Topical immunomodulators for management of oral mucosal conditions, a systematic review; Part II: Miscellaneous agents

Expert Opinion on Emerging Drugs

Volumn 16, Issue 1, 2011, Pages 183-202

  Elad, Sharon ^a   Epstein, Joel B ^b   Von Bltzingslöwen, Inger ^c   Drucker, Scott ^d   TzaC H , Rinat ^a   Yarom, Noam ^e,f  

^a HEBREW UNIVERSITY OF JERUSALEM   (Israel)

^b UNIVERSITY OF ILLINOIS AT CHICAGO   (United States)

^c UNIVERSITY OF GOTHENBURG   (Sweden)

^d UNIVERSITY OF PENNSYLVANIA   (United States)

^e SHEBA MEDICAL CENTER   (Israel)

^f TEL AVIV UNIVERSITY   (Israel)

Author keywords

azathioprine; bacillus Calmette Guerin polysaccharide nucleic acid; benzydamine; evidence based; G CSF; GM CSF; imiquimod; mechanism; mucosal; oral; retinoids; tetracyclines; therapy; topical

Indexed keywords

ALBENDAZOLE; AMLEXANOX; AZATHIOPRINE; BCG VACCINE; BENZYDAMINE; CHLORHEXIDINE; CLOBETASOL; DAPSONE; EFALIZUMAB; FLUOCINOLONE ACETONIDE; GRANULOCYTE COLONY STIMULATING FACTOR; GRANULOCYTE MACROPHAGE COLONY STIMULATING FACTOR; GRISEOFULVIN; IMIQUIMOD; IMMUNOMODULATING AGENT; INFLIXIMAB; ISOTRETINOIN; LEVAMISOLE; MINOCYCLINE; MYCOPHENOLIC ACID 2 MORPHOLINOETHYL ESTER; PENTOXIFYLLINE; PLACEBO; RAPAMYCIN; RETINOIC ACID; RETINOID; RETINOL; TETRACYCLINE; THALIDOMIDE; TRIAMCINOLONE ACETONIDE;

APHTHOUS STOMATITIS; BEHCET DISEASE; CANDIDIASIS; CHRONIC HYPERPLASTIC CANDIDIASIS; DRUG WITHDRAWAL; FOCAL EPITHELIUM HYPERPLASIA; GRAFT VERSUS HOST REACTION; HUMAN; LEUKOPLAKIA; LICHEN PLANUS; MOUTH DISEASE; MUCOSA INFLAMMATION; MUCOUS MEMBRANE PEMPHIGOID; PAIN; PEMPHIGOID; PEMPHIGUS; PEMPHIGUS VULGARIS; RANDOMIZED CONTROLLED TRIAL (TOPIC); REVIEW; SYSTEMATIC REVIEW; UNSPECIFIED SIDE EFFECT; WHITE SPONGE NEVUS;

ADMINISTRATION, TOPICAL; CLINICAL TRIALS AS TOPIC; DRUG DISCOVERY; HUMANS; IMMUNOLOGIC FACTORS; LICHEN PLANUS, ORAL; MOUTH DISEASES; MOUTH MUCOSA; RETINOIDS; STOMATITIS, APHTHOUS; TETRACYCLINES; TREATMENT OUTCOME;

EID: 79952136500     PISSN: 14728214     EISSN: None     Source Type: Journal    
DOI: 10.1517/14728214.2011.528390     Document Type: Review

References (93)

