Efficacy of steroidal vs non-steroidal agents in oral lichen planus: a randomised, open-label study

AbstractObjective:This study compared the therapeutic efficacy of steroidal and non-steroidal agents for treating oral lichen planus.Methods:Forty patients with clinical and/or histologically proven oral lichen planus were randomly placed into four groups and treated with topical triamcinolone, oral dapsone, topical tacrolimus or topical retinoid for three months. Pre- and post-treatment symptoms and signs were scored for each patient.Results:Patients in all treatment groups showed significant clinical improvement after three months (p < 0.05), with steroidal and non-steroidal agents having equal efficacy. Furthermore, of the non-steroidal drugs, oral dapsone had greater efficacy than topical retinoid (p < 0.05). However, no significant differences in outcome were recorded for oral dapsone vs topical tacrolimus (p > 0.05) and for topical retinoid vs topical tacrolimus (p > 0.05).Conclusion:Non-steroidal drugs such as dapsone, tacrolimus and retinoid are as efficacious as steroidal drugs for treating oral lichen planus, and avoid the side effects associated with steroids.

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Re: risk of malignancy and systemic absorption after application of topical tacrolimus in oral lichen planus

Journal of the European Academy of Dermatology and Venereology ◽

10.1111/jdv.13755 ◽

2016 ◽

Vol 31 (2) ◽

pp. e85-e86 ◽

Cited By ~ 1

Author(s):

S. Ribero ◽

L. Borradori

Keyword(s):

Lichen Planus ◽

Oral Lichen Planus ◽

Systemic Absorption ◽

Topical Tacrolimus ◽

Risk Of Malignancy ◽

Oral Lichen

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Topical Tacrolimus for the Treatment of Oral Lichen Planus

The Internet Journal of Dermatology ◽

10.5580/1528 ◽

2003 ◽

Vol 2 (1) ◽

Keyword(s):

Lichen Planus ◽

Oral Lichen Planus ◽

Topical Tacrolimus ◽

Oral Lichen

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Management of recalcitrant ulcerative oral lichen planus with topical tacrolimus

Journal of the American Academy of Dermatology ◽

10.1067/mjd.2002.120535 ◽

2002 ◽

Vol 46 (1) ◽

pp. 35-41 ◽

Cited By ~ 118

Author(s):

F. Kaliakatsou ◽

T.A. Hodgson ◽

J.D. Lewsey ◽

A.M. Hegarty ◽

A.G. Murphy ◽

...

Keyword(s):

Lichen Planus ◽

Oral Lichen Planus ◽

Topical Tacrolimus ◽

Oral Lichen

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Efficacy of Topical Calcineurin Inhibitors in Lichen Planus

Journal of Cutaneous Medicine and Surgery ◽

10.1177/120347541201600403 ◽

2012 ◽

Vol 16 (4) ◽

pp. 221-229 ◽

Cited By ~ 15

Author(s):

Michael Samycia ◽

Andrew N. Lin

Keyword(s):

Lichen Planus ◽

Strong Evidence ◽

Oral Lichen Planus ◽

Case Reports ◽

Calcineurin Inhibitors ◽

Double Blind ◽

Tacrolimus Ointment ◽

Topical Tacrolimus ◽

Topical Calcineurin Inhibitors ◽

Oral Lichen

Background: Topical calcineurin inhibitors have been studied in many skin disorders, including lichen planus. Objective: To evaluate published reports of the use of topical calcineurin inhibitors in lichen planus. Methods: We searched PubMed, Ovid/Cochrane, and Embase using the keywords “tacrolimus,” “pimecrolimus,” “topical calcineurin inhibitors,” and “lichen planus.” Results: We examined 5 double-blind studies, 1 investigator-blinded study, 10 open prospective studies, 6 retrospective studies, and 28 case reports evaluating tacrolimus or pimecrolimus for oral, vulvovaginal, and cutaneous lichen planus. Conclusions: Strong evidence (double-blind and open studies) supports the use of topical tacrolimus ointment in oral lichen planus, with efficacy at least equal to topical clobetasol propionate 0.05% ointment. Treatment of oral lichen planus with topical tacrolimus ointment can result in demonstrable blood tacrolimus levels, but without clinically significant adverse events. Strong evidence (double-blind and open studies) supports the use of topical pimecrolimus 1% cream in oral lichen planus, with efficacy equal to that of topical triamcinolone acetonide 0.1% paste. For vulvovaginal lichen planus, pimecrolimus was superior to placebo in one double-blind study, and tacrolimus was effective in open studies. Only case reports support the efficacy of topical calcineurin inhibitors in cutaneous lichen planus.

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