Basiliximab is a chimeric (of human and murine origins) monoclonal antibody directed to the interleukin 2 receptor and is directly able to prevent T-cell activation. Theoretically, therefore, it should be of benefit in patients affected by T-cell–mediated autoimmune diseases and, in particular, by lichen planus. The outcome of a patient of ours suggests that this may be the case.
A 67-year-old diabetic woman with severe erosive lichen planus of the mouth and vagina (the vaginal orifice was reduced to <1 cm in diameter) had been taking oral cyclosporine for 2 years. The initial dose (5 mg/kg per day) was tapered, but never went below 150 mg/d, lest the lesions might worsen. Whenever a further diminution was tried, the patient became unable to eat and speak. In addition, although there was no sign of renal function impairment, an impressive gum hyperplasia developed. The withdrawal of cyclosporine and the introduction of a new treatment were then decided. Basiliximab (Simulect; Novartis, Milan, Italy) was given as a bolus intravenous infusion (20 mg) on 2 occasions, 4 days apart.
Rebora A, Parodi A, Murialdo G. Basiliximab Is Effective for Erosive Lichen Planus. Arch Dermatol. 2002;138(8):1100-1101. doi:10.1001/archderm.138.8.1098