Lichen planus ruber, current therapy: a systematic review

Abstract

Background. Lichen planus ruber is a common inflammatory disease of skin and mucous membranes with a chronic relapsing course, resistance to conventional therapy, diverse clinical manifestations and capacity of tumourisation. Dermatosis is often comorbid with various underlying gastrointestinal, cardiovascular illnesses and endocrinopathies. Women are more impacted than men (ratio 1.4:1), the disease lasts from 5 to 40 years.Objectives. Assessment of the efficacy and safety of current therapies for lichen planus ruber.Methods. The PubMed, Web of Science, Medline, eLibrary and Scopus databases were mined for randomised controlled studies on treatment of this dermatosis in the period of 2014–2020, and selected impactive publications within 1991–2012 were also included in the review. The following keywords were used: lichen planus [красный плоский лишай], systemic and local drugs [системные и местные препараты], phototherapy [фототерапия], physiotherapeutic methods of treatment [физиотерапевтические методы лечения]. Publications in peer-reviewed journals had priority. Content and descriptive analyses were used as research tools.Results. Therapy for lichen planus ruber is multicomponent including a wide range of techniques, mostly immune-stimulating but often unproved for efficacy and safety. Selected studies are small-sample. The review presents feasible drug-based and physiotherapeutic methods to tackle lichen planus ruber, their application by the disease clinical presentation and prevalence, patient’s personal discomfort, psycho-emotional status and comorbidity. We describe the mechanisms of action, clinical efficacy, application types and noxious side effects in practiced albeit sometimes contentious therapies.Conclusion. Further well-designed research is warranted to aim at enhanced efficacy, safety and long-term remission in therapy for lichen planus ruber.