Off-label Uses of Topical Pimecrolimus

Pimecrolimus is a topical calcineurin inhibitor currently approved for second-line use in the management of mild-to-moderate atopic dermatitis in patients age 2 years and older. Given the safety profile and nonsteroidal mechanism of pimecrolimus, there has been significant interest in its use in the treatment of a variety of dermatological conditions. This article reviews research that has been published on the off-label uses of topical pimecrolimus, with a focus on published RCTs. Convincing evidence exists supporting pimecrolimus’ efficacy in oral lichen planus and seborrheic dermatitis. For other conditions studied to date, pimecrolimus may prove to be a useful treatment alternative when conventional agents fail. Adverse events seen with its off-label use were typically application site reactions, the most common being a transient burning sensation. In summary, pimecrolimus appears to be an effective agent in the treatment of multiple dermatological conditions and may be worth considering as a pharmacologic alternative in several conditions when first-line treatment fails, or for areas that are more susceptible to the adverse effects of topical corticosteroids.

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TANTANGAN FARMAKOLOGI PENGGUNAAN STEROID TOPIKAL PADA PASIEN ORAL LICHEN PLANUS

ODONTO Dental Journal ◽

10.30659/odj.6.1.30-36 ◽

2019 ◽

Vol 6 (1) ◽

pp. 30

Author(s):

Revi Nelonda ◽

Nanan Nur’aeny ◽

Irna Sufiawati

Keyword(s):

Lichen Planus ◽

Oral Lichen Planus ◽

Clinical Signs ◽

Topical Steroid ◽

Topical Steroids ◽

First Line ◽

Spicy Food ◽

Diffuse Erythema ◽

Chronic Autoimmune Disease ◽

Oral Lichen

Background: Oral lichen planus (OLP) is a chronic autoimmune disease sprinkled by T cells on the oral mucosal surface. The goal of OLP treatment is to eliminate erythema, ulceration and relieve symptoms. Corticosteroids are the first line in the treatment of OLP, either systemically or topically. The problem arises when using topical steroids, namely the time of topical steroid attachment to the oral mucosa, especially in cases of OLP with clinical desquamative gingivitis. Some studies suggest that the use of individual gingival tray can overcome this problem. Objective: To provide information on topical steroid use in OLP cases with desquamative gingivitis clinical signs.Case Management: Women, age 31, complain that pain with burning on the lips and mouth is aggravated by spicy food. Intraoral examination shows irregular white plaques on the buccal, labial and dorsal mucosa of the tongue accompanied by diffuse erythema in the anterior gingiva of the upper and lower jaws. Patients diagnosed with OLP. Lesions improve 3 months after topical steroid administration, except lesions on the gingiva. Gingival individual tray is then used to obtain adequate attachment of topical steroids on the gingiva surface. The gingiva showed significant improvement after a month later.Conclusion: The use of topical steroid concoctions applied to the gingival individual tray is effective in treating OLP lesions especially with clinical signs of desquamative gingivitis.

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Photodynamic Treatment of Oral Lichen Planus: A Literature Review

Integrative Journal of Medical Sciences ◽

10.15342/ijms.2021.485 ◽

2021 ◽

Vol 8 ◽

Author(s):

Asma Azzouzi ◽

Karima El Harti

Keyword(s):

Photodynamic Therapy ◽

Lichen Planus ◽

Oral Lichen Planus ◽

Signs And Symptoms ◽

First Line ◽

Photodynamic Treatment ◽

Randomized Controlled ◽

Oral Lichen ◽

Exact Origin

Lichen planus (LP) is a chronic, relapsing, non-infectious inflammatory disease affecting the skin and mucous membranes. The exact origin of oral lichen planus (OLP) is not well known. Complete spontaneous healing is rare. The treatment of oral lichen planus is palliative, and there is no curative treatment so far, which is a therapeutic challenge for practitioners. The goals of treatment are the control of pain, signs, and symptoms. Local corticosteroids remain the first-line treatment. In case of failure of drug therapy, other treatments can be considered, such as photodynamic therapy. Material and methods: Our work was carried out using the PubMed, ScienceDirect, and EBSCO search engines to explore the literature on the efficacy of photodynamic therapy in the treatment of lichen planus. Conclusion: Photodynamic therapy appears to have some effect in the treatment of OLP in adult patients. However, further randomized controlled trials with a long follow-up period, standardized PDT parameters, and comparison of PDT efficacy with steroid therapy are warranted to obtain firm conclusions in this regard.

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Off-Label Topical Calcineurin Inhibitor Use in Children

PEDIATRICS ◽

10.1542/peds.2013-0931 ◽

2013 ◽

Vol 132 (5) ◽

pp. e1327-e1332 ◽

Cited By ~ 11

Author(s):

Angelika D. Manthripragada ◽

Simone P. Pinheiro ◽

Thomas E. MaCurdy ◽

Shahin Saneinejad ◽

Chris M. Worrall ◽

...

Keyword(s):

Calcineurin Inhibitor ◽

Off Label ◽

Topical Calcineurin Inhibitor

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Off-Label Topical Calcineurin Inhibitor Use in Children

PEDIATRICS ◽

10.1542/peds.2013-0931d ◽

2013 ◽

Vol 132 (5) ◽

pp. X35-X35

Keyword(s):

Calcineurin Inhibitor ◽

Off Label ◽

Topical Calcineurin Inhibitor

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Efficacy of Topical Calcineurin Inhibitors in Oral Lichen Planus

Journal of Cutaneous Medicine and Surgery ◽

10.1177/1203475415591936 ◽

2015 ◽

Vol 19 (6) ◽

pp. 539-545 ◽

Cited By ~ 6

Author(s):

Bahman Sotoodian ◽

Jacky Lo ◽

Andrew Lin

Keyword(s):

Lichen Planus ◽

Oral Lichen Planus ◽

Calcineurin Inhibitor ◽

Case Reports ◽

Calcineurin Inhibitors ◽

Double Blind ◽

Topical Calcineurin Inhibitors ◽

Cochrane Database ◽

Significant Impairment ◽

Oral Lichen

Background: Oral lichen planus (OLP) is associated with severe pain and significant impairment for patients. Objective: To evaluate the safety and efficacy of topical calcineurin inhibitors (TCI) in the treatment of OLP. Methods: Medline and the Cochrane Database were searched using the keywords “calcineurin inhibitor OR tacrolimus OR pimecrolimus” AND “oral lichen planus.” Results: Four retrospective studies that looked at the effects of tacrolimus on OLP; 4 randomized, double-blind clinical trials (RDBCT) comparing tacrolimus with topical corticosteroids; and 5 RDBCT comparing pimecrolimus with placebo or triamcinolone were noted. Six open prospective and multiple case reports assessing the efficacy of calcineurin inhibitor for treatment of diverse types of OLP were found. Conclusion: There is strong evidence to suggest that the use of tacrolimus 0.1% ointment and pimecrolimus 1% cream is superior or equally efficacious as traditional therapies for OLP. Topical calcineurin inhibitors are well tolerated, with no significant systemic adverse effects.

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