title: Long-term efficacy and safety of topical tacrolimus in the management of ulcerative/erosive oral lichen planus.
abstract: The long-term safety and clinical benefit of topical tacrolimus for the management of erosive or ulcerative oral lichen planus has not been evaluated. 50 adults (39 female 11 male; group median age 59, range 29-88 years) with symptomatic, erosive or ulcerative lichen planus recalcitrant to topical corticosteroids applied 0.1% topical tacrolimus ointment twice daily to symptomatic mucosal lesions. Topical tacrolimus was applied for a median time of 19.8 months (range 2-39 months) in this patient group. Fourteen percent of the patients had complete resolution of ulcers or erosions, 80% partial resolution and 6% reported no clinical benefit. The most common adverse effects were a burning sensation (16%) at the site of application and transient taste disturbance (8%). No significant, long-standing changes in hepatic or renal biochemistry were observed. The mean tacrolimus level decreased with duration of therapy from 2.7 microg/l (week 1) to 0.5 microg/l (week 32). 0.1% topical tacrolimus is an effective means of controlling the symptoms and signs of erosive or ulcerative oral lichen planus and has no notable adverse effects over a mean duration of application of 19.8 months.
authors.affiliation: Oral Medicine, Eastman Dental Institute for Oral Health Care Sciences, UCL, University of London, 256 Gray's Inn Road, London, WC1X 8LD, UK.
authors.forename: Tim A
authors.initials: TA
authors.lastname: Hodgson
authors.forename: Neeraj
authors.initials: N
authors.lastname: Sahni
authors.forename: Fotini
authors.initials: F
authors.lastname: Kaliakatsou
authors.forename: John A G
authors.initials: JA
authors.lastname: Buchanan
authors.forename: Stephen R
authors.initials: SR
authors.lastname: Porter
mesh_terms: D000287:Administration, Topical; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015331:Cohort Studies; D005260:Female; D006801:Humans; D007166:Immunosuppressive Agents / Q000008:administration & dosage*; D017676:Lichen Planus, Oral / Q000150:complications / Q000188:drug therapy*; D008297:Male; D008875:Middle Aged; D019226:Oral Ulcer / Q000188:drug therapy* / Q000209:etiology; D016559:Tacrolimus / Q000008:administration & dosage*; D016896:Treatment Outcome
chemical_list: D007166:Immunosuppressive Agents; D016559:Tacrolimus