The effectiveness of 1% pimecrolimus cream in the treatment of oral erosive lichen planus.
BACKGROUND
The purpose of this study was to evaluate the efficacy, relative safety, and tolerability of 1% pimecrolimus cream in the treatment of oral erosive lichen planus (OELP).


METHODS
Twenty patients with OELP were randomized into equal groups; group 1 applied 1% pimecrolimus cream twice daily to their oral lesions for 4 weeks, whereas group 2 applied a placebo cream. Photographs of the lesions were taken and analyzed for areas of ulceration, erythema, and reticulation. Discomfort scores were also assessed with a visual analogue scale (VAS). Blood samples were taken at baseline and at study completion; a complete blood count with differential and comprehensive metabolic panel was ordered. The Wilcoxon signed rank test was used.


RESULTS
The experimental group showed a decrease in ulceration (alpha = 0.068) and erythema (alpha = 0.005) at the mid-point with continued reduction of erythema at the final (alpha = 0.075) time measurement. The control group demonstrated an increase in reticulation at the mid-point (alpha = 0.017) and final (alpha = 0.007) time measurement. The VAS scores for the experimental group decreased during the study (alpha = 0.022). Blood levels were within the normal range.


CONCLUSIONS
The OELP lesion size in the 1% pimecrolimus group decreased and the pimecrolimus cream was found to significantly reduce the patient's pain scores. Further study of 1% pimecrolimus as therapy for OELP is warranted since it was shown to be effective, relatively safe, and well tolerated by patients within the limits of this short-term study.
Swift
Julie C
JC
Private practice, Topeka, KS, USA.
Rees
Terry D
TD
Plemons
Jacqueline M
JM
Hallmon
William W
WW
Wright
John C
JC
D000328:Adult; D000368:Aged; D000704:Analysis of Variance; D004311:Double-Blind Method; D005157:Facial Pain / Q000188:drug therapy; D005260:Female; D006801:Humans; D007166:Immunosuppressive Agents / Q000008:administration & dosage*; D017676:Lichen Planus, Oral / Q000188:drug therapy*; D008297:Male; D008875:Middle Aged; D009824:Ointments / Q000008:administration & dosage; D010147:Pain Measurement; D010865:Pilot Projects; D018709:Statistics, Nonparametric; D016559:Tacrolimus / Q000008:administration & dosage* / Q000031:analogs & derivatives*
D007166:Immunosuppressive Agents; D009824:Ointments; C117268:pimecrolimus; D016559:Tacrolimus