Publication

Oral, esophageal and cutaneous lichen ruber planus controlled with alitretinoin: case report and review of the literature

Journal Paper/Review - Aug 15, 2013

Units
PubMed
Doi

Citation
Kolios A, Marques Maggio E, Gubler C, Cozzio A, Dummer R, French L, Navarini A. Oral, esophageal and cutaneous lichen ruber planus controlled with alitretinoin: case report and review of the literature. Dermatology (Basel) 2013; 226:302-10.
Type
Journal Paper/Review (English)
Journal
Dermatology (Basel) 2013; 226
Publication Date
Aug 15, 2013
Issn Electronic
1421-9832
Pages
302-10
Brief description/objective

BACKGROUND
Therapy-resistant lichen planus (LP) can be a challenging condition for dermatologists. There are some case reports about successful treatments with alitretinoin of cutaneous and oral, but not of esophageal LP.

OBJECTIVE
We present the unique case of a patient with cutaneous, oral and esophageal LP which was refractory to classical treatment options (topical clobetasol propionate and pimecrolimus, intramuscular triamcinolone acetonide); because of systemic side effects the patient did not tolerate systemic acitretin dosed up to 25 mg daily.

METHODS
Oral alitretinoin was used at a dose of 30 mg daily.

RESULTS
Both oral and skin changes as well as dysphagia completely resolved within 4 weeks without any severe side effects and the drug was used for 6 months. No papules, intraoral striae or dysphagia recurred during the 6 months of treatment. After 4 months the patient relapsed with mucosal patches so that a second cycle was initiated for 6 months where oral LP lesions resolved after 4 weeks also (with sporadic mild headache).

CONCLUSION
Further studies are needed to better understand the impact of alitretinoin in LP. Our observation suggests alitretinoin as a new, well-tolerated treatment option for esophageal LP after failed response to conventional treatments.