BACKGROUND: Bone marrow transplantation (BMT) is a common treatment used for deficiencies of host marrow or in the control of blood malignancies. Post-allogeneic BMT complications include graft-versus-host disease (GVHD). GVHD occurs when immunologically active T lymphocytes are transplanted into an immunosuppressed recipient who is genetically disparate from the donor. In this case report we describe the occurrence of oral lichen planus-like lesions as the first manifestation of chronic GVHD (c-GVHD) and the subsequent management of this disease with topical tacrolimus. METHODS: Diagnostic aids included routine histology and direct immunofluorescence studies to rule out immunobullous diseases and to confirm the c-GVHD. Treatment consisted of topical application of 0.1% tacrolimus ointment three times a day. RESULTS: Routine histology confirmed the clinical diagnosis of oral lichen planus-like c-GVHD. Treatment with tacrolimus ointment completely resolved the oral lesions after 2 months of therapy. CONCLUSIONS: Topical tacrolimus at low concentrations (0.1%) shows promise in the management of oral lichen planus-like c-GVHD. Controlled studies are necessary to assess the efficacy, the duration of therapy required for effective results, and the safety of this treatment over the long-term.
BACKGROUND: Bone marrow transplantation (BMT) is a common treatment used for deficiencies of host marrow or in the control of blood malignancies. Post-allogeneic BMT complications include graft-versus-host disease (GVHD). GVHD occurs when immunologically active T lymphocytes are transplanted into an immunosuppressed recipient who is genetically disparate from the donor. In this case report we describe the occurrence of oral lichen planus-like lesions as the first manifestation of chronic GVHD (c-GVHD) and the subsequent management of this disease with topical tacrolimus. METHODS: Diagnostic aids included routine histology and direct immunofluorescence studies to rule out immunobullous diseases and to confirm the c-GVHD. Treatment consisted of topical application of 0.1% tacrolimus ointment three times a day. RESULTS: Routine histology confirmed the clinical diagnosis of oral lichen planus-like c-GVHD. Treatment with tacrolimus ointment completely resolved the oral lesions after 2 months of therapy. CONCLUSIONS: Topical tacrolimus at low concentrations (0.1%) shows promise in the management of oral lichen planus-like c-GVHD. Controlled studies are necessary to assess the efficacy, the duration of therapy required for effective results, and the safety of this treatment over the long-term.
Authors: Leanne K Jackson; Douglas B Johnson; Jeffrey A Sosman; Barbara A Murphy; Joel B Epstein Journal: Support Care Cancer Date: 2014-09-13 Impact factor: 3.603
Authors: Paul A Carpenter; Carrie L Kitko; Sharon Elad; Mary E D Flowers; Juan C Gea-Banacloche; Jörg P Halter; Flora Hoodin; Laura Johnston; Anita Lawitschka; George B McDonald; Anthony W Opipari; Bipin N Savani; Kirk R Schultz; Sean R Smith; Karen L Syrjala; Nathaniel Treister; Georgia B Vogelsang; Kirsten M Williams; Steven Z Pavletic; Paul J Martin; Stephanie J Lee; Daniel R Couriel Journal: Biol Blood Marrow Transplant Date: 2015-03-31 Impact factor: 5.742
Authors: Rui Albuquerque; Zahid Khan; Ana Poveda; Jonathan Higham; Andrea Richards; Luis Monteiro; Enric Jané-Salas; José Lopez-Lopez; Saman Warnakulasuriya Journal: Med Oral Patol Oral Cir Bucal Date: 2016-01-01