Successful treatment of oral lichen planus-like chronic graft-versus-host disease with topical tacrolimus: a case report.
BACKGROUND
Bone marrow transplantation (BMT) is a common treatment used for deficiencies of host marrow or in the control of blood malignancies. Post-allogeneic BMT complications include graft-versus-host disease (GVHD). GVHD occurs when immunologically active T lymphocytes are transplanted into an immunosuppressed recipient who is genetically disparate from the donor. In this case report we describe the occurrence of oral lichen planus-like lesions as the first manifestation of chronic GVHD (c-GVHD) and the subsequent management of this disease with topical tacrolimus.


METHODS
Diagnostic aids included routine histology and direct immunofluorescence studies to rule out immunobullous diseases and to confirm the c-GVHD. Treatment consisted of topical application of 0.1% tacrolimus ointment three times a day.


RESULTS
Routine histology confirmed the clinical diagnosis of oral lichen planus-like c-GVHD. Treatment with tacrolimus ointment completely resolved the oral lesions after 2 months of therapy.


CONCLUSIONS
Topical tacrolimus at low concentrations (0.1%) shows promise in the management of oral lichen planus-like c-GVHD. Controlled studies are necessary to assess the efficacy, the duration of therapy required for effective results, and the safety of this treatment over the long-term.
Sánchez
Andrés R
AR
Division of Periodontics, Department of Dental Specialties, Mayo Clinic, Rochester, MN 55905, USA. sanchez.andres@mayo.edu
Sheridan
Phillip J
PJ
Rogers
Roy S
RS
D000287:Administration, Topical; D016026:Bone Marrow Transplantation / Q000009:adverse effects*; D002908:Chronic Disease; D006086:Graft vs Host Disease / Q000150:complications* / Q000188:drug therapy* / Q000209:etiology; D006801:Humans; D007166:Immunosuppressive Agents / Q000008:administration & dosage*; D017676:Lichen Planus, Oral / Q000188:drug therapy* / Q000209:etiology*; D008297:Male; D008875:Middle Aged; D016559:Tacrolimus / Q000008:administration & dosage*
D007166:Immunosuppressive Agents; D016559:Tacrolimus