Conflict of interest None.
Individualizing treatment and choice of medication in lichen planus: a step by step approach
Article first published online: 26 AUG 2013
© The Authors | Journal compilation © Blackwell Verlag GmbH, Berlin
JDDG: Journal der Deutschen Dermatologischen Gesellschaft
Volume 11, Issue 10, pages 981–991, October 2013
How to Cite
Manousaridis, I., Manousaridis, K., Peitsch, W. K. and Schneider, S. W. (2013), Individualizing treatment and choice of medication in lichen planus: a step by step approach. JDDG: Journal der Deutschen Dermatologischen Gesellschaft, 11: 981–991. doi: 10.1111/ddg.12141
- Issue published online: 25 SEP 2013
- Article first published online: 26 AUG 2013
- Manuscript Accepted: 25 APR 2013
- Manuscript Received: 8 FEB 2013
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.