1. Elad S, Epstein JB, Yarom N, et al. Topical immunomodulators for management of oral mucosal conditions, a systematic review; part I: calcineurin inhibitors. Expert Opin Emerg Drugs 2010;15(4):713-26
2. Oxford Center for Evidence-Based Medicine - Levels of Evidence (March 2009). Available from: http://www.cebm.net/index.aspx?o=1025. [Date accessed 3 January 2010]
3. Nevile B, Damm D, Allen C, et al. Dermatologic diseases. In: Nevile B, Damm D, Allen C, et al. editors, Oral and maxillofacial pathology, 3rd edition. Saunders Elsevier, St. Louis, Missouri; 2009. p. 783
4. Nevile B, Damm D, Allen C, et al. Allergies and immunologic diseases. In: Nevile B, Damm D, Allen C, et al. editor, Oral and maxillofacial pathology, edition. Saunders Elsevier, St. Louis, Missouri; 2009. p. 333
5. Rankin KV, Jones DL, Redding SW. Oral health in cancer therapy. A guide for health care professionals. Dental Oncology Education Program; American Cancer Society, Texas Division, Texas Dental Foundation, San Antonio; 2003
6. Al Johani KA, Hegarty AM, Porter SR, et al. Calcineurin inhibitors in oral medicine. J Am Acad Dermatol 2009;61:829-40
7. Marder W, McCune WJ. Advances in immunosuppressive therapy. Semin Respir Crit Care Med 2007;28:398-417 (Pubitemid 350194723) (Pubitemid 350194723)
8. Epstein JB, Gorsky M, Epstein MS, et al. Topical azathioprine in the treatment of immune-mediated chronic oral inflammatory conditions: a series of cases. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2001;91:56-61 (Pubitemid 33601611) (Pubitemid 33601611)
9. Epstein JB, Nantel S, Sheoltch SM. Topical azathioprine in the combined treatment of chronic oral graft-versus-host disease. Bone Marrow Transplant 2000;25:683-7 (Pubitemid 30156598) (Pubitemid 30156598)
10. Eggleston DJ, Nally FF. Treatment of aphthous ulceration with topical azathioprine. A double blind trial. Br J Oral Surg 1972;9:233-6
11. Cioli V, Corradino C, Scorza Barcellona P. Review of pharmacological data on benzydamine. Int J Tissue React 1985;7:205-13 (Pubitemid 15017748) (Pubitemid 15017748)
12. Kataoka S, Nishimura K, Naito T. In vivo metabolism and anti-inflammatory activity of benzydamine hydrochloride in rats treated with carrageenin. Chem Pharm Bull (Tokyo) 1979;27:2890-903 (Pubitemid 10145383) (Pubitemid 10145383)
13. Segre G, Hammarstrom S. Aspects of the mechanisms of action of benzydamine. Int J Tissue React 1985;7:187-93 (Pubitemid 15017746) (Pubitemid 15017746)
14. Quane PA, Graham GG, Ziegler JB. Pharmacology of benzydamine. Inflammopharmacology 1998;6:95-107 (Pubitemid 28343281) (Pubitemid 28343281)
15. Kim JH, Chu FC, Lakshmi V, et al. Benzydamine HCl, a new agent for the treatment of radiation mucositis of the oropharynx. Am J Clin Oncol 1986;9:132-4 (Pubitemid 16115725) (Pubitemid 16115725)
16. Prada A, Lozza L, Moglia D, et al. Effects of benzydamine on radio-polychemotherapeutic mucositis of the oral cavity. Int J Tissue React 1985;7:237-9 (Pubitemid 15017753) (Pubitemid 15017753)
17. Prada A, Chiesa F. Effects of benzydamine on the oral mucositis during antineoplastic radiotherapy and/or intra-arterial chemotherapy. Int J Tissue React 1987;9:115-19 (Pubitemid 17097101) (Pubitemid 17097101)
18. Kin-Fong Cheng K, Ka Tsui Yuen J. A pilot study of chlorhexidine and benzydamine oral rinses for the prevention and treatment of irradiation mucositis in patients with head and neck cancer. Cancer Nurs 2006;29:423-30 (Pubitemid 44483999) (Pubitemid 44483999)
19. Samaranayake LP, Robertson AG, MacFarlane TW, et al. The effect of chlorhexidine and benzydamine mouthwashes on mucositis induced by therapeutic irradiation. Clin Radiol 1988;39:291-4
