The effect of topical pimecrolimus on inflammatory infiltrate in vulvar lichen sclerosus.

OBJECTIVE: Lichen sclerosus (LS) is a relatively common chronic inflammatory disorder of the skin and mucosal surfaces.

STUDY DESIGN: A total of 29 women with histologically confirmed, active LS were recruited to this study with 2 aims. First, we evaluated the effectiveness of pimecrolimus treatment to LS not responding to conventional corticosteroid treatment. The second aim in this study was to provide information of in vivo effects of topical pimecrolimus in acute LS lesions, especially the inflammatory cell infiltration.

RESULTS: In all, 25 of 29 women applied cream as recommended. After 2 months of treatment, 20 patients had reached partial or complete clinical remission. Histology showed decreased inflammatory lymphoid infiltrate with down-regulation of CD3(+) T cells, CD8(+) T cells, and CD57(+) natural killer cells. Also macrophage marker CD68 staining showed down-regulation. There was no change in CD20(+) B lymphocytes.

CONCLUSION: We conclude that calcineurin inhibitors are an effective treatment for patients not responding to corticosteroid treatment.