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Alternative Therapies with Tacrolimus and Low-Dose Doxycycline for Oral Chronic Graft-versus-Host Disease That Is Resistant to Topical Corticosteroid Medication: Case Report
J Oral Med Pain 2018;43:16-20
Published online March 30, 2018
© 2018 Korean Academy of Orofacial Pain and Oral Medicine

Hye-Min Ju1,2, Yong-Woo Ahn2,3, Soo-Min Ok2,3, Sung-Hee Jeong2,3

1Department of Oral Medicine, Pusan National University Dental Hospital, Yangsan, Korea
2Dental Research Institute, Pusan National University Dental Hospital, Yangsan, Korea
3Department of Oral Medicine, School of Dentistry, Pusan National University, Yangsan, Korea
Correspondence to: Sung-Hee Jeong
Department of Oral Medicine, School of Dentistry, Pusan National University, 49 Busandaehak-ro, Mulgeum-eup, Yangsan 50612, Korea
Tel: +82-55-360-5242
Fax: +82-55-360-5238
E-mail: drcookie@pusan.ac.kr
Received February 6, 2018; Revised February 27, 2018; Accepted March 2, 2018.
This is an open-access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
Abstract
Graft-versus-host disease (GVHD) is frequent complications of hematopoietic stem cell transplantation. In the chronic GVHD (cGVHD), the oral cavity is the most commonly affected region. The clinical manifestations include erythema, ulceration, lichenoid-hyperkeratotic change in oral mucosa, dry mouth, and limitation of mouth opening. The initial treatment strategy of oral cGVHD patients is topical corticosteroid therapy in various formulation. However, corticosteroid resistance appears in some patients. We report a case of a 25-year-old male patient with oral cGVHD, who has resistance to topical corticosteroid medication, treated with 0.03% tacrolimus ointment and low-dose doxycycline. The patient showed subjective and objective improvement without side effect.
Keywords : Low-dose doxycycline; Oral chronic graft-versus-host disease; Resistance to steroid; Tacrolimus


June 2018, 43 (2)