[Question #7902] Tacrolimus
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50 months ago
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Hello,
I asked a question on here 2 weeks ago, but never got a reply to my second question. This question is actually relevant to the white patch I mentioned in that post. I biopsied it and was diagnosed with Lichen Sclerosus on my penis. The doctor prescribed a steroid as well as a immunosuppressant called Tacrolimus. I’ve read that immunosuppressants can cause a reactivition of HPV ( Had warts treated 7 months ago) It’s a topical cream I’m supposed to apply on my penis (under my foreskin) where the inflammation is. Should I apply this cream “Tacrolimus” given my history of HPV? Since I had warts within the last year is it certain or likely this cream would cause a reactivation of warts and/or advance any subclinical HPV into cancer? I’m very worried as Lichen Sclerosus HAS to be treated or it gets worse, but I also don’t want to worsen my HPV and reduce the likelihood of eradicating it. Thank you.
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Edward W. Hook M.D.
50 months ago
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My apologies for missing the opportunity to reply to your follow-up question. Hopefully we can clarify things now. It is a good thing that you saw a dermatologist. The diagnosis of lichen sclerosis is a more important diagnosis to make and not miss than a diagnosis of a widespread , innocuous infection such as HPV. There are no studies to inform us as to whether HPV is more likely to reactivate using tacrolimus and/or topical steroid therapy than if you were not using it. You certainly should treat your lichen sclerosis. Both drugs act to decrease inflammation through their affects on the immune system. Given that it is been nearly a year since resolution of your words, I would hazard a guess that the likelihood of recurrent HPV is relatively low. Irrespective, as you move forward with your therapy for lichen sclerosis, you should continue to be followed by your dermatologist.
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Sorry I cannot provide more information. You may want to discuss this with your dermatologist. Given that tacrolimus Is a relatively new therapy for like in sclerosis and data related to your situation is limited, the best course is to move forward with treatment and continue follow up. I hope this perspective helps. EWH