Response of oral lichen planus to topical tacrolimus in 37 patients

Background: Topical tacrolimus has been reported to be effective for the treatment of oral lichen planus. This article describes our experience with topical tacrolimus in patients treated for symptomatic oral lichen planus. Observations: A survey was mailed to 40 patients with symptomatic oral lichen planus treated with topical tacrolimus. Surveys were completed by 37 patients (93%) a mean of 1.3 years after initiation of treatment. Thirty-three (89%) of the 37 patients reported symptomatic improvement, and 31 (84%) reported partial to complete lesion clearance while using topical tacrolimus. On average, patients noted improvement in 1 month. Twelve patients (32%) reported adverse effects consistent with those reported previously (ie, burning, irritation, and tingling). Among the 28 patients still using the medication, 15 patients (54%) apply it at least once daily. Of the 9 patients who discontinued using the medication, 5 experienced recurrence. Conclusions: Topical tacrolimus is effective for the treatment of oral lichen planus. Most patients experienced symptomatic improvement in less than I month. However, the effect is temporary; when topical tacrolimus is discontinued, oral lichen planus may flare again.