The effect of topical pimecrolimus on inflammatory infiltrate in vulvar lichen sclerosus.
OBJECTIVE
Lichen sclerosus (LS) is a relatively common chronic inflammatory disorder of the skin and mucosal surfaces.


METHODS
A total of 29 women with histologically confirmed, active LS were recruited to this study with 2 aims. First, we evaluated the effectiveness of pimecrolimus treatment to LS not responding to conventional corticosteroid treatment. The second aim in this study was to provide information of in vivo effects of topical pimecrolimus in acute LS lesions, especially the inflammatory cell infiltration.


RESULTS
In all, 25 of 29 women applied cream as recommended. After 2 months of treatment, 20 patients had reached partial or complete clinical remission. Histology showed decreased inflammatory lymphoid infiltrate with down-regulation of CD3(+) T cells, CD8(+) T cells, and CD57(+) natural killer cells. Also macrophage marker CD68 staining showed down-regulation. There was no change in CD20(+) B lymphocytes.


CONCLUSIONS
We conclude that calcineurin inhibitors are an effective treatment for patients not responding to corticosteroid treatment.
Kauppila
Saila
S
Department of Pathology, University Hospital of Oulu, Oulu, Finland.
Kotila
Vesa
V
Knuuti
Eila
E
Väre
Päivi O
PO
Vittaniemi
Pia
P
Nissi
Ritva
R
D000287:Administration, Topical; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D018414:CD8-Positive T-Lymphocytes / Q000473:pathology; D065095:Calcineurin Inhibitors; D005260:Female; D006801:Humans; D007694:Killer Cells, Natural / Q000473:pathology; D008875:Middle Aged; D016559:Tacrolimus / Q000008:administration & dosage / Q000031:analogs & derivatives*; D007724:Vulvar Lichen Sclerosus / Q000188:drug therapy* / Q000276:immunology / Q000473:pathology
D065095:Calcineurin Inhibitors; C117268:pimecrolimus; D016559:Tacrolimus