Maassen Marloes S, van Doorn Helena C
Erasmus Medisch Centrum, afd. Gynaecologie, Rotterdam, the Netherlands.
Ned Tijdschr Geneeskd. 2012;156(36):A3908.
To provide an overview of the literature concerning the topical treatment of vulvar lichen sclerosus, a chronic inflammatory skin disease, with calcineurin inhibitors, such as pimecrolimus and tacrolimus.
A literature review into the use of topical calcineurin inhibitors (TCIs) in the treatment of vulvar lichen sclerosus.
A literature search was performed using PubMed and EMBASE and the search terms 'tacrolimus', 'pimecrolimus' or 'calcineurin inhibitors' and 'lichen sclerosus et atrophicus', 'vulvar lichen sclerosus', 'vulvar dermatoses' or 'vulvar diseases'.
The search produced 6 case reports, 5 patient series, 3 pilot studies, 2 open-label studies and 1 RCT concerning the use of TCIs for the treatment of vulvar lichen sclerosus. The literature shows that both medications are effective and well tolerated. However, glucocorticoids seem to be effective in more patients than TCIs. Tacrolimus has a stronger immunosuppressant effect than pimecrolimus and therefore seems to be more effective without having more observed side-effects.
TCIs may represent a useful second-line therapeutic option for patients for whom treatment with glucocorticoids is not effective or who do not tolerate them well. Randomized clinical studies are required to determine the role of TCIs in the treatment of lichen sclerosus.
none declared. Financial support: none declared.
综述有关使用钙调神经磷酸酶抑制剂（如吡美莫司和他克莫司）局部治疗外阴硬化性苔藓（一种慢性炎症性皮肤病）的文献。
对局部钙调神经磷酸酶抑制剂（TCIs）用于治疗外阴硬化性苔藓的文献进行综述。
使用PubMed和EMBASE进行文献检索，检索词为“他克莫司”“吡美莫司”或“钙调神经磷酸酶抑制剂”以及“萎缩性硬化性苔藓”“外阴硬化性苔藓”“外阴皮肤病”或“外阴疾病”。
检索得到6篇病例报告、5篇患者系列研究、3项初步研究、2项开放标签研究以及1项关于使用TCIs治疗外阴硬化性苔藓的随机对照试验。文献表明这两种药物均有效且耐受性良好。然而，糖皮质激素似乎比TCIs对更多患者有效。他克莫司的免疫抑制作用比吡美莫司更强，因此似乎更有效且未观察到更多副作用。
对于糖皮质激素治疗无效或耐受性差的患者，TCIs可能是一种有用的二线治疗选择。需要进行随机临床研究以确定TCIs在硬化性苔藓治疗中的作用。
未声明。资金支持：未声明。
