Mucosal (oral and vulval) lichen planus in women: are angiotensin-converting enzyme inhibitors protective, and beta-blockers and non-steroidal anti-inflammatory drugs associated with the condition?

Clayton, R.; Chaudhry, Shahid I; Ali, Iaisha; Cooper, Susan; Hodgson, TA; Wojnarowska, Fenella

doi:10.1111/j.1365-2230.2009.03581.x

Cited by 39 publications

(22 citation statements)

References 13 publications

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“…If any drugs associated with lichenoid eruptions (e.g., beta‐blockers, NSAIDs, thiazide diuretics, and others) are identified, then a trial of cessation may show some benefit. NSAIDs and beta‐blockers were associated with mucosal LP while angiotensin‐converting enzyme inhibitors were protective in one retrospective study (10).…”

Section: Treatmentmentioning

confidence: 97%

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Vulval lichen sclerosus and lichen planus

McPherson

Cooper

2010

Dermatologic Therapy

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Lichen sclerosus (LS) and lichen planus (LP) are both immunologically mediated diseases with a preference for the genitalia. The basic principles of management of vulval LS and vulvovaginal LP are the same and involve explanation of the disease, emphasizing the chronic nature of the condition and outlining treatment options. The main difference between the two conditions is that LP has a propensity to involve the mucous membranes including the mouth and vagina which are rarely affected in LS. First-line treatment for LS is a super-potent topical corticosteroid ointment which has a high response rate. Erosive vulvovaginal LP is more challenging to treat. Second-line therapies include topical calcineurin inhibitors and systemic agents. There is limited evidence for systemic treatments for both conditions. The risk of vulval squamous cell carcinoma (SCC) is increased in both LP and LS, and it is not known how treatment affects this risk. We recommend teaching self-examination and longitudinal evaluation.

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Section: Treatmentmentioning

confidence: 97%

“…A careful medication history including topical, systemic, and personal hygiene products should be obtained. LP can be triggered by medicaments, e.g., beta‐blockers, nonsteroidal anti‐inflammatory drugs (NSAIDs), thiazide diuretics and others (10). A history of personal or family history of autoimmune disorders should also be sought.…”

Section: Historymentioning

confidence: 99%

Vulval lichen sclerosus and lichen planus

McPherson

Cooper

2010

Dermatologic Therapy

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“…A retrospective study including 141 patients showed a significant association of VLP with beta blockers and nonsteroidal anti inflammatory drugs. Withdrawal of these drugs should be considered in the case of VLP being resistant to the usual treatments [34]. The clinical and pathological mucocutaneous features of chronic graft versus host (GVH) disease are indistinguishable from those of erosive LP [35].…”

Section: Aetiologymentioning

confidence: 99%

Vulvar dermatosis

Moyal‐Barracco¹,

Wendling²

2014

Best Practice & Research Clinical Obstetrics & Gynaecol

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Vulvar dermatoses are inflammatory conditions responsible for chronic or recurrent itching and soreness. The lesions are either circumscribed to the vulva or associated with extragenital localizations which may help to assess the diagnosis. They should be differentiated from infectious or neoplastic diseases which may have clinical similarities. As opposed to the majority of all dermatoses that have a benign and regular course, lichen sclerosus or lichen planus could exceptionally foster the occurrence of an epithelial cancer precursor which may evolve to squamous cell carcinoma. Topical corticosteroids are the mainstay treatment of vulvar dermatosis. We do not know if the treatment of vulvar lichen sclerosus and vulvar lichen planus prevents squamous cell carcinoma.

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“…One retrospective study showed that the oral lesions developed between 2 weeks and 3 months, with lesion resolution on withdrawal . However, the literature is contradictory regarding the link between NSAIDs and OLRs, with one prospective study not finding any association between oral keratoses (lichen planus and leukoplakia) and use of NSAIDs, while in contrast, another retrospective study supported the association between beta‐blockers and NSAIDs in the pathogenesis of OLRs . Finally, one case report clearly detailed a strong association between the use of indomethacin provoking an OLR, which recurred on rechallenge …”

Section: Drug‐induced Lichenoid Reactionsmentioning

confidence: 99%

A review and guide to drug‐associated oral adverse effects—Oral mucosal and lichenoid reactions. Part 2

Teoh

Moses

McCullough

2019

J Oral Pathology Medicine

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Dental practitioners and other health professionals commonly encounter and manage adverse medicine effects that manifest in the orofacial region. Numerous medicines are associated with a variety of oral adverse effects. However, due to lack of awareness and training, these side effects are not always associated with medicine use and are underreported to pharmacovigilance agencies by dentists and other health professionals. This article aims to inform health professionals about the various oral adverse effects that can occur and the most commonly implicated drugs to improve the management, recognition and reporting of adverse drug effects. This article follows on from Part 1; however, the focus here is on lichenoid reactions and oral mucosal disorders including oral aphthous‐like ulceration, mucositis and bullous disorders such as drug‐induced pemphigus, pemphigoid, Stevens‐Johnson syndrome and toxic epidermal necrolysis.

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Mucosal (oral and vulval) lichen planus in women: are angiotensin-converting enzyme inhibitors protective, and beta-blockers and non-steroidal anti-inflammatory drugs associated with the condition?

Abstract: Beta-blockers and NSAIDS are associated with LP, suggesting that withdrawal of these drugs should be considered. Further studies are needed to confirm or refute the inverse relationship between mucosal LP and use of ACE inhibitors.

Cited by 39 publications

References 13 publications

Vulval lichen sclerosus and lichen planus

Vulval lichen sclerosus and lichen planus

Vulvar dermatosis

A review and guide to drug‐associated oral adverse effects—Oral mucosal and lichenoid reactions. Part 2

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