20. Schubert MM, Newton RE. The use of benzydamine HCl for the management of cancer therapy-induced mucositis: preliminary report of a multicentre study. Int J Tissue React 1987;9:99-103 (Pubitemid 17097099) (Pubitemid 17097099)
21. Kazemian A, Kamian S, Aghili M, et al. Benzydamine for prophylaxis of radiation-induced oral mucositis in head and neck cancers: a double-blind placebocontrolled randomized clinical trial. Eur J Cancer Care (Engl) 2009;18:174-8
22. Epstein JB, Silverman S Jr, Paggiarino DA, et al. Benzydamine HCl for prophylaxis of radiation-induced oral mucositis: results from a multicenter, randomized, double-blind, placebo-controlled clinical trial. Cancer 2001;92:875-85 (Pubitemid 32783076) (Pubitemid 32783076)
23. Epstein JB, Stevenson-Moore P. Benzydamine hydrochloride in prevention and management of pain in oral mucositis associated with radiation therapy. Oral Surg Oral Med Oral Pathol 1986;62:145-8 (Pubitemid 17193614) (Pubitemid 17193614)
24. Epstein JB, Stevenson-Moore P, Jackson S, et al. Prevention of oral mucositis in radiation therapy: a controlled study with benzydamine hydrochloride rinse. Int J Radiat Oncol Biol Phys 1989;16:1571-5 (Pubitemid 19154345) (Pubitemid 19154345)
25. Edres MA, Scully C, Gelbier M. Use of proprietary agents to relieve recurrent aphthous stomatitis. Br Dent J 1997;182:144-6 (Pubitemid 127538784) (Pubitemid 127538784)
26. Matthews RW, Scully CM, Levers BG, et al. Clinical evaluation of benzydamine, chlorhexidine, and placebo mouthwashes in the management of recurrent aphthous stomatitis. Oral Surg Oral Med Oral Pathol 1987;63:189-91 (Pubitemid 17016152) (Pubitemid 17016152)
27. Sardella A, Uglietti D, Demarosi F, et al. Benzydamine hydrochloride oral rinses in management of burning mouth syndrome. A clinical trial. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 1999;88:683-6
28. Wadhwa M, Thorpe R. Haematopoietic growth factors and their therapeutic use. Thromb Haemost 2008;99:863-73 (Pubitemid 351705302) (Pubitemid 351705302)
29. Mantovani G, Massa E, Astara G, et al. Phase II clinical trial of local use of GM-CSF for prevention and treatment of chemotherapy- and concomitant chemoradiotherapy-induced severe oral mucositis in advanced head and neck cancer patients: an evaluation of effectiveness, safety and costs. Oncol Rep 2003;10:197-206
30. Sprinzl GM, Galvan O, de Vries A, et al. Local application of granulocyte-macrophage colony stimulating factor (GM-CSF) for the treatment of oral mucositis. Eur J Cancer 2001;37:2003-9 (Pubitemid 32938102) (Pubitemid 32938102)
31. Hejna M, Kostler WJ, Raderer M, et al. Decrease of duration and symptoms in chemotherapy-induced oral mucositis by topical GM-CSF: results of a prospective randomised trial. Eur J Cancer 2001;37:1994-2002 (Pubitemid 32938101) (Pubitemid 32938101)
32. van der Lelie H, Thomas BL, van Oers RH, et al. Effect of locally applied GM-CSF on oral mucositis after stem cell transplantation: a prospective placebo-controlled double-blind study. Ann Hematol 2001;80:150-4 (Pubitemid 32266154) (Pubitemid 32266154)
33. Herranz P, Arribas JR, Navarro A, et al. Successful treatment of aphthous ulcerations in AIDS patients using topical granulocyte-macrophage colony-stimulating factor. Br J Dermatol 2000;142:171-6 (Pubitemid 30074493) (Pubitemid 30074493)
34. Ibrah im EM, al-Mulhim FA. Effect of granulocyte-macrophage colony-stimulating factor on chemotherapy-induced oral mucositis in non-neutropenic cancer patients. Med Oncol 1997;14:47-51 (Pubitemid 27293864) (Pubitemid 27293864)
35. Rovirosa A, Ferre J, Biete A. Granulocyte macrophage-colonystimulating factor mouthwashes heal oral ulcers during head and neck radiotherapy. Int J Radiat Oncol Biol Phys 1998;41:747-54 (Pubitemid 28285950) (Pubitemid 28285950)
