title: Recalcitrant symptomatic vulvar lichen planus: response to topical tacrolimus.
abstract: BACKGROUND
  Topical tacrolimus has been reported to be an effective treatment for genital lichen planus in small case series. We retrospectively reviewed the medical records of 16 patients with symptomatic vulvar lichen planus who received treatment with tacrolimus ointment.
  
  
  METHODS
  All patients had symptomatic vulvar lichen planus recalcitrant to other treatments. Of 16 patients, 15 (94%) experienced a symptomatic response to tacrolimus treatment within 3 months (mean, 4.2 weeks) and had a partial or complete resolution of the lesions. Six patients (38%) reported mild adverse effects, including irritation, burning, and tingling. With continued use of the medication, these adverse effects resolved. When patients stopped treatment, lichen planus returned in 10 (83%) of 12 patients within 6 months after discontinuation of therapy (median, 1 week; range, 0.3-24 weeks), but in 6 patients the lesions were less severe than the lesions before treatment; all 10 patients resumed use of topical tacrolimus.
  
  
  CONCLUSIONS
  In this retrospective series of 16 women with vulvar lichen planus, topical tacrolimus therapy effectively controlled symptoms and improved lesions in all but 1 patient. The effect may be temporary, requiring continued use of tacrolimus, which appears to be safe and effective in controlling disease activity.
authors.affiliation: Department of Dermatology, Mayo Clinic, Rochester, MN 55905, USA.
authors.forename: Julie A
authors.initials: JA
authors.lastname: Byrd
authors.forename: Mark D P
authors.initials: MD
authors.lastname: Davis
authors.forename: Roy S
authors.initials: RS
authors.lastname: Rogers
mesh_terms: D000279:Administration, Cutaneous; D000368:Aged; D004334:Drug Administration Schedule; D005260:Female; D006801:Humans; D007166:Immunosuppressive Agents / Q000008:administration & dosage*; D008010:Lichen Planus / Q000188:drug therapy* / Q000453:epidemiology / Q000473:pathology; D008499:Medical Records; D008875:Middle Aged; D008910:Minnesota / Q000453:epidemiology; D012008:Recurrence; D012189:Retrospective Studies; D016559:Tacrolimus / Q000008:administration & dosage*; D016896:Treatment Outcome; D014845:Vulvar Diseases / Q000188:drug therapy* / Q000453:epidemiology / Q000473:pathology
chemical_list: D007166:Immunosuppressive Agents; D016559:Tacrolimus