title: Low-dose oral isotretinoin therapy in lichen planus pigmentosus: an open-label non-randomized prospective pilot study.
abstract: BACKGROUND
  Lichen planus pigmentosus (LPP) is a cosmetically distressing pigmentary disorder often posing a therapeutic challenge. Isotretinoin has been shown to be effective in oral and cutaneous LP, but its role in LPP is yet unknown.
  
  
  OBJECTIVE
  To evaluate the efficacy and safety of isotretinoin in the management of LPP.
  
  
  METHODS
  In this prospective study, 32 clinically and histologically proven patients with LPP were recruited. Subjects were treated with fixed low-dose (20 mg/day) oral isotretinoin once daily for 6 months along with topical sunscreens. Response was graded as mild (<25%), moderate (26-50%), and good (>50%) improvement based on decrease in intensity and progression of hyperpigmentation.
  
  
  RESULTS
  Twenty-seven patients (17 females and 10 males), aged 20-62 years, completed the study. Twenty-three (85.2%) patients had active disease and pruritus at presentation. Treatment outcome was moderate improvement in 15 patients (55.7%) followed by good in seven (21.8%) and mild in two (6.2%). Pruritus subsided at the earliest at 9-14 days, and disease stabilized by 4-6 weeks in treatment-responsive patients. Patients with a shorter duration (≤5 years) of disease and limited body area involvement had a better outcome.
  
  
  CONCLUSIONS
  Low-dose isotretinoin seems to be a promising treatment modality in stabilizing and decreasing the pigmentation in LPP particularly in early and limited disease.
authors.affiliation: Department of Dermatology, Venereology and Leprology, Postgraduate Institute of Medical Education and Research, Chandigarh, India.
authors.forename: Sendhil Kumaran
authors.initials: SK
authors.lastname: Muthu
authors.affiliation: Department of Dermatology, Venereology and Leprology, Postgraduate Institute of Medical Education and Research, Chandigarh, India.
authors.forename: Tarun
authors.initials: T
authors.lastname: Narang
authors.affiliation: Department of Pathology, Postgraduate Institute of Medical Education and Research, Chandigarh, India.
authors.forename: Uma N
authors.initials: UN
authors.lastname: Saikia
authors.affiliation: Department of Dermatology, Venereology and Leprology, Postgraduate Institute of Medical Education and Research, Chandigarh, India.
authors.forename: Amrinder Jit
authors.initials: AJ
authors.lastname: Kanwar
authors.affiliation: Department of Dermatology, Venereology and Leprology, Postgraduate Institute of Medical Education and Research, Chandigarh, India.
authors.forename: Davinder
authors.initials: D
authors.lastname: Parsad
authors.affiliation: Department of Dermatology, Venereology and Leprology, Postgraduate Institute of Medical Education and Research, Chandigarh, India.
authors.forename: Sunil
authors.initials: S
authors.lastname: Dogra
mesh_terms: D000328:Adult; D001830:Body Surface Area; D003879:Dermatologic Agents / Q000008:administration & dosage* / Q000009:adverse effects; D005260:Female; D006801:Humans; D017495:Hyperpigmentation / Q000150:complications / Q000188:drug therapy*; D015474:Isotretinoin / Q000008:administration & dosage* / Q000009:adverse effects; D008010:Lichen Planus / Q000150:complications / Q000188:drug therapy*; D008297:Male; D008875:Middle Aged; D010865:Pilot Projects; D011446:Prospective Studies; D011537:Pruritus / Q000209:etiology; D013997:Time Factors; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D003879:Dermatologic Agents; D015474:Isotretinoin