Efficacy of topical tacrolimus for oral lichen planus: a retrospective cohort study stratified by cutaneous involvement

BACKGROUND: Oral lichen planus (OLP) is a chronic T-cell-mediated inflammatory mucocutaneous disorder with limited evidence on topical tacrolimus efficacy in subgroups based on cutaneous involvement. METHODS: This single-center retrospective cohort study analyzed data (2019-2024) from 120 biopsy-confirmed OLP patients after propensity score matching. Patients were classified according to treatment with topical tacrolimus 0.1% gel or clobetasol propionate 0.05% gel and stratified by cutaneous involvement. Primary outcomes included 8-week changes in visual analog scale (VAS) pain and total atrophic area (TAA), analyzed using mixed-effects models. RESULTS: < 0.05). Adverse events were mild and transient; the most common event was burning sensation. CONCLUSIONS: Topical tacrolimus was associated with improved short-term OLP outcomes and may be particularly useful as a second-line or steroid-sparing option in patients with concomitant cutaneous involvement.