Efficacy of Oral Low-Dose Tretinoin (all-<i>tran</i><i>s</i>-Retinoic Acid) in Lichen planus

Abstract

Background: Retinoids were shown to be effective in the treatment of both oral and cutaneous forms of lichen planus. Objective: Confirm the beneficial effect of low doses of oral tretinoin in lichen planus. Methods: Eighteen patients with lichen planus were treated in an open study for up to 19 months. Efficacy and safety data were recorded. Results: Complete remission was observed in 13 (72%) and marked improvement in 4 (22%) out of 18 patients. Six patients showed moderate and 12 had no side effects. Conclusion: Tretinoin is a valuable drug when given at low doses to patients with lichen planus who failed to respond to other therapies.

Update on primary cicatricial alopecias

“…Short, tapered courses of prednisone can often effectively gain control over intractable disease (1 mg/kg or 30-40mg daily for 2-4 months) 2,6,101 and can be used as bridge therapy when use of retinoids or antimalarials is considered. 2 The assertion that acitretin should be considered first-line therapy for cutaneous LP owing to an extensive, evidence-based analysis of various therapeutic modalities, 142 and the observance of marked improvement in 2 patients with scalp lichen planopilaris who underwent treatment with lowdose oral tretinoin (10 mg daily for 1-10.5 months), 143 suggests that trial of a low-dose oral retinoid should be considered initially in the appropriate patient. Antimalarials have also been recommended 2,7,9,144 (200 mg twice daily 2 ) as firstline treatment, but may only provide symptomatic relief.…”

Commentary: Treatment of lichen planopilaris

“…Systemic retinoids (oral tretinoin, isotretinoin, and acitretin) have only showed promise in small case series. 10,11,20 Eight patients treated with etretinate for 6 months had no improvement in their LPP, and all experienced an iatrogenic telogen effluvium. 5 Griseofulvin was effective for symptomatic relief in two case series, 3,21 but did not seem to halt progression of alopecia.…”

CO2 laser evaporation of oral lichen planus

“…Traditional treatment consists of various drugs, including antifungal ointments, retinoids 22,2 , and local and systemic corticosteroids; for example, fluocinonide 18,6,20,3,30,27,1,5 , cyclosporine 13,31,10,26 , mouth psoralen + UVA radiation treatment 16 , tacrolimus 14,21,24 , pimecrolimus 7 , oral metronidazole 4 , interferon-a cream 23 , hydroxychloroquine 8 , heparin 12 and fenretinide 28 . Surgery and cryosurgery are seldom performed.The use of laser treatment in the oral cavity has gained acceptance, including treatment of oral premalignant lesions, for example leukoplakia 11 .…”