Imiquimod 5% cream for isolated lichen planus of the lip

Abstract

Lichen planus (LP) of the lips is a rare condition that is generally associated with other parts of the oral mucosa. Lip localization has an increased risk, since external trauma, smoking and ultraviolet light trigger malignant transformation. Only a few cases of isolated LP of the lips have been reported up to now, but results of larger series on oral LP suggest that it might be underestimated. Treatment of oral LP is usually difficult and lesions are generally resistant or recur, so that novel therapy alternatives are necessary. Here we report four cases of isolated LP of the lip successfully treated with imiquimod 5% cream. It was applied twice daily, 5 days a week, for 2 weeks. Two weeks after therapy, complete clinical and histopathological resolution was observed. No recurrence was observed during the 5, 10 and 18 months' follow-up period in cases 4, 3 and 1, respectively. Clinical and histopathological cure was also observed in case 2, but the patient showed clinical activation after 6 months. We suggest that imiquimod 5% cream is a safe and effective therapeutic treatment for oral LP.

Isolated lichen planus of lip: Diagnosis and treatment monitoring using dermoscopy

“…LP of lip should be differentiated from other forms of cheilitis like exfoliative cheilitis, lichen simplex chronicus, actinic cheilitis, discoid lupus erythematosus, pemphigus vulgaris, and herpes simplex . Since malignant transformation can occur, prompt treatment is necessary …”

“…To our knowledge, there is a single case report of dermoscopy of LP of the lower lip in the Korean language . In view of the risk of malignant transformation, early diagnosis and active early treatment are necessary . Only, a few studies have described isolated LP of the lips until now .…”

“…3 In view of the risk of malignant transformation, early diagnosis and active early treatment are necessary. 4 Only, a few studies have described isolated LP of the lips until now. 4 We report this case describing dermoscopy of oral LP localized to the lower lip because this method may allow early diagnosis, monitoring of treatment, and may also result in increased patient compliance.…”

Urban legends series: lichen planus

“…Topical therapies Several new topical drugs have been recently tested for OLP treatment including thalidomide (Wu et al , 2010), imiquimod (Gencoglan et al , 2011), hyaluronic acid (Nolan et al , 2009), sirolimus (rapamycin) (Soria et al , 2009), intralesional BCG‐PSN (Xiong et al , 2009), and pimecrolimus (McCaughey et al , 2011; Passeron et al , 2007; Swift et al , 2005; Volz et al , 2008). All but sirolimus, imiquimod, and intralesional BCG‐PSN have been tested in placebo‐controlled RCTs showing some benefits, but only pimecrolimus was tested in more than one study (Table 7).…”

Lichen Planus Affecting the Lips

“…A Pubmed search using the keywords "lichen planus lip", "lichen planus lips", or "lichen planus labial", leads us almost entirely into articles only briefly citing this particular presentation of LP, besides a few single case reports [3][4][5][6][7][8][9][10]. There is only one series reporting on ten patients [11].…”