Comparison of topical clobetasol propionate 0.05% and topical tacrolimus 0.1% in the treatment of cutaneous lichen planus

Introduction
The effectiveness of topical tacrolimus in the treatment of oral and genital lichen planus has been verified in many randomized studies; however, there are only few case reports in treatment of cutaneous lichen planus (CLP).

Aim
We sought to compare the safety and efficacy of topical clobetasol propionate and tacrolimus ointment in the treatment of CLP.

Material and methods
Retrospective analysis of patient files was performed. We enrolled patients who were diagnosed with CLP and treated with topical tacrolimus 0.1% or topical clobetasol propionate 0.05%. Visual Analogue Scale (VAS) scores of pigmentation and pruritus, clinical response, laboratory data and adverse effects were obtained from medical records.

Results
A total of 27 patients were included in the clobetasol group and 23 patients in the tacrolimus group. Both groups showed an improvement in VAS scores regarding pruritus and pigmentation but a statistically significant difference was observed in the clobetasol group (p < 0.05). At week 12, a complete response was observed in 63% (n = 17) of the clobetasol and 26% (n = 6) of the tacrolimus group.

Conclusions
In our study, both treatments were found effective in the treatment of CLP but clobetasol propionate was more effective. However tacrolimus may be preferred before topical corticosteroids for lesions on the face, neck, and intertriginous regions of the body, which are sensitive to the cutaneous adverse effects of topical corticosteroids. Our study may be one of the first studies to compare the effects of topical clobetasol and tacrolimus ointment in the management of CLP.