Phototherapy for pityriasis lichenoides: our experience

Abstract

Pityriasis lichenoides is a benign disease that includes a continuous spectrum with two polar ends: pityriasis lichenoides et varioliformis acuta (PLEVA) and pityriasis lichenoides chronica (PLC). Although its benign and self-limited character, treatment is required, both for itch relief and for cosmetic issues. The present study is a retrospective analysis of 13 patients (11 PLC and 2 PLEVA) treated in our institution with psoralen plus ultraviolet A (PUVA) or ultraviolet A combined with ultraviolet B (UVA/UVB) during the period 1998-2011. In the PUVA group, complete response was achieved in five patients and partial response in two. Total cumulative UVA dose was 84.4 J/cm(2). One patient quit therapy without therapeutic response. In the UVA/UVB group, complete response was achieved in two patients and partial response in an equal number of patients. One patient did not reach a significant improvement. Total cumulative doses were: 26.1 J/cm(2) for UVA and 3.62 J/cm(2) for UVB. There were no acute side effects in either therapeutic group. In the present study, PUVA phototherapy was preferred for patients with more widespread or long-evolving disease, while UVA/UVB was selected for patients who presented more recent disease or contraindications for PUVA therapy. Regardless of the absence of clinical guidelines, both therapeutic options proved to be successful, ascertaining phototherapy as an effective and safe option for pityriasis lichenoides patients.

Treatment of adult diffuse pityriasis lichenoides chronica with narrowband ultraviolet B: experience and literature review

“…In our study, CR was considered to be clearance of at least 90% of the lesions, and relapse as the appearance of new lesions, in agreement with other published studies . Session 20 was selected arbitrarily as the limit for patients with no improvement and no maintenance therapy, as in previous studies …”

“…7 Session 20 was selected arbitrarily as the limit for patients with no improvement and no maintenance therapy, as in previous studies. 3,4,[7][8][9][10] The number of sessions needed to obtain CR in PLC varies between studies. Table 2 shows the cases of adult PLC treated with NB-UVB in the published literature.…”

Pityriasis lichenoides: Long‐term follow‐up study

“…2,[20][21][22][23][24] PUVA has similar efficacy. 22,25 The lower response rates to treatments observed in our study may reflect a refractory cohort typical of a tertiary referral center.…”

“…The efficacy of NBUVB for PL is widely reported, with response rates of approximately 90% . PUVA has similar efficacy …”

A systematic review of treatments for pityriasis lichenoides

“…Macias et al . compared retrospectively in 13 patients with PL (PLEVA and PLC) the clinical response of PUVA phototherapy vs. UVA combined with UVB (UVA/UVB) phototherapy.…”