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