Alternative treatment using topical tacrolimus for erosive oral lichen planus resistant to steroids

Abstract

Lichen planus is a T-cell–mediated immunological disorder causing inflammatory lesions on the skin and oral mucosa. The etiology of lichen planus remains unknown, and the current therapeutic strategy is primarily to manage the symptoms. Although topical steroids are commonly used in the treatment of lichen planus, there are lesions refractory to steroids that require different treatment options. This report is of a patient with bilateral erosive oral lichen planus of the buccal mucosa. The lesions did not respond to highpotency topical steroids, so they were treated with topical tacrolimus 0.1% ointment, a potent topical immunosuppressant. All the erosive lesions healed, and the associated pain and bleeding disappeared after 6 weeks of treatment.