Byrd Julie A, Davis Mark D P, Rogers Roy S
Department of Dermatology, Mayo Clinic, Rochester, MN 55905, USA.
Arch Dermatol. 2004 Jun;140(6):715-20. doi: 10.1001/archderm.140.6.715.
Topical tacrolimus has been reported to be an effective treatment for genital lichen planus in small case series. We retrospectively reviewed the medical records of 16 patients with symptomatic vulvar lichen planus who received treatment with tacrolimus ointment.
All patients had symptomatic vulvar lichen planus recalcitrant to other treatments. Of 16 patients, 15 (94%) experienced a symptomatic response to tacrolimus treatment within 3 months (mean, 4.2 weeks) and had a partial or complete resolution of the lesions. Six patients (38%) reported mild adverse effects, including irritation, burning, and tingling. With continued use of the medication, these adverse effects resolved. When patients stopped treatment, lichen planus returned in 10 (83%) of 12 patients within 6 months after discontinuation of therapy (median, 1 week; range, 0.3-24 weeks), but in 6 patients the lesions were less severe than the lesions before treatment; all 10 patients resumed use of topical tacrolimus.
In this retrospective series of 16 women with vulvar lichen planus, topical tacrolimus therapy effectively controlled symptoms and improved lesions in all but 1 patient. The effect may be temporary, requiring continued use of tacrolimus, which appears to be safe and effective in controlling disease activity.
在小规模病例系列研究中，已报道外用他克莫司是治疗生殖器扁平苔藓的有效方法。我们回顾性分析了16例接受他克莫司软膏治疗的有症状外阴扁平苔藓患者的病历。
所有患者均患有对其他治疗无效的有症状外阴扁平苔藓。16例患者中，15例（94%）在3个月内（平均4.2周）对他克莫司治疗出现症状缓解，病变部分或完全消退。6例患者（38%）报告有轻度不良反应，包括刺激感、烧灼感和刺痛感。随着药物的持续使用，这些不良反应消失。当患者停止治疗时，12例患者中有10例（83%）在停药后6个月内（中位时间1周；范围0.3 - 24周）扁平苔藓复发，但6例患者的病变比治疗前轻；所有10例患者均重新开始使用外用他克莫司。
在这个对16例外阴扁平苔藓女性患者的回顾性系列研究中，外用他克莫司治疗除1例患者外均有效控制了症状并改善了病变。这种效果可能是暂时的，需要持续使用他克莫司，而他克莫司在控制疾病活动方面似乎是安全有效的。
