![]() However, the results of the latter technique, though seemingly safe, are variable. įor treating OLP, cyclosporine has been used as a topical therapy in the past, using the “swish and spit” technique. The failure of other systemic agents (dapsone and methotrexate) made cyclosporine a logical choice in our case. Moreover, the drug modulates cytokines, such as IL-2 and interferon-γ, leading to a reduced function of effector T cells that play a role in OLP. Cyclosporine has been used via its action on the helper/inducer T lymphocyte and inhibition of the CD1+ and CD14+ antigen-presenting cells. The pathogenesis of OLP is based on the interplay of helper/inducer T cells and the antigen-presenting cells, leading to the activation of auto-cytotoxic CD8+ T cells that release interferon-γ which triggers the apoptosis of the basal cells of the oral epithelium. The patient reported no adverse event connected with the use of cyclosporine. ![]() ![]() The patient was asked to continue the therapy at a dose of 1 mL a day for another month, which resulted in complete resolution of the lesion (Fig. (Fig.2) 2) with near complete resolution of the lesion. After 6 weeks of treatment with systemic cyclosporine, there was a dramatic response (Fig. The decision on giving the solution in preference to the capsule was based on the cost effectiveness of the solution and the fact that accurate dosing according to the bodyweight can be achieved by the oral solution. However, there was no significant improvement in the lesions after 5 weeks of therapy, and the patient was then asked to take cyclosporine 200 mg/day orally (1 mL of solution b.d.) mixed with water, milk, or juice (except grape fruit juice) 1 h before meals. The patient was started on cyclosporine (Psorid Biocon TM) oral solution 100 mg/mL as a “swish and spit” medication, 3 times daily, each treatment lasting for 5 min. Laboratory screen for hepatitis B and C and baseline hemogram, liver function tests, and kidney function tests were within normal limits. Histopathological examination of the lesion was performed to confirm the diagnosis and to rule out any malignant transformation which was consistent with LP. Here, we present a case report of a male patient with debilitating tongue LP which was resistant to various topical and systemic treatments and was successfully treated with cyclosporine oral solution.Ī large erythematous plaque present on the dorsum of the tongue at the first visit. Although it is often asymptomatic, the erythematous and erosive forms can cause severe pain, interfering with eating and swallowing and thus requiring therapy. The clinical presentation of OLP classically consists of 6 types: reticular, atrophic, papular, bullous, plaque, and erosive or ulcerative type. The buccal mucosa, tongue, and gingiva are commonly affected sites in OLP. Oral LP (OLP) is comparatively more frequent than the cutaneous form, and it is more persistent and resistant to treatment and afflicts the middle-aged population, especially tobacco chewers and smokers. LP is estimated to affect 0.5–2.0% of the general population, with a prevalence as high as 2.6% in the Indian population. Lichen planus (LP) is a chronic mucocutaneous disorder of the stratified squamous epithelium affecting oral and genital mucous membranes, the skin, nails, and scalp.
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