Treatment Of Lichen Simplex Chronicus Research Articles

Efficacy and Safety of Liquid Nitrogen Cryotherapy for Lichen Simplex Chronicus: A Meta-Analysis

Background: Lichen simplex chronicus (LSC) is characterized by localized lichenification and intense itching. It has been reported that the added use of liquid nitrogen cryotherapy (LNC) for LSC has significant efficacy and notable safety. Therefore, we conducted a meta-analysis based on existing randomized controlled trials (RCTs). Method: We searched RCTs on LNC for LSC published up to August 2020 using various databases, including PubMed, EMBASE, Web of Science, Cochrane Central Register of Controlled Trials, China Network Knowledge Infrastructure (CNKI), Chinese Biomedicine (CBM), Chinese Scientific Journals Database (VIP), and WanFang Database. Other studies were manually identified using the references cited in reviews. We applied fixed- or random-effects models, and all analyses were performed using Review Manager 5.4 software. Results: Twelve RCTs involving 1,066 participants provided eligible data for the meta-analysis. Based on the clinical effective rate, LNC treatment of LSC (risk ratio, RR 1.25, p = 0.005, I² = 82%) was superior to controls. Subgroup analysis showed that the use of LNC alone (RR 1.04, I² = 95%, p > 0.05) is not more effective than other therapies in the treatment of LSC, but the addition of LNC to the existing treatment increases the total clinical efficacy. Furthermore, the combined effect of LNC and topical medication (RR 1.39, I² = 0%, p < 0.0001) was better than that of LNC and oral medication (RR 1.30, I² = 0%, p < 0.00001). Greater frequency of LNC treatment did not improve the efficacy (thrice a week: RR 1.39 [1.21, 1.60]; twice a week: RR 1.27; once every 2 weeks: RR 1.32). Data from 6 RCTs with 508 participants showed no significant difference in AEs (p = 0.31) associated with added LNC treatment. Conclusion: The addition of LNC (applying a cotton swab soaked with liquid nitrogen to wipe the lesion for approximately 10 s each time) to topical ointments, is effective and safe in the treatment of LSC. Increasing the treatment frequency of LNC did not necessarily improve the efficacy.

The impact of disease information and behaviour development on the treatment of lichen simplex chronicus

The impact of disease information and behaviour development on the treatment of lichen simplex chronicus

Local use of a China-made compound betamethasone injection for the treatment of lichen simplex chronicus: a multi-center, randomized, parallel controlled clinical study

Objective To evaluate the safety and efficacy of single and local use of a China-made compound betamethasone injection in the treatment of lichen simplex chronicus. Methods A multi-center,randomized, parallel controlled study was conducted. Patients with lichen simplex chronicus were divided into test and control groups to receive a single dose of intralesional compound betamethasone injection made in China or Schering-Plough Labo N.V. Belgium. Patients were visited for the evaluation of efficacy and safety of the China-made injection at the beginning of the treatment (DO), on week 2 (D14) and 4 (D28) after the initiation of treatment. Results A total of 144 patients were enrolled, among which, 68 in the control group and 71 in the test group completed the trial. FAS analysis on week 4 revealed that the response rate and healing rate were 86.11% and 59.72% in the control group, respectively, 86.11% and 54.17% in the test group, respectively (χ2=0.00,0.45,respectively,both P>0.05).There was no severe adverse event in either group after the treatment, and only mild atrophoderma occurred in one patient in the control group, which was improved spontaneously within several weeks of follow-up. There was no statistically significant difference in the occurrence of side reactions between the two groups (P> 0.05). Conclusion The China-made compound betamethasone injection is effective and safe for the treatment of lichen simplex chronicus. Key words: Neurodermatitis; Compound betamethasone injection; Randomized controlled trials

Homoeopathy for the treatment of lichen simplex chronicus: A case series

Twenty-seven patients with chronic lichen simplex involving various parts of the body were treated. Hydrocotyle was prescribed to 21 patients in different potencies (6c, 30c, 200c, 1 M, 10 M), Thuja to three patients (1 M, 10 M), Graphites (6c), Kali bich (30c) and Sulphur (200c) to one patient each during 1 year study period. Only two patients showed complete improvement with Thuja and one with Graphites. In other cases, the response was limited to partial relief itching.

