Topical tacrolimus treatment is used for cutaneous diseases including atopic dermatitis and pyoderma gangrenosum but requires additives such as propylene carbonate to adequately absorb into the stratum corneum. This regimen should be performed twice daily. Patients were instructed to swish the oral solution for 2 minutes before spitting the solution for disposal. The treatment regimen involved dissolving the contents of a 1-mg tacrolimus capsule into 500 mL of water. Exclusion criteria included patients with other oral conditions (including herpes simplex virus infections and oral lichen planus), taking systemic steroids or immunomodulators, with fewer than 2 visits available for review, or who did not use the oral tacrolimus swish-and-spit regimen. Race/ethnicity data were collected to characterize the study population. Demographics collected included age, sex, and race. The primary outcome measure was attending physician–documented clinical improvement. Patients presented with classic patches of depapillation and raised serpiginous borders as well as no extralingual inflammation to the Wake Forest Dermatology Clinic in Winston-Salem, North Carolina, between January 1, 2008, and January 1, 2018. Inclusion criteria included patients 18 years or older diagnosed with geographic tongue. This retrospective medical record review was approved by the Wake Forest Baptist Health institutional review board, Winston-Salem, North Carolina.
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