A preliminary open study of topical cyclosporin for hypertrophic lichen planus

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Abstract
Four patients with chronic hypertrophic lichen planus were treated with daily applications of 5 per cent w/v cyclosporin intravenous solution under polythene occlusions for a month. Biopsies were taken before and after treatment for routine histology and cell marker studies. Cyclosporin concentrations were measured in lesional skin and whole blood to assess tissue penetration. Scaling improved in all patients, plaques were subjectively thinner in three, and irritation lessened in two. One patient showed a striking reduction in the intensity of inflammatory infiltrate after topical cyclosporin. Dermat T-lymphocyte helper to suppressor ratios were reduced after cyclosporin in two patients, and HLA-DR expression was diminished, both in Dermat lymphocytes and keratinocytes, in three. Cyclosporin was not detected in blood or skin.

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