PRESCRIPTION PATTERNS AND TREATMENT OUTCOMES IN LICHEN PLANUS
Main Article Content
Keywords
Lichen Planus, Corticosteroids, Calcineurin inhibitors, Systemic therapy, Treatment outcomes, Prescription patterns, LPASI, DLQI
Abstract
Lichen Planus is a chronic inflammatory dermatosis affecting the skin and mucous membranes, with variable clinical presentations and therapeutic responses. Despite multiple treatment options, standardized outcome data remain limited.
Methods: Eighty-four patients with clinically confirmed Lichen Planus were enrolled and followed for 12 months. Treatment modalities, including topical corticosteroids, calcineurin inhibitors, systemic agents, and combination therapies, were documented. Disease severity was assessed using the Lichen Planus Area and Severity Index (LPASI), and quality of life was measured using the Dermatology Life Quality Index (DLQI). Statistical analysis included paired t-tests and logistic regression to identify predictors of treatment response.
Results: Topical corticosteroids were prescribed in 78.5% of cases, followed by systemic therapy (26.1%) and calcineurin inhibitors (19%). At 12 weeks, 41.6% of patients achieved complete resolution, 38% showed partial improvement, and 20.4% had minimal or no response. LPASI and DLQI scores improved significantly (p < 0.001). Systemic corticosteroids were associated with higher response rates, especially in hypertrophic and genital variants.
Conclusion: Topical corticosteroids remain the mainstay of treatment for Lichen Planus, while systemic agents offer enhanced outcomes in extensive disease. Combining objective and patient-reported measures provides a robust framework for evaluating therapeutic efficacy. Further multicenter studies are needed to establish standardized treatment protocols.
References
2. Wu T, Bai Y, Jing Y, Chen F. What can we learn from treatments of oral lichen planus? Front Cell Infect Microbiol. 2024; 14:1279220.
3. Nikhil B, Pavithra B, Lohita M. Clinico-epidemiological study of lichen planus. Res J Med Sci. 2024;18(6):147–151.
4. Hussain S, Mohammed D. Comprehensive systematic review of oral lichen planus (2004–2024). Int J Pharm Biomed Sci. 2024;4(12):665.
5. Abduelmula A, Yeung J. The use of Janus Kinase inhibitors for lichen planus: An evidence-based review. J Cutan Med Surg. 2023;27(3):271–276.
6. Gorouhi F, Davari P. Emerging role of apremilast in the treatment of lichen planus. SciQst Rev. 2023;12(2):45–56.
7. Mayo Clinic Research. Clinical trials in lichen planus: phosphate cream and baricitinib. Mayo Clin Trials. 2023.
8. Jawanda MK, Gupta S. Effectiveness and tolerability of systemic therapies in oral lichen planus. JAAD Int. 2024;3(2):85–92.
9. ICH-GCP Registry. Adjunctive systemic Vitamin E in oral lichen planus patients: randomized controlled trial. ICH-GCP Clinical Trials. 2023.
10. Toro J, et al. Cross-sectional evaluation of dermatologist management of lichen planus. J Am Acad Dermatol. 2022;87(4):753–761.
11. Singh R, et al. Prescription trends in mucocutaneous lichen planus: A multicenter Indian study. Indian J Dermatol. 2023;68(2):145–152.
12. Chen Y, et al. Systemic corticosteroids versus calcineurin inhibitors in oral lichen planus: A comparative study. Oral Dis. 2022;28(7):1892–1901.
13. Patel P, et al. Quality-of-life outcomes in lichen planus using DLQI: A prospective cohort. Clin Exp Dermatol. 2021;46(9):1650–1657.
14. Sharma A, et al. LPASI validation in Indian patients with cutaneous lichen planus. Dermatol Ther. 2021;34(6): e15123.
15. Bai Y, et al. Long-term outcomes of oral lichen planus: A 3-year follow-up study. J Oral Pathol Med. 2022;51(5):456–463.
16. Wu T, et al. Calcineurin inhibitors in genital lichen planus: A real-world study. J Eur Acad Dermatol Venereol. 2023;37(4):812–819.
17. Hussain S, et al. Retinoids in hypertrophic lichen planus: efficacy and safety. Dermatol Res Pract. 2022; 2022:9856234.
18. Zhang L, et al. Hydroxychloroquine in refractory oral lichen planus: A randomized trial. Oral Surg Oral Med Oral Pathol Oral Radiol. 2023;135(1):45–52.
19. Chen F, et al. Malignant transformation risk in oral lichen planus: Updated meta-analysis. Oral Oncol. 2021; 118:105–112.
20. Wu J, et al. Biologics in lichen planus: Current evidence and future directions. J Dermatolog Treat. 2024;35(3):512–520.
21. Singh P, et al. Phototherapy in cutaneous lichen planus: A systematic review. Photodermatol Photoimmunol Photomed. 2022;38(6):451–460.
22. Kumar A, et al. Adverse effects of systemic therapy in lichen planus: A prospective analysis. Int J Dermatol. 2023;62(8):1012–1019.
23. Bai Y, et al. DLQI as a predictor of treatment escalation in lichen planus. Br J Dermatol. 2022;187(2):234–242.
24. Wu T, et al. Integrated care strategies for chronic inflammatory dermatoses: Lessons from lichen planus. Clin Dermatol. 2024;42(5):567–574.
Article Sidebar
Article Details
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
All articles published in JPTCP are licensed under Copyright Creative Commons Attribution-NonCommercial 4.0 International License.
Dr. V. Ravichandran
Professor & Head of Department, Department of Dermatology, Venereology, and Leprosy (DVL). Swamy Vivekananda Medical College and Research Institute. Thiruchengodu. Namakkal Dt. Tamil Nadu – 637211.