The Role of Calcineurin Inhibitors in the Management of Lichen Sclerosus

American Journal of Clinical Dermatology - Tập 10 - Trang 313-318 - 2012
Paul D. Yesudian1
1Department of Dermatology, Glan Clwyd Hospital, Denbigshire, UK

Tóm tắt

Lichen sclerosus is a chronic inflammatory disorder with a propensity to affect the mucocutaneous anogenital area. Topical corticosteroids remain the treatment of choice for this condition and constitute an effective therapeutic modality. However, in patients with corticosteroid-resistant disease, when long-term remission is not sustainable, or in those intolerant to these agents, topical calcineurin inhibitors may be considered. Studies have demonstrated their efficacy and tolerability; however, concerns remain with regard to their malignant potential with long-term use. As lichen sclerosus is a potentially precancerous dermatosis, topical calcineurin inhibitors should be used with caution in this disorder.

Tài liệu tham khảo

Meffert JJ, Davis BM, Grimwood RE. Lichen sclerosus. J Am Acad Dermatol 1995; 32: 393–416 Neill SM, Tatnall FM, Cox NH., British Association of Dermatologists. Guidelines for the management of lichen sclerosus. Br J Dermatol 2002; 147: 640–9 Bohm M, Frieling U, Luger TA, et al. Successful treatment of anogenital lichen sclerosus with topical tacrolimus. Arch Dermatol 2003; 139: 922–4 Kunstfeld R, Kirnbauer R, Stingl G, et al. Successful treatment of vulvar lichen sclerosus with topical tacrolimus. Arch Dermatol 2003; 139: 850–2 Novak N, Kwiek B, Bieber T. The role of topical immunomodulators in the immunological network of atopic dermatitis. Clin Exp Dermatol 2005; 30: 160–4 Yesudian PD, Sugunendran H, Bates CM, et al. Lichen sclerosus. Int J STD AIDS 2005; 16: 465–73 Oyama N, Chan I, Neill SM, et al. Autoantibodies to extracellular matrix protein 1 in lichen sclerosus. Lancet 2003; 362: 118–23 Meyrick Thomas RH, Ridley CM, McGibbon DH, et al. Lichen sclerosus et atrophicus and autoimmunity: a study of 350 women. Br J Dermatol 1988; 118: 41–6 Smith YR, Haefner HK. Vulval lichen sclerosus: pathophysiology and treatment. Am J Clin Dermatol 2004; 5: 105–25 Meffert JJ, Grimwood RE. Lichen sclerosus et atrophicus appearing in an old burn scar. J Am Acad Dermatol 1994; 31: 671–3 Bunker CB. Male genital lichen sclerosus and tacrolimus. Br J Dermatol 2007; 157: 1079–80 Bunker CB. Management of penile dermatoses. Expert Rev Dermatol 2006; 1: 241–60 Val I, Almeida G. An overview of lichen sclerosus. Clin Obstet Gynecol 2005; 48: 808–17 Marren P, Cherry C, Day A. Lichen sclerosus: the patients, the hormonal influences and the disease impact [abstract]. Br J Dermatol 1995; 133: 21 Friedrich Jr EG, Kalra PS. Serum levels of sex hormones in vulvar lichen sclerosus, and the effect of topical testosterone. N Engl J Med 1984; 310: 488–91 Cox NH, Mitchell JN, Morley WN. Lichen sclerosus et atrophicus in nonidentical female twins [letter]. Br J Dermatol 1986; 115: 743 Marren P, Yell J, Charnock FM, et al. The association between lichen sclerosus and the antigens of the HLA system. Br J Dermatol 1995; 132: 197–203 Azurdia RM, Luzzi GA, Byren I, et al. Lichen sclerosus in adult men: a study of HLA associations and susceptibility to autoimmune disease. Br J Dermatol 1999; 140: 79–83 Clay FE, Cork MJ, Tarlow JK, et al. Interleukin 1 receptor antagonist gene polymorphism associated with lichen sclerosus. Hum Genet 1994; 94: 407–10 Scrimin F, Rustja S, Radillo O, et al. Vulvar lichen sclerosus: an