title: Efficacy of topical tacrolimus for oral lichen planus: real-life experience in a retrospective cohort of patients with a review of the literature.
abstract: OBJECTIVE
  Management of oral lichen planus (OLP) is challenging and therapeutic options are limited. The use of topical tacrolimus has shown promising results. We reviewed our daily life experience with topical tacrolimus in OLP patients.
  
  
  METHODS
  This retrospective unicentre study included all 21 patients with OLP, which were evaluated over a 53-month period and treated with topical tacrolimus. Patients were initially given a topical preparation of 0.1% tacrolimus twice daily. The response to treatment was assessed using a 4-point scale at month 2 and 6: complete response of affected area (CR), major remission (>50%, MR), partial remission (25-50%, PR) and either no response (<25%) or worsening. The pain score was also assessed using a 3-point scale.
  
  
  RESULTS
  Four of 21 patients (19%) showed a CR at month 2, whereas at month 6, 7 (33%) had a CR. For patients who reported MR (n = 2) and PR (n = 8) at month 2, the therapy was continued. Of those, at 6 months, three patients showed a CR, while four maintained a PR. The pain score improved during treatment. After 2 months of therapy, eight of 10 patients with an initial high pain score achieved a significant improvement. In patients starting with moderate pain an improvement was observed in one of seven patients. Overall, for three patients there was a complete loss of pain, while in nine there was a reduction. Except for transitory burning sensation and altered taste sensation, no relevant side-effects were reported.
  
  
  CONCLUSIONS
  This retrospective analysis confirms that topical tacrolimus is a valuable therapeutic option in severe or treatment-resistant OLP. Our findings in daily practice suggested nevertheless that the efficacy of topical tacrolimus is overestimated with regard to both complete response and pain reduction.
authors.affiliation: Department of Dermatology, University Hospital-Inselspital Bern, University of Bern, Bern, Switzerland.|Section of Dermatology, Department of Medical Sciences, University of Turin, Turin, Italy.
authors.forename: S
authors.initials: S
authors.lastname: Ribero
authors.affiliation: Department of Dermatology, University Hospital-Inselspital Bern, University of Bern, Bern, Switzerland.
authors.forename: M
authors.initials: M
authors.lastname: Stieger
authors.affiliation: Section of Dermatology, Department of Medical Sciences, University of Turin, Turin, Italy.
authors.forename: P
authors.initials: P
authors.lastname: Quaglino
authors.affiliation: Department of Dermatology, University Hospital-Inselspital Bern, University of Bern, Bern, Switzerland.
authors.forename: T
authors.initials: T
authors.lastname: Hongang
authors.affiliation: Department of Oral Surgery and Stomatology, School of Dental Medicine, University of Bern, Bern, Switzerland.
authors.forename: M M
authors.initials: MM
authors.lastname: Bornstein
authors.affiliation: Department of Dermatology, Azienda Ospedaliera Papa Giovanni XXIII, Bergamo, Italy.
authors.forename: L
authors.initials: L
authors.lastname: Naldi
authors.affiliation: Department of Dermatology, University Hospital-Inselspital Bern, University of Bern, Bern, Switzerland.
authors.forename: L
authors.initials: L
authors.lastname: Borradori
mesh_terms: D000287:Administration, Topical; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D007166:Immunosuppressive Agents / Q000008:administration & dosage*; D017676:Lichen Planus, Oral / Q000150:complications / Q000188:drug therapy*; D008297:Male; D008875:Middle Aged; D010146:Pain / Q000209:etiology; D010147:Pain Measurement; D012189:Retrospective Studies; D016559:Tacrolimus / Q000008:administration & dosage*; D016896:Treatment Outcome
chemical_list: D007166:Immunosuppressive Agents; D016559:Tacrolimus