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Low‐dose oral isotretinoin therapy in lichen planus pigmentosus: an open‐label non‐randomized prospective pilot study
Author(s) -
Muthu Sendhil Kumaran,
Narang Tarun,
Saikia Uma N.,
Kanwar Amrinder Jit,
Parsad Davinder,
Dogra Sunil
Publication year - 2016
Publication title -
international journal of dermatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.677
H-Index - 93
eISSN - 1365-4632
pISSN - 0011-9059
DOI - 10.1111/ijd.13293
Subject(s) - medicine , isotretinoin , dermatology , hyperpigmentation , prospective cohort study , acne , open label , randomized controlled trial , surgery
Abstract Background Lichen planus pigmentosus ( LPP ) is a cosmetically distressing pigmentary disorder often posing a therapeutic challenge. Isotretinoin has been shown to be effective in oral and cutaneous LP , but its role in LPP is yet unknown. Objective To evaluate the efficacy and safety of isotretinoin in the management of LPP . Methods In this prospective study, 32 clinically and histologically proven patients with LPP were recruited. Subjects were treated with fixed low‐dose (20 mg/day) oral isotretinoin once daily for 6 months along with topical sunscreens. Response was graded as mild (<25%), moderate (26–50%), and good (>50%) improvement based on decrease in intensity and progression of hyperpigmentation. Results Twenty‐seven patients (17 females and 10 males), aged 20–62 years, completed the study. Twenty‐three (85.2%) patients had active disease and pruritus at presentation. Treatment outcome was moderate improvement in 15 patients (55.7%) followed by good in seven (21.8%) and mild in two (6.2%). Pruritus subsided at the earliest at 9–14 days, and disease stabilized by 4–6 weeks in treatment‐responsive patients. Patients with a shorter duration (≤5 years) of disease and limited body area involvement had a better outcome. Conclusions Low‐dose isotretinoin seems to be a promising treatment modality in stabilizing and decreasing the pigmentation in LPP particularly in early and limited disease.