SUCCESSFUL TREATMENT OF ORAL LICHEN PLANUS WITH TOPICAL TACROLIMUS

Tacrolimus is a new, non-steroidal immunosuppressive macrolide which modulate the immunological mechanism by blocking t-cell activation. the topical form of tacrolimus constitutes a promising new treatment for recalcitrant inflammatory skin and mucosal disorders. in this report we present the successful treatment of two specific oral lichen planus cases with tacrolimus. case i is a 68-year-old female patient suffering perpetually from lichen planus lesions involving gingiva for 10 years. she had painful, erythematous lichen planus lesions especially on the gum of maxillary incisors region. she wore full- mouth fixtures on both jaws. the patient was allergic to dental materials which caused the lichen planus lesions to be more recalcitrant. case ll is a 34-year-old female who had recalcitrant lichen planus lesions on oral and vaginal mucosa. the oral lesions on the buccal mucosa and gingivae were in reticular form. in both cases the lesions were unresponsive to different types of topical steroid agents which are applied for one month. after the steroid therapy, although there was a relative relief of the pain complaint, the appearance of lesions disclosed no change. following these therapies, the patients were administered % 0.1 tacrolimus ointment per twice a day. on the third week of the therapy we achieved to control the symptoms and to clear the lesions. in conclusion, topical tacrolimus forms a new option for the treatment of oral lichen planus.