Linear Nodular Collagenoma—Successful Treatment with Intralesional Triamcinolone acetonide

Abstract:   A 17-year-old boy presented with papules and nodules arranged linearly on the neck and on the forehead. A diagnosis of collagenoma was made. Intralesional injection of triamcinolone acetonide resulted in marked effacement of the lesions.     

Clinical and serological efficacy of topical calcineurin inhibitors in oral lichen planus: a prospective randomized controlled trial

Oral lichen planus (OLP) is a T‐cell‐mediated disease characterized by immune‐mediated basal cell degeneration releasing interleukins (ILs) such as IL‐6 and IL‐8 into the circulation. Their serum levels reportedly reflect disease activity. Although many therapeutic options are available, none are curative. We compared the efficacy of tacrolimus 0.1% ointment and pimecrolimus 1% cream in OLP and correlated with serum IL‐6 and IL‐8 levels before and after treatment. Forty patients with symptomatic OLP were randomized into two groups, to receive either topical tacrolimus 0.1% ointment or pimecrolimus 1% cream (twice daily for 8 weeks). Patients were assessed at 2, 4, 8, and 12 weeks. At each visit, objective improvement in the net clinical score (NCS), drug tolerability, and side effects were evaluated. Serum IL‐6 and IL‐8 levels were measured at baseline and at eight weeks. Baseline characteristics were comparable between the groups. The mean NCS declined from 10.9 ± 4.5 and 9.9 ± 4.6 at baseline to 5.4 ± 3.5 and 5.3 ± 4.2 at 12 weeks for tacrolimus and pimecrolimus group, respectively. At each visit, in both groups, the decline in mean NCS from baseline was statistically significant (P < 0.05) and so was the decline in mean serum IL‐6 and IL‐8 levels pre‐ and post‐treatment. Pimecrolimus 1% cream seems to be as effective as tacrolimus 0.1% ointment. Serum IL‐6 and IL‐8 may act as markers of disease activity. However, future efforts are needed to objectify the use of serum interleukin levels in the disease severity index.