Lichen Planus Pigmentosus Treatment Options

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Tips

  1. Sunscreen usage is highly encouraged alongside other treatments of lichen planus pigmentosus.
  2. Combination therapies (e.g., topical + systemic) may be more effective than monotherapies.
  3. Treatment duration often ranges from 3-6 months, with some extending up to a year.
  4. Regular follow-ups are important to assess treatment efficacy and adjust as needed.
  5. Some cases may show spontaneous improvement, so watchful waiting could be considered in mild cases.
  6. Patient education on the chronic nature of the condition and the importance of sun protection is crucial.

Topical treatments for Lichen Planus Pigmentosus

  • Tacrolimus 0.03% ointment applied twice daily for 6-12 weeks
  • Tacrolimus 0.1% ointment applied twice daily (duration not specified)
  • Mometasone furoate 0.1% cream (duration not specified)
  • Clobetasol cream once daily for 15 days
  • Betamethasone valerate 0.05% cream once daily for 4 months
  • Azelaic acid 5% foam applied to face each morning
  • Tretinoin 0.1% cream applied to face and arms each evening
  • Hydroquinone 2% (duration not specified)

Oral treatments for Lichen Planus Pigmentosus

  • Tranexamic acid 250mg daily for 4-6 months
  • Isotretinoin 20 mg/day for 6 months
  • Dexamethasone 2.5 mg twice weekly (oral mini-pulse therapy)
  • Prednisolone 40 mg (duration not specified)
  • Colchicine 1 mg/day for 3 months, then tapered for 6 months
  • Dapsone 100mg once daily
  • Acitretin 25 mg daily

Combination treatments

  • Topical mometasone furoate 0.1% cream and tacrolimus 0.1% ointment
  • Oral isotretinoin (20mg/day) with topical mometasone and tacrolimus
  • Topical tacrolimus 0.1% with oral hydroxychloroquine 200 mg twice daily

Laser treatments

  • Q-switched Nd:YAG laser (1064 nm, 3-4.6 J/cm², 5 mm spot size, 5-Hz frequency) every 4-8 weeks for 5-6 sessions
  • Picosecond Nd:YAG laser (1064 nm, various settings) for 3 treatment sessions

Other treatments

  • Narrow band ultraviolet B phototherapy 2x/week starting at 50 mJ/cm²
  • Chemical peels (Jessner’s for arms, glycolic acid for face) every 2 weeks

References

  • Updates In Therapeutics for Lichen Planus Pigmentosus[link]


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