Successful Treatment of Oral Lichen Planus-Like Chronic Graft-Versus-Host Disease With Topical Tacrolimus:: A Case Report

• Autores: Andrés R. Sánchez, Phillip J. Sheridan, Roy S. Rogers
• Localización: Journal of periodontology, ISSN 0022-3492, Vol. 75, Nº. 4, 2004, págs. 613-619
• Idioma: inglés
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• Resumen

  • Background: Bone marrow transplantation (BMT) is a common treatment used for deficiencies of host marrow or in the control of blood malignancies. Post-allogeneic BMT complications include graft-versus-host disease (GVHD). GVHD occurs when immunologically active T lymphocytes are transplanted into an immunosuppressed recipient who is genetically disparate from the donor. In this case report we describe the occurrence of oral lichen planus-like lesions as the first manifestation of chronic GVHD (c-GVHD) and the subsequent management of this disease with topical tacrolimus.

    Methods: Diagnostic aids included routine histology and direct immunofluorescence studies to rule out immunobullous diseases and to confirm the c-GVHD. Treatment consisted of topical application of 0.1% tacrolimus ointment three times a day.

    Results: Routine histology confirmed the clinical diagnosis of oral lichen planus-like c-GVHD. Treatment with tacrolimus ointment completely resolved the oral lesions after 2 months of therapy.

    Conclusions: Topical tacrolimus at low concentrations (0.1%) shows promise in the management of oral lichen planus-like c-GVHD. Controlled studies are necessary to assess the efficacy, the duration of therapy required for effective results, and the safety of this treatment over the long-term. J Periodontol 2004;75:613-619.