[Treatment of therapy-resistant erosive oral lichen planus with extracorporeal photopheresis (ECP)].
BACKGROUND
Erosive, oral lichen planus is typically therapy-resistant. Histologically and immunopathologically there are many similarities between lichen planus and lichenoid graft versus host disease (GvHD). Extracorporeal photopheresis (ECP) therapy has been shown effective in GvHD in several publications; only one study addresses its use in chronic erosive lichen planus.


METHODS
Four patients with erosive oral lichen planus were treated. Therapy was performed on two consecutive days (therapy cycle) every two weeks. Following clinical improvement, the therapy intervals were prolonged.


RESULTS
In all four patients clinical symptoms and mucosal lesions improved after seven to nine therapy cycles. A temporary worsening occurred in two patients following dental procedures. One of those patients still requires regular ECP therapy. Two patients discontinued therapy following nearly complete remission for other reasons. One patient stopped therapy after 19 cycles of ECP therapy and has remained in complete remission for 9 months. No side effects were seen during treatment.


CONCLUSIONS
Extracorporeal photopheresis is an effective therapeutic option for the treatment of erosive oral lichen planus, especially due to the lack of side effects in contrast to other established therapies. Adjunctive topical treatment is also required.
Kunte
Christian
C
Klinikum der Ludwig-Maximilians-Universität München, Klinik und Poliklinik für Dermatologie und Allergologie, Frauenlobstrasse 9-11, D-80337 Munich, Germany. C.Kunte@lrz.uni-muenchen.de
Erlenkeuser-Uebelhoer
Istrid
I
Michelsen
Silke
S
Scheerer-Dhungel
Karla
K
Plewig
Gerd
G
D000368:Aged; D004334:Drug Administration Schedule; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D017676:Lichen Planus, Oral / Q000188:drug therapy*; D008297:Male; D008875:Middle Aged; D017893:Photopheresis; D016896:Treatment Outcome