Treatment of lichen planus with acitretin

Laurberg, Grete; Geiger, Jean-M.; Hjorth, N; Holm, Per Sonne; Hou‐Jensen, Klaus; Jacobsen, K U; Nielsen, Aksel Otkjear; Pichard, J.; Serup, Jørgen; Sparre-Jorgensen, Annelise; Sorensen, Dennis; Thestrup‐Pedersen, Kristian; Thomsen, Kristian Korsgaard; Unna, P.; Urup, Jette

doi:10.1016/0190-9622(91)70067-c

Cited by 128 publications

(29 citation statements)

References 9 publications

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“…A double-blind trial on the effect of acitretin on lichen planus showed that 88% of the patients had some adverse effect during medication and 52"/0 during pla-Downloaded by [University of Saskatchewan Library] at 09:23 13 August 2015 cebo treatment (17). The most usual complaints were dryness of the lips, mouth, nose, eyes, and skin, which all were reversible.…”

Section: Discussionmentioning

confidence: 98%

“…The mean activity of MMP-9 during medication was higher than at control examination (P = 0.0442). The enzyme activity increased in 13 of 17 Systemic retinoids (such as isotretinoin), vitamin A derivates, have been used for the treatment of acne vulgaris ( l ) , oral lichen planus (2-4), oral leukoplakia (5), and in some other precancerous conditions (6). The influence of retinoids on the oral mucosa is mediated via retinoid-binding proteins (7), causing modulation in stratified epithelium and in epithelial differentiation Patients treated with systemic oral isotretinoin complain of dry mouth, increased viscosity of the saliva, and changes in the texture of the oral mucosa (10).…”

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confidence: 96%

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Systemic oral isotretinoin therapy and flow rate, pH, and matrix metalloproteinase-9 activity of stimulated saliva

Oikarinen

Salo

Kylmäniemi

et al. 1995

Acta Odontologica Scandinavica

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Systemic retinoids are known to cause dryness of the mouth and changes in oral and lip mucosa. The purpose of this study was to evaluate changes in salivary variables during treatment with oral isotretinoin in patients receiving the drug for 3 months for cutaneous acne. Patients were examined 1 month after initiation of medication and approximately 3.7 months after its discontinuation. Salivary flow and pH could be measured in 8 and the relative amount of matrix metalloproteinase-9 (MMP-9) of stimulated saliva in 17 patients. The mean flow rate of stimulated saliva was lower during medication than at control examination (P = 0.0277), but no change in the mean pH value was observed during medication. The mean activity of MMP-9 during medication was higher than at control examination (P = 0.0442). The enzyme activity increased in 13 of 17 and decreased in 4 of 17 cases.

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Section: Discussionmentioning

confidence: 98%

mentioning

confidence: 96%

Systemic oral isotretinoin therapy and flow rate, pH, and matrix metalloproteinase-9 activity of stimulated saliva

Oikarinen

Salo

Kylmäniemi

et al. 1995

Acta Odontologica Scandinavica

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“…Systemic isotretinoin has also been used with effect (Woo, 1985;, but a newer, as-yet-unavailable alternative is isotretinoin as a gel, which appears to have fewer side-effects and is also efficacious in the management of OLP (Giustina et al, 1986). Tretinoin (BaudetPommel et al, 1991) and acitretin (Laurberg et al, 1991) have also been used. Temarotene is a new retinoid analogue which does not cause undesirable side-effects and has been shown to be efficacious in an open pilot study of 25 patients (Bollag and Ott, 1989).…”

Section: Retinoidsmentioning

confidence: 99%

Update On Oral Lichen Planus: Etiopathogenesis and Management

Scully

Beyli²,

Ferreiro

et al. 1998

Critical Reviews in Oral Biology & Medicine

475

461

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Lichen planus (LP) is a relatively common disorder of the stratified squamous epithelia, which is, in many ways, an enigma. This paper is the consensus outcome of a workshop held in Switzerland in 1995, involving a selection of clinicians and scientists with an interest in the condition and its management. The oral (OLP) eruptions usually have a distinct clinical morphology and characteristic distribution, but OLP may also present a confusing array of patterns and forms, and other disorders may clinically simulate OLP. Lesions may affect other mucosae and/or skin. Lichen planus is probably of multifactorial origin, sometimes induced by drugs or dental materials, often idiopathic, and with an immunopathogenesis involving T-cells in particular. The etiopathogenesis appears to be complex, with interactions between and among genetic, environmental, and lifestyle factors, but much has now been clarified about the mechanisms involved, and interesting new associations, such as with liver disease, have emerged. The management of lichen planus is still not totally satisfactory, and there is as yet no definitive treatment, but there have been advances in the control of the condition. There is no curative treatment available; immunomodulation, however, can control the condition. Based on the observed increased risk of malignant development, OLP patients should be offered regular follow-up examination from two to four times annually and asked to report any changes in their lesions and/or symptoms. Follow-up may be particularly important in patients with atrophic/ulcerative/erosive affections of the tongue, the gingiva, or the buccal mucosa. Much more research is required into the genetic and environmental aspects of lichen planus, into the premalignant potential, and into the possible associations with chronic liver, and other, disorders. More clinical studies are required into the possible efficacy of immunomodulatory drugs such as pentoxifylline and thalidomide.

