General Dermatology

Antioxidants as an Adjunctive Treatment for Lichen Planus

Estie Mermelstein, MSN, FNP-BC
|
Lichen planus (LP) is a chronic, inflammatory, papulosquamous, autoimmune disease that is estimated to occur in <1% of the general population.1 It appears to be more common in individuals with HCV, with 1 study reporting a 4.80 times higher prevalence in this population.4 LP can affect the skin, scalp, genitals, oral cavity and other mucus membranes, and nails. Its etiology is not well understood, but genetic, environmental, and lifestyle factors are thought to play a role. An immune mechanism directed by activated CD81 T cells against basal keratinocytes has been suggested to play a major role in the pathophysiology of the disease, with cytokines such as tumor necrosis factor-α, interferon-γ, and interleukin-6 and interleukin-8 thought to contribute in the setting of HCV infection.1 Cutaneous LP is a self-limited disease that usually resolves within 6 to 12 months and mainly affects adults. Photo Credit: ISM/CID.

Lichen planus (LP) is a chronic, inflammatory, papulosquamous, autoimmune disease that is estimated to occur in <1% of the general population.1 It appears to be more common in individuals with HCV, with 1 study reporting a 4.80 times higher prevalence in this population.4 LP can affect the skin, scalp, genitals, oral cavity and other mucus membranes, and nails. Its etiology is not well understood, but genetic, environmental, and lifestyle factors are thought to play a role. An immune mechanism directed by activated CD81 T cells against basal keratinocytes has been suggested to play a major role in the pathophysiology of the disease, with cytokines such as tumor necrosis factor-α, interferon-γ, and interleukin-6 and interleukin-8 thought to contribute in the setting of HCV infection.1 Cutaneous LP is a self-limited disease that usually resolves within 6 to 12 months and mainly affects adults.

Photo Credit: ISM/CID.

A prospective, case-control study examines the effectiveness of antioxidants in treating lichen planus.

According to a prospective case-control study cited in a letter published in Dermatologic Therapy.

Investigators separated 90 adults with lichen planus into 3 groups: those treated with systemic corticosteroids for 3 months (prednisolone 0.5 mg/kg/day), those treated with systemic antioxidants (1 selenium-ACE tablet once daily) for 3 months, and those treated with low-dose systemic corticosteroids (10 mg once daily) and antioxidants (1 selenium-ACE tablet once daily) for 3 months. Investigators collected blood samples at baseline and treatment end and used ELISA to determine the total oxidative capacity (TOC) levels. To compare the 3 treatments with each other, investigators quantified the average number of lesions before and after treatment and used the Visual Analog Scale score to measure disease severity.

All 3 groups of patients showed a statistically significant different in TOC levels before and after treatment. All 3 groups also showed a decrease in the number of lesions before and after treatment; however, patients treated with systemic corticosteroids had a 92.5% improvement, patients treated with antioxidants had an 18.76% improvement, and patients treated with low-dose corticosteroids plus antioxidants had a 91.3% improvement.

“It can be concluded that the usage of low-dose topical corticosteroids combined with antioxidants have a potential role in treatment of LP,” the letter’s authors wrote.

Reference

Hassan Mohammed M, Abd-ElRaheem TA, Shaker OG, Mousa RM. Combination of low dose corticosteroids and antioxidants in treatment of cutaneous lichen planus. Dermatol Ther. Published online December 14, 2021. doi:10.1111/dth.15265

Related Content

  • Latest News Your top articles for Sunday

  • Haymarket Medical NetworkTop Picks

  • Loading...

    Continuing Medical Education (CME/CE) Courses

    Show More