A systematic review 1 including 83 studies was abstracted in DARE.
Cutaneous LP:
There is evidence from controlled trials that acitretin has efficacy in the treatment of cutaneous LP.
There is some evidence that PUVA is able to decrease pruritus during the first weeks of treatment. Bath PUVA could be more effective than oral PUVA, but it may also cause an exacerbation of the disease. There is very limited evidence on the effectiveness of short-course systemic corticosteroids, griseofulvin and cyclosporine. Various other drugs, such as dapsone, hydroxychloroquine sulphate and metronidazole have been examined in small trials with weak study designs.
Mucous LP:
There is evidence from controlled trials that topical corticosteroids are effective in in oral LP.
The efficacy of systemic corticosteroids in mucous LP has not been demonstrated by rigorous trials. Etretinate seems to be effective in reducing the lesions in oral LP. Both 0.1% tretinoin and 0.1% isotretinoin seem to be effective when applied topically to oral LP. The efficacy of 0.05% tretinoin is poor. After withdrawal of systemic or topical retinoids, recurrences are common.
Topical cyclosporine washes seem to be effective against oral LP, especially the severe erosive forms, but they do not appear to better than local corticosteroid therapy.
There is very limited evidence on the effectiveness of oral PUVA therapy with low-dose UV-A and it can cause side effects, mainly nausea, related to oral ingestion of psoralen.
Comment: The quality of evidence is downgraded by indirectness (differences in studied interventions).
Primary/Secondary Keywords