INTRODUCTION
Lichen planus pigmentosus (LPP) is a rare variant of lichen planus presenting most commonly in middle-aged patients of color and characterized by the insidious onset of violaceous, brown, or grayish patches on photo distributed areas. Currently, there is limited data regarding the efficacy of treatments for LPP. We, therefore, sought to provide an analysis of current treatment protocols for this condition. A PubMed search on articles detailing treatment regimens yielded 37 total studies. Outcomes were graded according to the American College of Physicians grading system.1
The highest level of evidence amongst all available studies was grade 2, largely consisting of prospective analyses (Table I).2-5 In 13 patients treated with topical tacrolimus ointment 0.03% applied twice daily for 6–12 weeks, 7 (53.8%) demonstrated lightening of LPP after 12 weeks.2 Twenty patients received oral tranexamic acid at 250mg daily for 4–6 months. Upon completion of the trial, partial improvement was evident in 10 patients, 3 patients showed no improvement, and 7 patients were lost to follow-up. Pruritus was evident in nine patients and completely resolved following treatment. After 12 months, there was no evidence of worsening of the disease.3
Muthu et. al demonstrated that a low dose of oral isotretinoin (20 mg/day) for 6 months with broad-spectrum sunscreen use was effective in stabilizing and decreasing hyperpigmentation associated with LPP. Based on the decrease in progression as well as the intensity of hyperpigmentation, 15 of 27 patients
The highest level of evidence amongst all available studies was grade 2, largely consisting of prospective analyses (Table I).2-5 In 13 patients treated with topical tacrolimus ointment 0.03% applied twice daily for 6–12 weeks, 7 (53.8%) demonstrated lightening of LPP after 12 weeks.2 Twenty patients received oral tranexamic acid at 250mg daily for 4–6 months. Upon completion of the trial, partial improvement was evident in 10 patients, 3 patients showed no improvement, and 7 patients were lost to follow-up. Pruritus was evident in nine patients and completely resolved following treatment. After 12 months, there was no evidence of worsening of the disease.3
Muthu et. al demonstrated that a low dose of oral isotretinoin (20 mg/day) for 6 months with broad-spectrum sunscreen use was effective in stabilizing and decreasing hyperpigmentation associated with LPP. Based on the decrease in progression as well as the intensity of hyperpigmentation, 15 of 27 patients
