Low‐dose oral isotretinoin therapy in lichen planus pigmentosus: an open‐label non‐randomized prospective pilot study

Kumaran, Muthu Sendhil; Narang, Tarun; Saikia, Uma Nahar; Kanwar, Amrinder J.; Parsad, Davinder; Dogra, Sunil

doi:10.1111/ijd.13293

Cited by 56 publications

(86 citation statements)

References 24 publications

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“…Although ashy dermatosis and LPP are currently considered distinct entities with specific differences in epidemiology, pathogenesis, clinical presentation, histopathological findings, prognosis, and response to treatment, overlap between these two conditions is frequently observed. Therefore, some authors consider them part of the same nosological spectrum of a unique entity, while others argue that they are different diseases .…”

Section: Current Nosological Status Of Ashy Dermatosis and Lichen Plamentioning

confidence: 99%

“…In the majority of patients, it presents between the 3rd and 5th decades of life, but it has been found in individuals 13–67 years of age. It is more common in females, except for one study from the Middle East where it was observed more frequently in men with hepatitis C virus …”

Section: Epidemiologymentioning

confidence: 99%

“…LPP causes emotional stress due to its aesthetic appearance and chronic nature. Moreover, it may be associated with other disorders such as hepatitis C virus‐induced liver disease, endocrinopathies, and autoimmune diseases as well as other variants of LP and its sequelae …”

Section: Introductionmentioning

confidence: 99%

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Lichen planus pigmentosus and its variants: review and update

Robles-Méndez¹,

Rizo-Frías²,

et al. 2017

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Lichen planus pigmentosus (LPP) is considered a rare variant of lichen planus (LP). It is characterized by acquired dark brown to gray macular pigmentation located on sun-exposed areas of the face, neck, and flexures, commonly found in dark-skinned patients. In patients with LPP, an inflammatory lichenoid response results in marked pigmentary incontinence. It has been associated with hepatitis C virus, sun exposure, and contactants such as mustard oil and nickel. LPP-inversus affects fair and dark skin, predominantly involving flexural and intertriginous areas, while sun-exposed areas are spared; friction is an associated trigger. LPP along Blaschko's lines has been associated with susceptibility to genetic mosaicisms. LPP can present concomitantly with other variants of LP such as frontal fibrosing alopecia, as well as endocrinopathies, and autoimmune diseases. Treatment is difficult and consists of avoidance of triggers and topical and systemic medications in order to stop the inflammatory reaction and reduce pigmentation, improving aesthetic appearance and quality of life.

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Section: Current Nosological Status Of Ashy Dermatosis and Lichen Plamentioning

confidence: 99%

Section: Epidemiologymentioning

confidence: 99%

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Lichen planus pigmentosus and its variants: review and update

Robles-Méndez¹,

Rizo-Frías²,

et al. 2017

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“…Management of LPP is challenging and existing therapeutic modalities are showing only a limited value (Muthu et al, ). The pigment and pigment laden macrophages are seen in the papillary dermis in the patients of LPP.…”

Section: Discussionmentioning

confidence: 99%

Effect of Q‐switched Nd‐YAG laser on the clinical, pigmentary, and immunological markers in patients with lichen planus pigmentosus: A pilot study

Bhari

Sharma

Singh

et al. 2020

Dermatologic Therapy

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The persistent discoloration in lichen planus pigmentosus (LPP) is secondary to persistent melanophages in the superficial dermis in these patients. We evaluated the effect of Q‐switched Nd‐YAG laser on the clinical, pigmentary, and immunological markers in patients with LPP. Nine females with a clinical diagnosis of LPP were included in the study. After six sessions of laser with toning protocol, performed over a representative area of 5 × 5 cm2 at 2‐weekly intervals, the mean clinical improvement as per the physician assessment was 25.7% (10–40%). There was no significant reduction in melanin and erythema index. On expression analysis using quantitative‐polymerase chain reaction, the reduction in tyrosinase (p = 0.03) was statistically significant, though, the reduction in other pigment and immunological markers was not significant. The immunohistochemistry quantification data of corresponding proteins also did not show any significant difference. Post inflammatory hypopigmentation was noted in one patient. Q‐switched Nd‐YAG laser toning protocol resulted in modest clinical and histological improvement in patients of LPP.

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“…Low-fluence QS Nd:YAG lasers have also been reported to be efficacious with and without tacrolimus [107,108]. Oral treatment using lowdose oral isotretinoin has also been reported to be efficacious [109].…”

Section: Treatmentsmentioning

confidence: 99%

Facial Hyperpigmentation in Skin of Color: Special Considerations and Treatment

et al. 2016

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Differences in cutaneous diseases in people of color call for nuanced evaluation and management. One of the most common dermatological complaints from patients with skin of color is dyspigmentation, particularly hyperpigmentation. The challenge for clinicians is to establish correct diagnoses along with consistently successful treatments to meet the needs of the increasingly diverse population served. This review focuses on facial hyperpigmentation and outlines the most common skin disorders and treatment options.

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Low‐dose oral isotretinoin therapy in lichen planus pigmentosus: an open‐label non‐randomized prospective pilot study

Abstract: Low-dose isotretinoin seems to be a promising treatment modality in stabilizing and decreasing the pigmentation in LPP particularly in early and limited disease.

Cited by 56 publications

References 24 publications

Lichen planus pigmentosus and its variants: review and update

Lichen planus pigmentosus and its variants: review and update

Effect of Q‐switched Nd‐YAG laser on the clinical, pigmentary, and immunological markers in patients with lichen planus pigmentosus: A pilot study

Facial Hyperpigmentation in Skin of Color: Special Considerations and Treatment

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