The effect of topically applied aspirin on localized circumscribed neurodermatitis

Background: Lichen simplex chronicus is a troublesome intractable itchy dermatosis, which may persist despite intensive topical treatments. Recently it has been demonstrated that topical aspirin solution with dichloromethane has a significant antipruritic effect in an experimentally induced itch. Objective: The aim of this double-blind, crossover placebo trial was to evaluate the efficacy of this solution in the treatment of lichen simplex chronicus. Methods: Twenty-nine patients with lichen simplex chronicus of at least 3 months' duration that did not respond to topical corticosteroids were randomized in a double-blind fashion to receive aspirin/dichloromethane solution in treatment period 1 for 2 weeks followed by placebo in treatment period 2 or placebo followed by aspirin in period 2 with a crossover design after a 2-week washout. The patients rated the pruritus intensity before and during therapy with a visual analog scale; a blinded investigator performed photographic assessment. Results: A significant therapeutic response was achieved in 11 (46%) of the patients who completed the study compared with 3 patients (12%) receiving placebo. Overall, aspirin-treated patients experienced an average decrease in the visual analog scale of 2.18 ± 2.86 versus 0.69 ± 2.31 of those receiving placebo. The difference between the 2 treatments for week 2 was significant (P = .03). Conclusion: The study suggests that topical aspirin/dichloromethane might be a practical treatment for lichen simplex chronicus. (J Am Acad Dermatol 2001;45:910-3.)

Transmittance properties of flurandrenolide tape for psoriasis: helpful adjunct to phototherapy.

Flurandrenolide tape is a valuable agent in the treatment of lichen simplex chronicus and in psoriasis. The corticosteroid is helpful for reducing the symptoms and induration of the lichen simplex chronicus lesion, and occlusion of the lesion with the tape reduces the patient's opportunity to rub and scratch the affected area. The purpose of this study was to determine to what extent flurandrenolide tape may block ultraviolet (UV) light and interfere with phototherapy of psoriasis. Flurandrenolide tape was applied to quartz spectroscopy cuvettes, and the absorption spectrum was determined using a Beckman DU-600 spectrophotometer. The effect of the tape on UV light transmission was also determined using our UVA-UVB office phototherapy unit. Flurandrenolide tape has considerable UV absorption in the UVC range with less absorption in the UVB and UVA range. The transmittance is greater (less absorption) with longer wavelengths. There was greater UV absorption in the UVB range than in the UVA range. Although flurandrenolide tape may be left in place during PUVA therapy, adjustment of UV dose or removal of the tape is probably needed during UVB phototherapy.

Vibra-puncture technique in the treatment of localized neurodermatitis; a preliminary study on the effect of hydrocortisone acetate injected by the multiple Vibra-puncture method into areas of lichen simplex chronicus.

The purpose of this preliminary report is to demonstrate a new, simple, and effective method of therapy for lichen simplex chronicus (localized neurodermatitis). We were prompted to use the vibra-puncture technique for this chronic type of dermatitis after our successful results with the injection of hydrocortisone acetate by use of the syringe and needle technique. Since this work was started, Dr. Leonard E. Savitt1has also reported on the successful treatment of lichen simplex chronicus and other conditions by the local injection of hydrocortisone acetate. Like Dr. Savitt, we also found that hydrocortisone acetate, when injected into the area of dermatitis, appeared to have a prolonged local anti-inflammatory effect. However, certain disadvantages were found inherent in this technique. In thickened, lichenified areas it was difficult to inject the solution superficially because of the resistance offered by the epidermis and the dermis.