Topical Tacrolimus for the Treatment of Oral Lichen Planus

Lichen planus is a chronic inflammatory mucocutaneous disease that can have both cutaneous and oral involvement. Clinical presentations of oral lichen planus are varied and the erosive form can be the most symptomatic and difficult to treat. New research in cytokine biology may begin to help explain the pathogenesis and chronicity of oral lichen planus. Conventional treatment for oral lichen planus includes topical and intralesional corticosteroids. Tacrolimus, a calcineurin-inhibitor, has been shown to be effective in treating lesions of erosive oral lichen planus that are recalcitrant to topical steroid therapy. We would like to present a case in which a patient with severe erosions of the tongue, due to oral lichen planus, was effectively treated with topical tacrolimus following unsuccessful topical and intralesional steroid therapy.