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Individualizing treatment and choice of medication in lichen planus: a step by step approach
Author(s) -
Manousaridis Ioannis,
Manousaridis Kleanthis,
Peitsch Wiebke Katharina,
Schneider Stefan Werner
Publication year - 2013
Publication title -
jddg: journal der deutschen dermatologischen gesellschaft
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.463
H-Index - 60
eISSN - 1610-0387
pISSN - 1610-0379
DOI - 10.1111/ddg.12141
Subject(s) - medicine , azathioprine , dermatology , acitretin , methotrexate , modalities , therapeutic modalities , hydroxychloroquine , treatment modality , dapsone , disease , surgery , psoriasis , social science , covid-19 , sociology , infectious disease (medical specialty)
Summary Although lichen planus is one of the most common dermatological entities, very few reviews on its management exist in the literature. Standard therapeutic approaches include various topical treatments (including topical corticosteroids, calcineurin inhibitors, vitamin D analogs) and phototherapy modalities, as well as systemic corticosteroids and systemic retinoids. While localized skin lesions are easily managed with standard modalities, generalized forms and in particular involvement of hair follicles, nails and mucosa, as well as eyes are often challenging. This review proposes an evidence‐based and differential therapeutic regime, taking into account many new emerging systemic therapies to help clinicians optimize treatment according to the type, extent and severity of the disease. An individual therapeutic ladder has been developed for each location, starting with standard modalities and ranking alternative systemic treatments (mainly methotrexate and hydroxychloroquine, as well as cyclosporine, azathioprine and mycophenolate mofetil) according to efficacy, evidence level and side‐effect profile.