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Treatment of lichen sclerosus with antibiotics

Walter B. Shelley MD, PhD

From the Division of Dermatology, Department of Medicine, Medical University of Ohio, Ohio, OH

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E. Dorinda Shelley MD

From the Division of Dermatology, Department of Medicine, Medical University of Ohio, Ohio, OH

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Cristine V. Amurao MD

From the Division of Dermatology, Department of Medicine, Medical University of Ohio, Ohio, OH

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First published: 31 August 2006
Cited by: 13
Walter B. Shelley, MD, PhD Medical University of Ohio Division of Dermatology Ruppert Health Center 3120 Glendale Avenue Toledo Ohio 43614‐5809 USA E‐mail: stovar@meduohio.edu

Abstract

Current therapy for lichen sclerosus centers on topical steroids, particularly clobetasol propionate. As some evidence suggests an infectious etiology owing to Borrelia, we studied the effect of penicillin and cephalosporin therapy on patients with lichen sclerosus who had responded poorly to treatment with potent topical corticosteroids.

Fifteen patients with lichen sclerosus were treated for 3–21 months with either penicillin or cephalosporins in an observational study. Thirteen patients (nine women, four men) received penicillin, including intramuscular penicillin G benzathine suspension and/or oral penicillin V potassium, amoxicillin, or amoxicillin/clavulanate potassium. Two additional men received cephalosporins, either intramuscular ceftriaxone sodium or oral cefadroxil monohydrate.

All patients showed a significant response, evident within a few weeks. Most striking was the rapid relief of pain, pruritus and burning. Four patients cleared completely, four experienced marked improvement, and the remaining seven had a favorable improvement of symptoms with incomplete clearing of lesions.

We recommend treatment of lichen sclerosus with either intramuscular ceftriaxone every 3 weeks or intramuscular penicillin every 2–3 weeks. The addition of oral penicillin or cephalosporin presumably helps maintain antibiotic blood levels and may be a sufficient treatment in some cases.

Number of times cited: 13

  • , Liquen escleroso genital, Piel, 10.1016/j.piel.2017.05.025, (2017).
  • , Annular Lichenoid Dermatitis (of Youth) Immunohistochemical and Serological Evidence for Another Clinical Presentation of Borrelia Infection in Patients of Western Austria, The American Journal of Dermatopathology, 10.1097/DAD.0000000000000621, 39, 3, (177-180), (2017).
  • , Extensive anogenital lichen sclerosus with vaginal stenosis: A case report, Journal of Dermatology & Dermatologic Surgery, 19, 2, (140), (2015).
  • , Evidence‐based (S3) Guideline on (anogenital) Lichen sclerosus, Journal of the European Academy of Dermatology and Venereology, 29, 10, (e1-e43), (2015).
  • , A case of oral lichen sclerosus with gingival involvement and orrelia identification, Histopathology, 65, 1, (146-148), (2014).
  • , EMAS clinical guide: Vulvar lichen sclerosus in peri and postmenopausal women, Maturitas, 74, 3, (279), (2013).
  • , Cutaneous and systemic Lyme disease, Expert Review of Dermatology, 8, 1, (65), (2013).
  • , Presence of Borrelia burgdorferi“Sensu Lato” in patients with morphea from the Amazonic region in Brazil, International Journal of Dermatology, 50, 11, (1373-1378), (2011).
  • , Extragenital lichen sclerosus with aetiological link to Borrelia, Medical Journal Armed Forces India, 67, 4, (370), (2011).
  • , Borrelia in granuloma annulare, morphea and lichen sclerosus: a PCR‐based study and review of the literature, Journal of Cutaneous Pathology, 37, 5, (571-577), (2009).
  • , Plantar involvement in lichen sclerosus, International Journal of Dermatology, 48, 6, (662-663), (2009).
  • , Lichen sclerosus of the oral mucosa: clinicopathological features of six cases, International Journal of Oral and Maxillofacial Surgery, 38, 8, (855), (2009).
  • , Review of squamous premalignant vulvar lesions, Critical Reviews in Oncology/Hematology, 10.1016/j.critrevonc.2008.02.012, 68, 2, (131-156), (2008).