Application of superluminescent diodes (sLED) in the treatment of scarring alopecia - A pilot study.

INTRODUCTION: Photobiomodulation therapy with the use of light-emitting diodes (LEDs) is a fast growing therapeutic technique with a wide range of dermatologic indications. Recently it has been suggested that LED therapy could be beneficial in scarring alopecia. AIM: Assessment of the efficacy of novel superluminescent diodes (sLED) with a "soft- start" as an adjuvant treatment in selected types of scarring alopecia. METHODS: This pilot study included 16 female patients: 8 with frontal fibrosing alopecia (FFA) and 8 with lichen planopilaris (LPP), aged 41-76 years with a stable treatment, either topical or systemic. In all patients, sLED irradiations were performed once a week for a 10-week period. The sLEDs' effectiveness was assessed clinically and using trichoscopy. RESULTS: The therapy was well tolerated. Both Lichen Planopilaris Activity Index (LPPAI) and Frontal Fibrosing Alopecia Severity Score (FFASS) were significantly reduced after the therapy (p = 0.012, p = 0.017 respectively). Within the treated area, the number of thick hairs significantly increased after the therapy (p = 0.009), whereas the number of medium-sized hairs and thin hairs did not change significantly (p = 0.836, p = 0.675 respectively). CONCLUSIONS: Irradiations with sLEDs were demonstrated to be safe and well tolerated. This noninvasive therapy leads to the reduction of subjective symptoms, and improve the outcome both in FFA and in LPP. This effective novel light source can be used as an adjuvant therapy in patients with chronic LPP or FFA. However, further studies including a larger study group and a control group are needed to evaluate the long-term effects of the therapy.

Liquen plano generalizado tratado con ultravioleta B de banda estrecha: resultados en 10 pacientes y revisión de la literatura / Generalized Licen Planus Treated With Narrowband UV-B Phototherapy: Results From 10 Patients and a Review of the Literature

El liquen plano en su forma generalizada (LPG) es en ocasiones difícil de tratar. Cuando fallan los tratamientos tópicos y sistémicos más utilizados como corticoides y antihistamínicos orales la fototerapia se plantea como alternativa. En el momento actual y dadas sus ventajas se utiliza con más frecuencia el ultravioleta B de banda estrecha (UVB-BE). En este trabajo presentamos los resultados en 10 pacientes con LPG tratados con UVB-BE. Para ello realizamos un estudio prospectivo en el que se incluyeron pacientes adultos afectados de LPG en más del 20% de su superficie corporal. Se obtuvo respuesta completa en 8 de los pacientes (80%) con una tasa de recidiva del 25% (2/8). Estos resultados son similares a la literatura revisada. La fototerapia con UVB-BE es ampliamente utilizada como alternativa a los tratamientos sistémicos en el LPG, sin embargo, existen pocos estudios publicados en la literatura sobre sus resultados

Generalized lichen planus can be difficult to treat. One alternative for patients who do not respond to common topical and systemic treatments, such as corticosteroids and oral antihistamines, is phototherapy. Narrowband UV-B phototherapy offers several advantages and is currently the main treatment modality. In this study, we present the results corresponding to 10 patients with generalized lichen planus treated with narrowband UV-B phototherapy. We performed a prospective study of adult patients with generalized lichen planus affecting more than 20% of their body surface area. A complete response was observed in 8 patients (80%) and the disease recurred in 2 of these (recurrence rate, 25%). These rates are similar to those reported in the literature reviewed. Narrowband UV-B phototherapy is a widely used alternative to systemic treatments in GLP, but there are very few reports of its results in the literatura

Generalized Licen Planus Treated With Narrowband UV-B Phototherapy: Results From 10 Patients and a Review of the Literature. / Liquen plano generalizado tratado con ultravioleta B de banda estrecha: resultados en 10 pacientes y revisión de la literatura.

