Methotrexate for the treatment of generalized lichen planus

Turan, Hakan; Başkan, Emel Bülbül; Tunali, Şükran; Yazıcı, Serkan; Sarıcaoğlu, Hayriye

doi:10.1016/j.jaad.2008.09.054

Cited by 39 publications

(26 citation statements)

References 3 publications

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“…As the role of CD4 and CD8 T cells in the pathogenesis of LP is important, it can be assumed that methotrexate should be effective in LP. Methotrexate has been recently tried in cutaneous (Kanwar & De, ; Turan, Baskan, Tunali, Yazici, & Saricaoglu, ), oral (Hazra, Choudhury, Khondker, & Khan, ; Torti, Jorizzo & McCarty, ), erosive vulvovaginal LP (Jang & Fischer, ; Kortekangas‐Savolainen & Kiilholma, ) and LP pemphigoides (Duong, Marks, Sami, & Theos, ) wherein it was found effective. However, evidence for efficacy of methotrexate in OLP is not robust and it has not been compared with the present gold standard, that is topical corticosteroids.…”

Section: Introductionmentioning

confidence: 99%

A prospective observational study to compare efficacy of topical triamcinolone acetonide 0.1% oral paste, oral methotrexate, and a combination of topical triamcinolone acetonide 0.1% and oral methotrexate in moderate to severe oral lichen planus

Chauhan

Handa

et al. 2017

Dermatologic Therapy

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Topical corticosteroids are considered to be the most effective treatment for oral lichen planus (OLP). Methotrexate has been found to be effective in extensive cutaneous lichen planus. The objectives of the study were to evaluate the clinical efficacy and safety of topical triamcinolone 0.1% oral paste, oral methotrexate and a combination of these in symptomatic moderate-to- severe OLP. Forty-five patients were recruited and were allocated to three treatment arms with 15 patients in each treatment arm. They were treated for a period of 16 weeks or until complete clinical remission, whichever was earlier. The parameters assessed were clinical severity score, visual analogue score, and quality of life impairment questionnaire score. Forty-three patients completed the study. All three treatment modalities were effective. The patients in the combination group had significantly better reduction in the outcome parameters assessed compared to the other two groups. Nine patients achieved complete clinical remission, 6 in the combination group and 3 in the topical triamcinolone group. Systemic methotrexate, alone or in combination with topical triamcinolone, is effective in management of moderate to severe OLP.

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Section: Introductionmentioning

confidence: 99%

A prospective observational study to compare efficacy of topical triamcinolone acetonide 0.1% oral paste, oral methotrexate, and a combination of topical triamcinolone acetonide 0.1% and oral methotrexate in moderate to severe oral lichen planus

Chauhan

Handa

et al. 2017

Dermatologic Therapy

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“…Systemic therapies Systemic treatments including systemic steroids (Malhotra et al , 2008) and immunosuppressants (Dalmau et al , 2007; Torti et al , 2007; Turan et al , 2009) have traditionally had a limited role in OLP management given the chronic course of the disease and the need to balance treatment risks and benefits. However, some recalcitrant or widespread cases might require systemic therapy.…”

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confidence: 99%

Urban legends series: lichen planus

et al. 2012

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Oral Diseases (2012) Lichen planus (LP) is a common disorder affecting the oral cavity (OLP) and skin. Despite intensive research, LP/OLP etiology and treatment remain controversial. We investigated four controversial topics: (i) Is hepatitis C virus (HCV) infection associated with LP and involved in its pathogenesis? (ii) Should all patients with LP be screened for HCV? (iii) Should patients with OLP have all their amalgam restorations removed? (iv) Are there any new treatments for OLP? Results from extensive literature searches suggested that: (i) Robust evidence from three meta-analyses indicate that HCV is associated with LP and might be involved in OLP pathogenesis (ii) It would be prudent to screen patients with LP/OLP at significant risk with an ELISA for HCV antibodies using country-specific screening strategies (iii) There is no evidence that either OLP or oral lichenoid lesions patients would routinely benefit from having all their amalgam restorations replaced. Weak evidence from potentially very biased, small, non-randomized, unblinded studies suggests that a small fraction of patients may benefit from targeted amalgam replacement. (iv) There is weak evidence that, among new OLP treatments, topical pimecrolimus, aloe vera, and oral curcuminoids may be useful. The development of specific formulations for oral delivery of topical medications is a promising field.

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“…MTX was administered in a dosage of 15–20 mg once weekly for a mean duration of about 10 weeks. Almost all patients achieved complete remission as early as one month after the initiation of treatment, and only one patient had a recurrence after 2.5 months during the follow‐up period (6 months) . In our experience low‐dose MTX (10 mg subcutaneously once weekly) is as effective as higher dosages (Figure ).…”

Section: Disseminated Skin Lesions and Exanthematous Lichen Planusmentioning

confidence: 54%

Individualizing treatment and choice of medication in lichen planus: a step by step approach

Manousaridis

Peitsch

et al. 2013

J Deutsche Derma Gesell

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SummaryAlthough lichen planus is one of the most common dermatological entities, very few reviews on its management exist in the literature. Standard therapeutic approaches include various topical treatments (including topical corticosteroids, calcineurin inhibitors, vitamin D analogs) and phototherapy modalities, as well as systemic corticosteroids and systemic retinoids. While localized skin lesions are easily managed with standard modalities, generalized forms and in particular involvement of hair follicles, nails and mucosa, as well as eyes are often challenging. This review proposes an evidence-based and differential therapeutic regime, taking into account many new emerging systemic therapies to help clinicians optimize treatment according to the type, extent and severity of the disease. An individual therapeutic ladder has been developed for each location, starting with standard modalities and ranking alternative systemic treatments (mainly methotrexate and hydroxychloroquine, as well as cyclosporine, azathioprine and mycophenolate mofetil) according to efficacy, evidence level and side-effect profile.

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Methotrexate for the treatment of generalized lichen planus

Cited by 39 publications

References 3 publications

A prospective observational study to compare efficacy of topical triamcinolone acetonide 0.1% oral paste, oral methotrexate, and a combination of topical triamcinolone acetonide 0.1% and oral methotrexate in moderate to severe oral lichen planus

A prospective observational study to compare efficacy of topical triamcinolone acetonide 0.1% oral paste, oral methotrexate, and a combination of topical triamcinolone acetonide 0.1% and oral methotrexate in moderate to severe oral lichen planus

Urban legends series: lichen planus

Individualizing treatment and choice of medication in lichen planus: a step by step approach

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