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“…[2,3,4,5,6,7,8,9,10] Out of all systemic modalities oral corticosteroids, [3,11,12,13] are the mainstay of therapy, in present study an attempt was made to compare the efficacy between oral mini pulse therapy with betamethasone, [12] and oral acitretin. [5] Age Distribution: In present study, Out of 60 patients, 78.33% of lichen planus cases were in age group of 30-60years which is comparable to western study by melgren et al Sex distribution ( Table 9): In present study female patients outnumbered males in a ratio of 2.1:1, which is nearly comparable to study by vijay kumar et al, In a study done by ramesh et al, [13] male patients outnumbered females, (54.28%) patients were males and 16(45.71%) were females. Present study out of 60 patients, 40(66.66%) patients had severe pruritus with sleep disturbance affecting quality of life and itching subsided around 4-6 weeks after starting treatment and is slightly early in patients treated with mini pulse therapy.…”

Section: Resultsmentioning

confidence: 99%

“…The present study was done to compare the efficacy between oral betamethasone mini pulse therapy and oral acitretin and to know the relapse rate. [2,3,4,5,6,7,8,9,10] MATERIALS AND METHODS: The study was carried out on patients who were clinically diagnosed as generalised lichen planus, attending the outpatient department of dermatology, venereology and leprosy, King George hospital, affiliated to Andhra medical college, Visakhapatnam from November 2011 to December 2012. A total of 60 patients were included in study and divided into two equal groups.…”

Section: Introductionmentioning

confidence: 99%

A Study of Comparative Effeiciency of Oral Mini Pulse Therapy Versus Oral Acitret in in Genaralised Lichen Planus

P¹,

S²,

Shalini³

et al. 2015

jemds

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BACKGROUND:Lichen planus is a chronic inflammatory disease that effects skin, mucous membranes, hair and nails. There are several drugs both topical and systemic for the treatment of lichen planus. AIMS AND OBJECTIVES: Present study was done to compare the efficacy between oral mini pulse therapy with betamethasone and with acetretin in the management of generalised lichen planus. MATERIALS AND METHODS: The study was carried out on patients who were clinically diagnosed as generalised lichen planus, attending the outpatient department of dermatology, venereology and leprosy, King George hospital, affiliated to Andhra medical college, Vishakhapatnam from November 2011 to December 2012. A total of 60 patients were included in study and divided into two equal groups. Group1 patients were treated with 0.1mg/kg of oral betamethasone given on 2 consecutive days in a week till 8 weeks and tapered. Group 2 patients were treated with 0.5mg/kg of acetretin for 8 weeks and tapered. INCLUSION CRITERIA: All patients of age group in between 11-60 years, of either sex, suffering from lichen planus of duration >3 months, and women in group 2 who were in reproductive age group on two methods of contraception were included. EXCLUSION CRITERIA: Pregnant and lactating women, in Group 1: patients suffering from diabetes, hypertension, peptic ulcer disease, renal, hepatic, heart disease or tuberculosis, in Group 2: patients with abnormal lipid profile, diabetes, hypertension, renal, liver or heart disease were excluded. RESULTS: out of 60 patients enrolled in study, 2 patients from group 1 and 5 patients from group 2 were dropped from study and results were concluded. Majority of patients were in age group of 31-60 (78.3%) with male to female ratio of 2.1:1.Group 1 patients at the end of 8 weeks response was seen in 92.8%, with relapse rate of 15.38% after 6 months of follow up. Group 2 patients at end of 8 weeks response was seen in 72 % with relapse rate of 5.5%. CONCLUSION: In our study oral mini pulse therapy with betamethasone has early onset of action and with a complete response in majority of patients with slightly more relapse rate when compared to oral acetretin. Oral acetretin has less relapse rate due to prolonged half-life.

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Treatment of lichen planus with acitretin

Cited by 128 publications

References 9 publications

Systemic oral isotretinoin therapy and flow rate, pH, and matrix metalloproteinase-9 activity of stimulated saliva

Systemic oral isotretinoin therapy and flow rate, pH, and matrix metalloproteinase-9 activity of stimulated saliva

Update On Oral Lichen Planus: Etiopathogenesis and Management

A Study of Comparative Effeiciency of Oral Mini Pulse Therapy Versus Oral Acitret in in Genaralised Lichen Planus

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