immunologic study. Obstet Gynecol 2000; 95: 147–50 Cantwell Jr AR. Histologic observations of pleomorphic, variably acid-fast bacteria in scleroderma, morphea, and lichen sclerosus et atrophicus. Int J Dermatol 1984; 23: 45–52 Tuffanelli D. Do some patients with morphea and lichen sclerosus et atrophicus have a Borrelia infection? Am J Dermatopathol 1987; 9: 371–3 Drut RM, Gomez M, Drut R, et al. Human papilloma virus is present in some cases of childhood penile lichen sclerosus: an in-situ hybridization and SP-PCR study. Pediatr Dermatol 1998; 15: 85–90 Hampton PJ, Reynolds NJ. Calcineurin inhibitors for the treatment of skin disease: how do they work? Clin Exp Allergy 2005; 35: 549–50 Patel TS, Greer SC, Skinner RB. Cancer concerns with topical immunomodulators in atopic dermatitis. Am J Clin Dermatol 2007; 8: 189–94 Rustin MH. The safety of tacrolimus for the treatment of atopic dermatitis: a review. Br J Dermatol 2007; 157: 861–73 Strittmatter HJ, Hengge UR, Blecken SR. Calcineurin antagonists in vulval lichen sclerosus. Arch Gynecol Obstet 2006; 274: 266–70 Wollenberg A, Sharma S, von Bubnoff D, et al. Tacrolimus (FK 506) leads to profound phenotypic and functional alterations of epidermal antigen-presenting dendritic cells in atopic dermatitis. J Allergy Clin Immunol 2001; 107: 519–25 Meingassner JG, Aschauer H, Stuetz A, et al. Pimecrolimus permeates less than tacrolimus through normal, inflamed or corticosteroid-penetrated skin. Exp Dermatol 2005; 14: 752–7 Wollina U. The role of topical calcineurin inhibitors for skin disease other than atopic dermatitis. Am J Clin Dermatol 2007; 8: 157–73 Meurer M, Fartasch M, Albrecht G, et al. Long-term efficacy and safety of pimecrolimus cream 1% in adults with moderate atopic dermatitis. Dermatology 2004; 208: 365–72 Assmann T, Becker-Wegerich P, Grewe M, et al. Tacrolimus ointment for the treatment of vulvar lichen sclerosus. J Am Acad Dermatol 2003; 48: 935–7 Matsumoto Y, Yamamoto T, Isobe T, et al. Successful treatment of vulvar lichen sclerosus in a child with low-concentration topical tacrolimus ointment. J Dermatol 2007; 34: 114–6 Ginarte M, Toribio J. Vulvar lichen sclerosus successfully treated with topical tacrolimus. Eur J Obstet Gynecol Reprod Biol 2005; 123: 123–4 Goldstein AT, Marinoff SC, Christopher K. Pimecrolimus for the treatment of vulvar lichen sclerosus in a premenarchal girl. J Pediatr Adolesc Gynecol 2004; 17: 35–7 Goldstein AT, Marinoff SC, Christopher K. Pimecrolimus for the treatment of vulvar lichen sclerosus: a report of 4 cases. J Reprod Med 2004; 49: 778–80 Boms S, Gambichler T, Freitag M, et al. Pimecrolimus 1%cream for anogenital lichen sclerosus in childhood. BMC Dermatol 2004; 4: 14 Luesley DM, Downey GP. Topical tacrolimus in the management of lichen sclerosus. BJOG 2006; 113: 832–4 Virgili A, Lauriola MM, Mantovani E, et al. Vulvar lichen sclerosus: 11 women treated with tacrolimus 0.1% ointment. Acta Derm Venereol 2007; 87: 69–72 Oskay T, Sczer HK, Genc C, et al. Pimecrolimus 1% cream in the treatment of vulvar lichen sclerosus in post-menopausal women. Int J Dermatol 2007; 46: 527–32 Nissi R, Eriksen H, Risteli J, et al. Pimecrolimus cream 1% in the treatment of lichen sclerosus. Gynecol Obstet Invest 2007; 63: 151–4 Hengge UR, Krause W, Hofmann H, et al. Multicentre, phase 2 trial on the safety and efficacy of topical tacrolimus ointment for the treatment of lichen sclerosus. Br J Dermatol 2006; 155: 1021–8 Berger TG, Duvic M, Van Voorhees AS, et al. The use