36. Cartee L, Petros WP, Rosner GL, et al. Evaluation of GM-CSF mouthwash for prevention of chemotherapy-induced mucositis: a randomized, double-blind, dose-ranging study. Cytokine 1995;7:471-7
37. de la Torre A, Reguiero CA, Valcarcel FJ. Granulocyte-macrophage colony-stimulating factor mouthwashes improve radiation induced mucositis in AIDS patients. Radiother Oncol 1997;43:229-30 (Pubitemid 27261595) (Pubitemid 27261595)
38. Nicolatou O, Sotiropoulou-Lontou A, Skarlatos J, et al. A pilot study of the effect of granulocyte-macrophage colony-stimulating factor on oral mucositis in head and neck cancer patients during X-radiation therapy: a preliminary report. Int J Radiat Oncol Biol Phys 1998;42:551-6 (Pubitemid 28501104) (Pubitemid 28501104)
39. Bacanli A, Yerebakan Dicle O, Parmaksizoglu B, et al. Topical granulocyte colony-stimulating factor for the treatment of oral and genital ulcers of patients with Behcet's disease. J Eur Acad Dermatol Venereol 2006;20:931-5
40. Karthaus M, Rosenthal C, Huebner G, et al. Effect of topical oral G-CSF on oral mucositis: a randomised placebo-controlled trial. Bone Marrow Transplant 1998;22:781-5 (Pubitemid 28488322) (Pubitemid 28488322)
41. Duggar BM. Aureomycin; a product of the continuing search for new antibiotics. Ann N Y Acad Sci 1948;51:177-81
42. Roberts MC. Tetracycline therapy: update. Clin Infect Dis 2003;36:462-7 (Pubitemid 36241313) (Pubitemid 36241313)
43. Thomas I, Khorenian S, Arbesfeld DM. Treatment of generalized bullous pemphigoid with oral tetracycline. J Am Acad Dermatol 1993;28:74-7 (Pubitemid 23019569) (Pubitemid 23019569)
44. Poskitt L, Wojnarowska F. Treatment of cicatricial pemphigoid with tetracycline and nicotinamide. Clin Exp Dermatol 1995;20:258-9
45. Peoples D, Fivenson DP. Linear IgA bullous dermatosis: successful treatment with tetracycline and nicotinamide. J Am Acad Dermatol 1992;26:498-9
46. Graykowski EA, Kingman A. Double-blind trial of tetracycline in recurrent aphthous ulceration. J Oral Pathol 1978;7:376-82 (Pubitemid 9104329) (Pubitemid 9104329)
47. Gorsky M, Epstein J, Raviv A, et al. Topical minocycline for managing symptoms of recurrent aphthous stomatitis. Spec Care Dentist 2008;28:27-31
48. Gorsky M, Epstein J, Rabenstein S, et al. Topical minocycline and tetracycline rinses in treatment of recurrent aphthous stomatitis: a randomized cross-over study. Dermatol Online J 2007;13:1
49. Guggenheimer J, Brightman VJ, Ship II. Effect of chlortetracycline mouthrinses on the healing of recurrent aphthous ulcers: a double-blind controlled trial. J Oral Ther Pharmacol 1968;4:406-8
50. McDonagh AJ, Gawkrodger DJ, Walker AE.White sponge naevus successfully treated with topical tetracycline. Clin Exp Dermatol 1990;15:152-3 (Pubitemid 20072098) (Pubitemid 20072098)
51. Lim J, Ng SK. Oral tetracycline rinse improves symptoms of white sponge nevus. J Am Acad Dermatol 1992;26:1003-5
52. Otobe IF, de Sousa SO, Migliari DA, et al. Successful treatment with topical tetracycline of oral white sponge nevus occurring in a patient with systemic lupus erythematosus. Int J Dermatol 2006;45:1130-1 (Pubitemid 44317151) (Pubitemid 44317151)
53. Otobe IF, de Sousa SO, Matthews RW, et al. White sponge naevus: improvement with tetracycline mouth rinse: report of four cases. Clin Exp Dermatol 2007;32:749-51 (Pubitemid 47609768) (Pubitemid 47609768)
54. Becker LR, Lutz C, Erbard H, et al. White sponge naevus successfully treated with tetracycline mouth rinse. Acta Derm Venereol 1997;77:413
55. Walchner M, Messer G, Salomon N, et al. Topical tetracycline treatment of erosive oral lichen planus. Arch Dermatol 1999;135:92-3 (Pubitemid 29069532) (Pubitemid 29069532)
56. Bauco van der Wal V, Jonkman MF. Topical tetracycline in cicatricial pemphigoid. J Am Acad Dermatol 1997;36:492-3 (Pubitemid 27131985) (Pubitemid 27131985)
