The erosive variant of lichen planus (LP) is an infrequent but disabling disease that can lead to a major functional impairment of the affected areas, mainly the mucous membranes and the extremities. This pathological condition is a therapeutic challenge as usual treatments of the common forms of LP are most often ineffective (retinoids, photochemotherapy, local and systemic corticosteroids). We report 2 cases of severe acral erosive LP previously unresponsive to multiple therapeutic attempts and dramatically improved by thalidomide, a drug not classically used in this indication.
Report of Cases.Case 1.
A 60-year-old woman was referred in 1985 for a severe, hepatitis C—negative, erosive LP that involved the lips, tongue, and extremities, leading to a nearly complete functional impairment of these areas. High-potency local corticosteroids, systemic steroids, total-body photochemotherapy, etretinate, dapsone, and cyclosporin A resulted in a very limited or transient improvement and/or unbearable side effects.
Dereure O, Basset-Seguin N, Guilhou J. Erosive Lichen Planus: Dramatic Response to Thalidomide. Arch Dermatol. 1996;132(11):1392-1393. doi:10.1001/archderm.1996.03890350136031