of topical calcineurin inhibitors in dermatology: safety concerns: report of the American Academy of Dermatology Association Task Force. J Am Acad Dermatol 2006; 54: 818–23 Callen J, Chamlin S, Eichenfield LF, et al. A systemic review of the safety of topical therapies for atopic dermatitis. Br J Dermatol 2007; 156: 203–21 Kawashima M, Nakagawa H, Ohtsuki M, et al. Tacrolimus concentrations in blood during topical treatment of atopic dermatitis. Lancet 1996; 348: 1240–1 Qureshi AA, Fischer MA. Topical calcineurin inhibitors for atopic dermatitis: balancing clinical benefit and possible risks. Arch Dermatol 2006; 142: 633–7 Stern RS. Topical calcineurin inhibitors labelling: putting the ‘box’ in perspective. Arch Dermatol 2006; 142: 1233–4 Topical tacrolimus and pimecrolimus: reports of malignancies. Curr Probl Pharmacovigilance 2006; 31: 1–2 Langeland T, Engh V. Topical use of tacrolimus and squamous cell carcinoma on the penis. Br J Dermatol 2005; 152: 183–5 Fischer G, Bradford J. Topical immunosuppressants, genital lichen sclerosus and the risk of squamous cell carcinoma: a case report. J Reprod Med 2007; 52: 329–31 Niwa Y, Terashima T, Sumi H. Topical application of the immunosuppressant tacrolimus accelerates carcinogenesis in mouse skin. Br J Dermatol 2003; 149: 960–7 Bilenchi R, Poggiali S, De Padova LA, et al. Human papilloma virus reactivation following topical tacrolimus therapy for anogenital lichen sclerosus. Br J Dermatol 2007; 156: 405–6 Lonsdale-Eccles AA, Velangi S. Herpes simplex of the vulva evoked by topical tacrolimus. Clin Exp Dermatol 2005; 30: 95–6 Kim YJ, Kang HY. Pigmentation after using topical tacrolimus to treat lichen sclerosus: possible role of stem cell factor. J Am Acad Dermatol 2007; 57: S125–7 Dalziel KL, Millard PR, Wojnarowska F. The treatment of vulval lichen sclerosus with a very potent topical steroid (clobetasol proprionate 0.05%) cream. Br J Dermatol 1991; 124: 461–4 Virgili A, Corazza M, Bianchi A, et al. Open study of topical 0.025% tretinoin in the treatment of vulval lichen sclerosus. J Reprod Med 1995; 40: 614–8 Ayhan A, Urman B, Yuce K, et al. Topical testosterone for lichen sclerosus. Int J Gynecol Obstet 1989; 30: 253–5 Lascano EF, Montes LF, Mazzini MA. Lichen sclerosus et atrophicus in childhood. Obstet Gynecol 1964; 24: 872–7 Bousema MT, Romppanem U, Geiger JM, et al. Acitretin in the treatment of severe lichen sclerosus et atrophicus of the vulva: a double blind, placebo controlled trial. J Am Acad Dermatol 1994; 30: 225–31 Cooper CM, Gao X-H, Powell JJ, et al. Does treatment of vulvar lichen sclerosus influence its prognosis? Arch Dermatol 2004; 140: 702–6 Simonart T, Lahaye M, Simonart J-M. Vulvar lichen sclerosus: effect of maintenance treatment with a moisturiser on the course of the disease. Menopause 2007; 15: 1–4 Powell JJ, Wajnarowska F. Lichen sclerosus. Lancet 1999; 353: 1777–83 Carli P, Cattaneo A, De Magnis A, et al. Squamous cell carcinoma of the vulva and lichen sclerosus: a longitudinal cohort study. Eur J Cancer Prev 1995; 4: 491–5 Walkden V, Chia Y, Wojnarowska F. The association of squamous cell carcinoma of the vulva and lichen sclerosus: implications for follow up. J Obstet Gynaecol 1997; 17: 551–3 Bunker CB, Neill S, Staughton RCD. Topical tacrolimus, genital lichen sclerosus, and risk of squamous cell carcinoma [letter]. Arch Dermatol 2004; 140: 1169 Edey K, Bisson D, Kennedy C. Topical tacrolimus in the management of lichen sclerosus [letter]. BJOG 2006; 113: 1482