Generalized lichen planus can be difficult to treat. One alternative for patients who do not respond to common topical and systemic treatments, such as corticosteroids and oral antihistamines, is phototherapy. Narrowband UV-B phototherapy offers several advantages and is currently the main treatment modality. In this study, we present the results corresponding to 10 patients with generalized lichen planus treated with narrowband UV-B phototherapy. We performed a prospective study of adult patients with generalized lichen planus affecting more than 20% of their body surface area. A complete response was observed in 8 patients (80%) and the disease recurred in 2 of these (recurrence rate, 25%). These rates are similar to those reported in the literature reviewed. Narrowband UV-B phototherapy is a widely used alternative to systemic treatments in GLP, but there are very few reports of its results in the literature.

An open-label non-randomized prospective pilot study of the efficacy of Q-switched Nd-YAG laser in management of facial lichen planus pigmentosus.

Lichen planus pigmentosus (LPP) is a cosmetically disfiguring condition. Many treatment options are available which are effective in halting the progression of the disease. The treatment of persistent pigmentation is still a challenge. We describe the use of Q-switched Nd-YAG laser in 13 patients with stable LPP using a standard protocol. Most of our patients showed complete to near-complete resolution of pigment without much complications.

Treatments for Cutaneous Lichen Planus: A Systematic Review and Meta-Analysis.

BACKGROUND: Cutaneous lichen planus (CLP) is an inflammatory dermatosis. Its chronic relapsing course and frequently spontaneous regression hamper the assessment of treatment effectiveness. OBJECTIVE: To evaluate the efficacy of available treatment modalities for CLP. DATA SOURCES: PubMed, Cochrane Central Register of Controlled Trials (CENTRAL), ClinicalTrials.gov registry. METHODS: We performed a systematic review of the current literature. All randomized controlled trials, nonrandomized case-control studies, and cohort studies with more than one treatment arm were included. The primary outcomes were complete response and time to complete response. The secondary outcomes were partial response, relapse, time to relapse, reduction of itch, the adverse event rate, and withdrawal due to adverse events. DATA SYNTHESIS: Sixteen studies met the inclusion criteria, of which 11 were randomized controlled trials. Most trials had a small sample size. In the rare studies in which variants other than generalized or classic lichen planus were included, they could not be analyzed separately. Body-of-evidence quality ranged from very low to moderate. Acitretin, sulfasalazine, and griseofulvin were associated with increased overall response rates in comparison with placebo. Narrow-band ultraviolet B radiation (NBUVB) was more effective than 6 weeks' low-dose prednisolone in achieving a complete response, and prednisolone was more effective than enoxaparin. Hydroxychloroquine was more effective than griseofulvin in achieving an overall response. Betamethasone valerate 0.1% ointment had comparable efficacy to calcipotriol ointment. Methotrexate was effective, with a nonsignificant difference in the complete response rate in comparison with oral betamethasone. In nonrandomized controlled trials, oral psoralen plus ultraviolet A photochemotherapy (PUVA) had comparable efficacy to a PUVA bath and NBUVB. Psoralen plus sunlight exposure (PUVASOL) and betamethasone dipropionate 0.05% cream were effective relative to a short course of oral metronidazole. CONCLUSIONS: Several effective treatment options are available for CLP. Further well-designed studies are warranted to investigate the efficacy of topical glucocorticoids-the current first-line therapy-as well as other treatment modalities, and the treatment of different variants of CLP.

Narrow band ultraviolet B for the treatment of generalized lichen planus.

OBJECTIVE: Although various treatment options have been used in the treatment of lichen planus (LP), it is still challenging to choose the most effective one. Scarce data are available in the literature examining efficacy of NB-UV in the treatment of LP. Thus, we aimed to evaluate efficacy of NB-UVB for LP. METHODS: Twenty-four patients with generalized LP who received NB-UVB treatments in between January 2011 and December 2014 were included in the study. Response types were classified into three groups which complete response refers to ≥90% reduction in the number of the lesions; partial response 51-89%; and no response ≤50%. RESULTS: Sixteen patients responded to the NB-UVB treatment [5 partial (20.8%) and 11 complete (45.8%) remissions], whereas 8 patients (33.3%) did not respond to the treatment. A number of sessions and accordingly cumulative dose of UVB were significantly higher in responded group than in non-responders. When we compared these two groups according to duration of the disease, there was no significant difference. CONCLUSIONS: Two-thirds of patients with generalized LP favorably responded to NB-UVB treatment without any remarkable adverse events. This significant response rate coupled with safety should prompt further clarification of the place of NB-UVB in generalized LP.

