Interventions for erosive lichen planus affecting mucosal sites

Cheng, Suzanne; Kirtschig, Gudula; Cooper, Susan M.; Thornhill, Martin H.; Leonardi‐Bee, Jo; Murphy, Ruth

doi:10.1002/14651858.cd008092.pub2

Cited by 95 publications

(75 citation statements)

References 79 publications

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“…Thus, systemic therapies, such as oral retinoids and cyclosporine, are scarce, of questionable efficacy, and with significant adverse events [14,15,16,17,18]. As for the local therapies available, there is not strong evidence for the effectiveness of any single treatment, including topical corticosteroids, which are currently the first-line accepted therapy for OELP [1]. …”

Section: Discussionmentioning

confidence: 99%

“…Although in many cases the disease is asymptomatic, some patients develop erosive and very painful lesions that can be difficult to treat, reducing their quality of life. Topical corticosteroids are the most widely accepted treatment [1], and systemic administration should be reserved for acute exacerbations of the disease [2]. However, a significant number of patients, especially those with extensive involvement, respond poorly to treatment and even develop fungal superinfections due to repeated/prolonged administration [3].…”

Section: Introductionmentioning

confidence: 99%

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Antimalarial Drugs for the Treatment of Oral Erosive Lichen Planus

Rivas-Tolosa

Requena

Llombart³

et al. 2015

Dermatology

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Background: Treatment of oral erosive lichen planus is considered a therapeutic challenge. Various systemic and topical agents aimed at controlling the symptoms, rather than curing the lesions, have been used with varying results. Objective: To evaluate the response to treatment with antimalarial drugs in patients with oral erosive lichen planus. Methods: Eight patients diagnosed with oral erosive lichen planus were treated with antimalarial agents. The first clinical evaluation was made after a month of treatment and then every 2-3 months. Baseline ophthalmologic examinations were performed, and laboratory values were monitored before and during treatment. Results: All studied patients who had previously been resistant to other treatments responded favorably. Pain relief and reduced erythema and erosions were observed after of a mean of 2.4 months. Conclusion: Antimalarials may be useful for the treatment of oral erosive lichen planus. They are easily administered and affordable, with few adverse effects.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Antimalarial Drugs for the Treatment of Oral Erosive Lichen Planus

Rivas-Tolosa

Requena

Llombart³

et al. 2015

Dermatology

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“…Up to date 10 cases have been described [27,28,29,30,31,32,33,34,35]. Erosive LP is a painful variant of LP with eroded or ulcerated lesions mainly in mucocutaneous sites which is often difficult to treat and may lead to scarring [36,37,38]. Lichen planus pemphigoides refers to a cross-over syndrome of LP and bullous pemphigoid [5] and associations with drug intake have been described (PUVA [39], UVB, paracetamol or ibuprofen [40], simvastatin [41] and ramipril [42,43]).…”

Section: Discussionmentioning

confidence: 99%

“…TNF-α inhibitors like etanercept [129,130] and adalimumab [4,131] can ameliorate but paradoxically also elicit LP. Meta-analyses show very weak evidence of effectiveness of any treatment of oral and erosive LP [37,132,133]. …”

Section: Discussionmentioning

confidence: 99%

Oral, Esophageal and Cutaneous Lichen Ruber Planus Controlled with Alitretinoin: Case Report and Review of the Literature

Kolios¹,

Maggio²,

Gubler

et al. 2013

Dermatology

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Background: Therapy-resistant lichen planus (LP) can be a challenging condition for dermatologists. There are some case reports about successful treatments with alitretinoin of cutaneous and oral, but not of esophageal LP. Objective: We present the unique case of a patient with cutaneous, oral and esophageal LP which was refractory to classical treatment options (topical clobetasol propionate and pimecrolimus, intramuscular triamcinolone acetonide); because of systemic side effects the patient did not tolerate systemic acitretin dosed up to 25 mg daily. Methods: Oral alitretinoin was used at a dose of 30 mg daily. Results: Both oral and skin changes as well as dysphagia completely resolved within 4 weeks without any severe side effects and the drug was used for 6 months. No papules, intraoral striae or dysphagia recurred during the 6 months of treatment. After 4 months the patient relapsed with mucosal patches so that a second cycle was initiated for 6 months where oral LP lesions resolved after 4 weeks also (with sporadic mild headache). Conclusion: Further studies are needed to better understand the impact of alitretinoin in LP. Our observation suggests alitretinoin as a new, well-tolerated treatment option for esophageal LP after failed response to conventional treatments.

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“…There is no evidence from randomized controlled trials (RCTs) on which to base clinical practice [3]. The existing literature consists of a number of retrospective case series with only 1 prospective cohort study [4].…”

Section: To the Editormentioning

confidence: 99%