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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

  • Ju, Hye-Min (Department of Oral Medicine, Pusan National University Dental Hospital) ;
  • Ahn, Yong-Woo (Dental Research Institute, Pusan National University Dental Hospital) ;
  • Ok, Soo-Min (Dental Research Institute, Pusan National University Dental Hospital) ;
  • Jeong, Sung-Hee (Dental Research Institute, Pusan National University Dental Hospital)
  • Received : 2018.02.06
  • Accepted : 2018.03.02
  • Published : 2018.03.30

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

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