Ultraviolet-B treatment for cutaneous lichen planus: our experience with 50 patients.

BACKGROUND: Previous small reports suggested the role of ultraviolet (UV)-B in the management of cutaneous lichen planus. OBJECTIVE: To summarize our experience with UVB in a relatively large study group looking specifically into predictive factors for complete response and the long-term relapse rates. METHODS: A retrospective analysis of 50 patients with generalized cutaneous lichen planus, treated by broad or narrow band UVB. RESULTS: Seven and 43 patients were treated by broad and narrow band UVB, respectively. Complete response was achieved in 70% and 85% of those were still in remission after a median of 34.7 months. The complete response rate and the need for higher cumulative exposure doses were not influenced by sex, age, skin type, presence of additional diseases, failure of previous treatment or disease duration. LIMITATIONS: This is a retrospective non-randomized analysis of a usually self-limiting disease. CONCLUSION: UVB is a safe and efficient treatment option for generalized cutaneous lichen planus.

Psoralen plus UVA vs. UVB-311 nm for the treatment of lichen planus.

BACKGROUND: The purpose of this study was to evaluate and compare the short- and long-term therapeutic efficacy of psoralen plus UVA (PUVA) vs. UVB-311 nm in the treatment of patients with disseminated lichen planus. METHODS: A computerized data bank search and chart review revealed that data from a total of 28 patients, including 15 patients [11 women, four men; mean age 47 years (range, 16-65 years)] treated between 1998 and 2004 with PUVA and 13 patients [10 women, three men; mean age 51 years (range, 19-69 years)] treated with UVB-311 nm, were available at our institution for retrospective analysis. RESULTS: All 15 patients (100%) treated with oral PUVA had a complete [n=10 (67%)] or partial [n=5 (33%)] clinical response, whereas 10 of 13 patients (77%) treated with UVB-311 nm showed complete [n=4 (31%)] or partial [n=6 (46%)] clinical response. Statistical analysis revealed that the initial response to PUVA was superior to that of UVB-311 nm (P=0.0426; Wilcoxon's exact test). There were no statistically significant differences between the PUVA- and UVB-311 nm-treated patient groups with regard to mean therapy duration (10.5 vs. 8.2 weeks; P=0.1107; unpaired, two-tailed Student's t test) or mean number of treatment exposures (25.9 vs. 22.5; P=0.1775). After a mean follow-up period of 20.5 months (range, 2-49 months) and 35.7 months (range, 3-60 months), respectively, disease recurrence or deterioration was observed in seven of 15 PUVA-treated patients (47%) and three of 10 UVB-311 nm-treated patients (30%). Kaplan-Meier lifetime table analysis revealed no statistically significant difference between the 2 treatment groups in terms of sustained overall (i.e., partial and complete) clinical response rate (P=0.8593; log-rank test). CONCLUSIONS: Even though oral PUVA produces a better initial clinical response rate, both oral PUVA and UVB-311 nm are effective treatments for lichen planus that produce similar long-term outcomes.

Ultraviolet A-1 as a treatment for ulcerative lichen planus of the feet.

Ulcerative lichen planus of the feet is a rare variant of lichen planus characterized by the constellation of a chronic bullous and ulcerative eruption limited to the feet, atrophy of involved skin and nails, and cicatricial alopecia. Only split-thickness skin grafting has here to been documented to be effective. We here report a case with ulcerative lichen planus of the feet successfully treated with medium-dose ultraviolet A-1.