Evaluation of Clinical Efficacy of Topical Tacrolimus 0.1% and Clobetasol Propionate 0.05% in Desquamative Gingivitis, Manifestation of Oral Lichen Planus

Abstract

Introduction: Oral lichen planus (OLP) is a chronic inflammatory mucocutaneous disorder with unknown etiology. Numerous treatment options have been reported, with topical corticosteroids being very often used as the first-line therapy for gingival lesions. However, a relatively novel therapeutic option is provided by tacrolimus. Aim: To compare the clinical effectiveness of topical tacrolimus 0.1% and clobetasol propionate 0.05% in the management of desquamative gingivitis, a distinct clinical manifestation of OLP. Materials and methods: This comparative study included 20 patients with histologically proven symptomatic OLP with gingival manifestation. The participants were divided into 2 groups: group A (clobetasol propionate 0.05% cream) and group B (topical tacrolimus 0.1% ointment). They were instructed to apply topical medications twice daily for three consecutive weeks. Custom trays have been used for better drug delivery. The patients were recalled at 1, 2, and 3 months after cessation of therapy for a follow-up control of any relapse. Results: The subjects in both groups showed a significant reduction in the burning sensation/pain and discomfort according to the visual analog scale (VAS). Similarly, both groups showed reduction in the efficiency index, and moderate improvement especially was seen in the tacrolimus 0.1% group (53%) and the clobetasol propionate group 0.05% (47%). Patients treated with clobetasol propionate 0.05% didn't have a relapse at 2 and 3 months after cessation of treatment. In contrast, 30% of the patients treated with tacrolimus 0.1% had a relapse of the condition at 2 and 3 months. Conclusions: Tacrolimus can be considered as a good alternative topical medication in the treatment of OLP, especially in those patients that do not respond to topical corticosteroids.