57. Gorsky M, Epstein JB. The effect of retinoids on premalignant oral lesions: focus on topical therapy. Cancer 2002;95:1258-64 (Pubitemid 35013060) (Pubitemid 35013060)
58. Jones DA. The potential immunomodulatory effects of topical retinoids. Dermatol Online J 2005;11:3
59. Sloberg K, Hersle K, Mobacken H, et al. Topical tretinoin therapy and oral lichen planus. Arch Dermatol 1979;115:716-18 (Pubitemid 9249661) (Pubitemid 9249661)
60. Giustina TA, Stewart JC, Ellis CN, et al. Topical application of isotretinoin gel improves oral lichen planus. A double-blind study. Arch Dermatol 1986;122:534-6 (Pubitemid 16090915) (Pubitemid 16090915)
61. Piattelli A, Carinci F, Iezzi G, et al. Oral lichen planus treated with 13-cis-retinoic acid (isotretinoin): effects on the apoptotic process. Clin Oral Investig 2007;11:283-8
62. Buajeeb W, Kraivaphan P, Pobrurksa C. Efficacy of topical retinoic acid compared with topical fluocinolone acetonide in the treatment of oral lichen planus. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 1997;83:21-5 (Pubitemid 127671828) (Pubitemid 127671828)
63. Scardina GA, Messina P, Carini F, et al. A randomized trial assessing the effectiveness of different concentrations of isotretinoin in the management of lichen planus. Int J Oral Maxillofac Surg 2006;35:67-71 (Pubitemid 43033429) (Pubitemid 43033429)
64. Zegarelli DJ. Treatment of oral lichen planus with topical vitamin A acid. J Oral Med 1984;39:186-91 (Pubitemid 14032497) (Pubitemid 14032497)
65. Piattelli A, Fioroni M, Santinelli A, et al. bcl-2 expression and apoptotic bodies in 13-cis-retinoic acid (isotretinoin)-topically treated oral leukoplakia: a pilot study. Oral Oncol 1999;35:314-20 (Pubitemid 29148366) (Pubitemid 29148366)
66. Tete S, Pappalardo S, Rubini C, et al. The role of apoptosis and bcl-2 protein in topical treatment of oral leukoplakia with isotretinoin. Minerva Stomatol 1999;48:411-18
67. Scardina GA, Carini F, Maresi E, et al. Evaluation of the clinical and histological effectiveness of isotretinoin in the therapy of oral leukoplakia: ten years of experience: is management still up to date and effective? Methods Find Exp Clin Pharmacol 2006;28:115-19
68. Epstein JB, Gorsky M. Topical application of vitamin A to oral leukoplakia: A clinical case series. Cancer 1999;86:921-7 (Pubitemid 29439844) (Pubitemid 29439844)
69. Scardina GA, Ruggieri A, Messina P. Chronic hyperplastic candidosis: a pilot study of the efficacy of 0.18% isotretinoin. J Oral Sci 2009;51:407-10
70. Gaspari AA. Mechanism of action and other potential roles of an immune response modifier. Cutis 2007;79:36-45
71. Yasar S, Mansur AT, Serdar ZA, et al. Treatment of focal epithelial hyperplasia with topical imiquimod: report of three cases. Pediatr Dermatol 2009;26:465-8
72. Xiong C, Li Q, Lin M, et al. The efficacy of topical intralesional BCG-PSN injection in the treatment of erosive oral lichen planus: a randomized controlled trial. J Oral Pathol Med 2009;38:551-8
73. Meng W, Dong Y, Liu J, et al. A clinical evaluation of amlexanox oral adhesive pellicles in the treatment of recurrent aphthous stomatitis and comparison with amlexanox oral tablets: a randomized, placebo controlled, blinded, multicenter clinical trial. Trials 2009;10:30
74. Rodriguez M, Rubio JA, Sanchez R. Effectiveness of two oral pastes for the treatment of recurrent aphthous stomatitis. Oral Dis 2007;13:490-4 (Pubitemid 47247006) (Pubitemid 47247006)
75. Liu J, Zeng X, Chen Q, et al. An evaluation on the efficacy and safety of amlexanox oral adhesive tablets in the treatment of recurrent minor aphthous ulceration in a Chinese cohort: a randomized, double-blind, vehicle-controlled, unparallel multicenter clinical trial. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2006;102:475-81 (Pubitemid 44403144) (Pubitemid 44403144)
