Oral, esophageal and cutaneous lichen ruber planus controlled with alitretinoin: case report and review of the literature.
BACKGROUND
Therapy-resistant lichen planus (LP) can be a challenging condition for dermatologists. There are some case reports about successful treatments with alitretinoin of cutaneous and oral, but not of esophageal LP.


OBJECTIVE
We present the unique case of a patient with cutaneous, oral and esophageal LP which was refractory to classical treatment options (topical clobetasol propionate and pimecrolimus, intramuscular triamcinolone acetonide); because of systemic side effects the patient did not tolerate systemic acitretin dosed up to 25 mg daily.


METHODS
Oral alitretinoin was used at a dose of 30 mg daily.


RESULTS
Both oral and skin changes as well as dysphagia completely resolved within 4 weeks without any severe side effects and the drug was used for 6 months. No papules, intraoral striae or dysphagia recurred during the 6 months of treatment. After 4 months the patient relapsed with mucosal patches so that a second cycle was initiated for 6 months where oral LP lesions resolved after 4 weeks also (with sporadic mild headache).


CONCLUSIONS
Further studies are needed to better understand the impact of alitretinoin in LP. Our observation suggests alitretinoin as a new, well-tolerated treatment option for esophageal LP after failed response to conventional treatments.
Department of Dermatology, University Hospital of Zurich, Zurich, Switzerland.
Antonios G A
AG
Kolios
Ewerton
E
Marques Maggio
Christoph
C
Gubler
Antonio
A
Cozzio
Reinhard
R
Dummer
Lars E
LE
French
Alexander A
AA
Navarini
D000077556:Alitretinoin; D000970:Antineoplastic Agents / Q000627:therapeutic use*; D003680:Deglutition Disorders / Q000209:etiology; D004935:Esophageal Diseases / Q000150:complications / Q000188:drug therapy* / Q000473:pathology; D005260:Female; D006801:Humans; D008010:Lichen Planus / Q000150:complications / Q000188:drug therapy*; D017676:Lichen Planus, Oral / Q000150:complications / Q000188:drug therapy / Q000473:pathology; D008875:Middle Aged; D014212:Tretinoin / Q000627:therapeutic use*
D000970:Antineoplastic Agents; D000077556:Alitretinoin; D014212:Tretinoin