Treatment of Oral Lichen Sclerosus with 1% Pimecrolimus Cream

Department of Dermatology and Institute of Health Science, School of Medicine, Gyeongsang National University, Jinju, Korea.
Annals of Dermatology (Impact Factor: 1.39). 08/2010; 22(3):326-9. DOI: 10.5021/ad.2010.22.3.326
Source: PubMed


Lichen sclerosus is a chronic inflammatory mucocutaneous disorder predominately affecting prepubertal girls and postmenopausal women. Isolated lichen sclerosus affecting the oral mucosa is exceedingly rare, and only 13 patients with biopsy-proved isolated oral disease have been reported in the literature. We report on a 7-year-old Korean girl with a well-demarcated 1.2x1.2 cm atrophic white plaque with an erythematous border and focal telangiectasia on the left vermillion lip, extending to the labial mucosa. No other cutaneous surfaces, including genitalia, were involved. An incisional biopsy of the plaque on the lip revealed a patchy lichenoid infiltrate of lymphocytes associated with sclerosis of the papillary dermis and a thinned epidermis consistent with a diagnosis of linear orofacial lichen sclerosus. Treatment with a short course of 1% pimecrolimus cream effectively prevented the progression of this lesion.

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Available from: Chee Won Oh, Mar 07, 2014
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    • "Kim et al. [108] recently added an oral case of LS in a 7-year-old girl successfully treated with pimecrolimus cream 1 % twice daily for 8 weeks. After unsatisfactory treatment with ultrapotent topical corticosteroids, the lesion improved within 4 weeks of treatment with pimecrolimus and disappeared after 12 weeks. "
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    ABSTRACT: Lichen sclerosus (LS) is a chronic, inflammatory, mucocutaneous disorder of genital and extragenital skin. LS is a debilitating disease, causing itch, pain, dysuria and restriction of micturition, dyspareunia, and significant sexual dysfunction in women and men. Many findings obtained in recent years point more and more towards an autoimmune-induced disease in genetically predisposed patients and further away from an important impact of hormonal factors. Preceding infections may play a provocative part. The role for Borrelia is still controversial. Trauma and an occlusive moist environment may act as precipitating factors. Potent and ultrapotent topical corticosteroids still head the therapeutic armamentarium. Topical calcineurin inhibitors are discussed as alternatives in the treatment of LS in patients who have failed therapy with ultrapotent corticosteroids, or who have a contraindication for the use of corticosteroids. Topical and systemic retinoids may be useful in selected cases. Phototherapy for extragenital LS and photodynamic therapy for genital LS may be therapeutic options in rare cases refractory to the already mentioned treatment. Surgery is restricted to scarring processes leading to functional impairment. In men, circumcision is effective in the majority of cases, but recurrences are well described. Anogenital LS is associated with an increased risk for squamous cell carcinoma of the vulva or penis. This review updates the epidemiology, clinical presentation, histopathology, pathogenesis, and management of LS of the female and male genitals and extragenital LS in adults and children.
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    ABSTRACT: Lichen sclerosus is a chronic inflammatory disease of unknown origin, which affects mostly women in the fifth and sixth decades of life, but can also occur in men and children. The involvement of the oral mucosa alone or together with other forms of presentation is extremely rare, requiring a differential diagnosis with other diseases of the oral cavity, particularly lichen planus. There are less than 30 cases of lichen sclerosus in the oral mucosa described in the literature and there are no reports on malignant transformation so far. We describe a patient with skin, oral and genital lesions of lichen sclerosus.
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    ABSTRACT: Lichen Sclerosus (LS) is a chronic mucocutaneous inflammatory disorder that most commonly affects the anogenital skin and occurs more frequently in females than males(1) . Clinically it presents as white, sometimes painful, pruritic papules or plaques. Despite its predilection for the anogenital regions, the condition can occur throughout the body, although lesions of the oral mucosa are exceedingly rare and those involving the gingiva are even more so.(2,3) This article is protected by copyright. All rights reserved.
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