Ann Dermatol.  2010 Aug;22(3):326-329. 10.5021/ad.2010.22.3.326.

Treatment of Oral Lichen Sclerosus with 1% Pimecrolimus Cream

• Kim CY
• Kim JG
• Oh CW

• KMID: 2265369
• DOI: http://doi.org/10.5021/ad.2010.22.3.326

Abstract

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.

Keyword

Childhood; Lichen sclerosus; Oral; Pimecrolimus

MeSH Terms

Biopsy
Child
Dermis
Epidermis
Female
Genitalia
Humans
Lichen Sclerosus et Atrophicus
Lichens
Lip
Lymphocytes
Mouth Mucosa
Mucous Membrane
Sclerosis
Tacrolimus
Telangiectasis
Tacrolimus

Figure

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  Fig. 1 (A) The 2.5×1.5 cm sized, creamy white atrophic, erythematous and telangiectatic bordered lichen sclerosus et atrophicus lesion is affecting the left lower lip and extending intraorally onto the left buccal mucosa. Clinical appearance after 4 weeks (B) and 30 months (C) of treatment with 1% pimecrolimus cream.

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  Fig. 2 (A) Histopathological findings show a patchy lichenoid infiltrate of lymphocytes associated with degenerative changes and hyalinization of the papillary dermis (H&E stain, ×40). (B) Hydropic degeneration along the basement membrane is shown on high power magnification (H&E stain, ×100).

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