76. Murray B, Biagioni PA, Lamey PJ. The efficacy of amlexanox OraDisc on the prevention of recurrent minor aphthous ulceration. J Oral Pathol Med 2006;35:117-22
77. Greer RO Jr, Lindenmuth JE, Juarez T, et al. A double-blind study of topically applied 5% amlexanox in the treatment of aphthous ulcers. J Oral Maxillofac Surg 1993;51:243-8; discussion 248-9
78. Khandwala A, Van Inwegen RG, Alfano MC. 5% amlexanox oral paste, a new treatment for recurrent minor aphthous ulcers: I. clinical demonstration of acceleration of healing and resolution of pain. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 1997;83:222-30 (Pubitemid 127670955) (Pubitemid 127670955)
79. Khandwala A, Van Inwegen RG, Charney MR, et al. 5% amlexanox oral paste, a new treatment for recurrent minor aphthous ulcers: II. Pharmacokinetics and demonstration of clinical safety. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 1997;83:231-8 (Pubitemid 127670956) (Pubitemid 127670956)
80. Murray B, McGuinness N, Biagioni P, et al. A comparative study of the efficacy of Aphtheal in the management of recurrent minor aphthous ulceration. J Oral Pathol Med 2005;34:413-19 (Pubitemid 41003296) (Pubitemid 41003296)
81. Soria A, Agbo-Bedeau S, Tareb A, Frances C. Treatment of refractory oral erosive lichen planus with topical rapamycin: 7 cases. Dermatology 2009;21B(1):22-5
82. Sironi M, Pozzi P, Polentarutti N, et al. Inhibition of inflammatory cytokine production and protection against endotoxin toxicity by benzydamine. Cytokine 1996;8:710-16 (Pubitemid 26383719) (Pubitemid 26383719)
83. Sironi M, Milanese C, Vecchi A, et al. Benzydamine inhibits the release of tumor necrosis factor-alpha and monocyte chemotactic protein-1 by Candida albicans-stimulated human peripheral blood cells. Int J Clin Lab Res 1997;27:118-122
84. Guglielmotti A, Aquilini L, Rosignoli MT, et al. Benzydamine protection in a mouse model of endotoxemia. Inflamm Res 1997;46:332-5 (Pubitemid 27443304) (Pubitemid 27443304)
85. Ueyama Y, Misaki M, Ishihara Y, et al. Effects of antibiotics on human polymorphonuclear leukocyte chemotaxis in vitro. Br J Oral Maxillofac Surg 1994;32:96-9 (Pubitemid 24116066) (Pubitemid 24116066)
86. Kloppenburg M, Verweij CL, Miltenburg AM, et al. The influence of tetracyclines on T cell activation. Clin Exp Immunol 1995;102:635-41 (Pubitemid 26013229) (Pubitemid 26013229)
87. Taylor LJ, Bagg J, Walker DM, et al. Increased production of tumour necrosis factor by peripheral blood leukocytes in patients with recurrent oral aphthous ulceration. J Oral Pathol Med 1992;21:21-5
88. Sapadin AN, Fleischmajer R. Tetracyclines: nonantibiotic properties and their clinical implications. J Am Acad Dermatol 2006;54:258-65 (Pubitemid 43144395) (Pubitemid 43144395)
89. Kang S. The mechanism of action of topical retinoids. Cutis 2005;75:10-13; discussion 13 (Pubitemid 40326995) (Pubitemid 40326995)
90. Saijo T, Kuriki H, Ashida Y, et al. Mechanism of the action of amoxanox (AA-673), an orally active antiallergic agent. Int Arch Allergy Appl Immunol 1985;78:43-50 (Pubitemid 16255573) (Pubitemid 16255573)
91. Araki K, Youngblood B, Ahmed R. The role of mTOR in memory CA8 T-cell differentiation. Immunol Rev 2010;234(1):234-48
92. Becker JC, Houben R, Vetter CS, et al. The carcinogenic potential of tacrolimus ointment beyond immune suppression: a hypothesis creating case report. BMC Cancer 2006;6:7
93. Mattsson U, Magnusson B, Jontell M. Squamous cell carcinoma in a patient with oral lichen planus treated with topical application of tacrolimus. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2010;110:e19-25