Topical cyclosporine for oral mucosal disorders

The medical literature concerning the effectiveness of topical cyclosporine for treating disorders of the mucous membranes of the mouth is reviewed. In general, topical cyclosporine has not been effective against conditions known to respond to systemic (for instance, orally administered) cyclosporine, but direct injection into skin lesions can produce results. This implies that increased skin absorption of the drug could improve its effectiveness. Absorption by the oral mucosa is known to be considerably better than by skin, thus presumably increasing drug action. The results are presented from cyclosporine treatment of oral lichen planus (red, itchy bumps and scales), bullous disorders (in which blisters form), and aphthous stomatitis (severe canker sores). Most patients with lichen planus of the mouth were helped by the drug. Many patients with oral bullous disorders are elderly, and the potential toxicity of cyclosporine is a concern. However, in studies involving small numbers of patients, several experienced reduction in lesion size as well as pain relief. Treatment with cyclosporine of aphthous stomatitis was effective in some cases but not others, for reasons that may be linked to the various causes of this disorder. These results using topical cyclosporine for treating oral mucosal disorders are encouraging, and support further investigation. (Consumer Summary produced by Reliance Medical Information, Inc.)