Table of contents
Lichen planus
What's new
Added 2020 and 2017 EADV guidelines for the management of lichen planus.
Guidelines
Key sources
The following summarized guidelines for the management of lichen planus are prepared by our editorial team based on guidelines from the European Academy of Dermatology and Venereology (EADV/EDF 2020), the Royal College of Ophthalmologists (RCOphth 2020), and the European Academy of Dermatology and Venereology (EADV 2017)....
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Medical management
Management of cutaneous lichen planus: as per EADV/EDF 2020 guidelines, Offer the following as first-line therapy in patients with cutaneous lichen planus:
topical corticosteroids (superpotent and potent such as triamcinolone acetonide, fluocinolone acetonide, betamethasone dipropionate and clobetasol propionate)
intralesional triamcinolone, especially for more hypertrophic or unresponsive lesions (5-20 mg/mL every 2-4 weeks)
systemic corticosteroids (oral or IM injections) If lesions are unresponsive to topical treatment (oral prednisone of 30-80 mg/day for 4-6 weeks or IM injections of triamcinolone 40-80 mg every 6-8 weeks)
acitretin (20-35 mg/day) or isotretinoin
oral cyclosporine (3-5 mg/kg/day).
E
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Management of oral lichen planus
Management of genital lichen planus
Management of appendageal lichen planus
Follow-up and surveillance
Follow-up
As per EADV 2017 guidelines:
Obtain careful monitoring for all potentially toxic therapies (such as azathioprine, dapsone, griseofulvin, chloroquine, minocycline, cyclosporine, methotrexate, mycophenolate, retinoids, oral corticosteroids) preferably supervised by a dermatologist at a specialized clinic.
B
Assess active disease as clinically required. Ensure long-term specialized follow-up in patients with erosive vulvar lichen planus.
B
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Monitoring for chloroquine/hydroxychloroquine retinopathy