oral mucosa at the end of therapy four hours after the patients swished were similar to the levels previously reported in psoriatic lesions after treatment with systemic cyclosporine (14 mg per kilogram of body weight per day).


CONCLUSIONS
As a topical preparation, cyclosporine may be useful in the treatment of oral lichen planus and possibly other cutaneous disorders.
Department of Dermatology, University of Michigan Medical Center, Ann Arbor 48109-0314.
D
D
Eisen
C N
CN
Ellis
E A
EA
Duell
C E
CE
Griffiths
J J
JJ
Voorhees
D000368:Aged; D003524:Cyclosporins / Q000008:administration & dosage* / Q000493:pharmacokinetics / Q000627:therapeutic use; D004311:Double-Blind Method; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008010:Lichen Planus / Q000188:drug therapy*; D008297:Male; D008875:Middle Aged; D009059:Mouth Diseases / Q000188:drug therapy*; D009061:Mouth Mucosa / Q000378:metabolism; D009067:Mouthwashes; D016032:Randomized Controlled Trials as Topic
D003524:Cyclosporins; D009067:Mouthwashes