Treatment of cutaneous lichen planus: an evidence based analysis of efficacy by the Italian Group for Cutaneous Immunopathology
Antiga, E.; Caproni, M.; Parodi, A.; Cianchini, G.; Fabbri, P.
Giornale Italiano di Dermatologia e Venereologia Organo Ufficiale Societa Italiana di Dermatologia e Sifilografia 149(6): 719-726
2014
ISSN/ISBN: 0392-0488 PMID: 25664824 Document Number: 677247
Cutaneous lichen planus (LP) is an inflammatory papulo-squamous disorder presenting with violaceous, polygonal, flat-topped papules and plaques on the skin that shows a chronic-relapsing course. However, in most cases, the disease spontaneously regresses 1 month to 7 years after onset; for this reason, it is very difficult to evaluate the effectiveness of the therapeutic strategies for cutaneous LP. This study reviewed the more recent status of systemic therapies for cutaneous LP. No level A trials on the medical or physical treatment of cutaneous LP were found in the literature. Moreover, only three trials were found with acceptable methods including more than 20 patients (one on the use of acitretin, one on the use of phototherapy and the other one on the use of sulfasalazine, respectively). Among the new drugs, although few evidences could be provided, alitretinoin may represent a novel effective and well-tolerated treatment option for refractory cutaneous LP. By contrast, no trials were found about the treatment of specific LP variants (including inverse, hypertrophic or ulcerative LP), but only treatment reports of single cases. Finally, basing on the careful revision of the whole Literature and on the personal experience of the Authors, the therapeutic recommendations for cutaneous LP proposed by the Italian Group for Cutaneous Immunopathology were reported.