Efficacité de la photochimiothérapie extracorporelle dans le traitement du lichen plan érosif : étude rétrospective

Abstract

Erosive lichen planus of the skin and mucosa is an invalidating disease that impacts the quality of life of patients and for which there is no codified treatment. Herein we report retrospective efficacy data for extracorporeal photopheresis (ECP) in the treatment of erosive lichen planus in 11patients. We treated 10women and 1man with PCE for erosive lichen planus refractory on average to two previous treatments. PCE was administered in two sessions on two successive days every two weeks at the start of treatment, followed by more widely spaced cycles. The primary evaluation criterion was partial or complete clinical efficacy. PCE had a positive effect on all 11patients. We noted 6complete remissions and 5partial remissions. Complete remission was achieved within a mean 5.5months, with improvement in symptoms occurring earlier. Relapse was frequent during the intervals between PCE sessions and on discontinuation of treatment but resumption of PCE once again proved effective. Our study supports the data in the literature from 28published cases. Treatment efficacy and improvement in symptoms were rapidly apparent. PCE is generally a well-tolerated treatment, with only one patient dropping out of our study, but it imposes certain scheduling, technical and cost constraints. These constraints and the frequency of relapse underscore the question of treatment duration. The initial therapeutic schedule for PCE does not appear to modify the times required to achieve remission of erosive lichen planus.