Cutaneous Lichen Amyloidosis When Phototherapy Has Not Achieved Resolution
Clinical Scenario
Cutaneous lichen amyloidosis is characterised by persistent pruritus and papule formation. A structured treatment approach is required when initial therapy has failed to achieve the target goals of resolution of pruritus and reduction of papules.
Prior Treatment & Unmet Goals
Phototherapy — narrowband UVB (NbUVB), PUVA (topical psoralen with ultraviolet A), or Re-PUVA (acitretin combined with bath PUVA) — is a recognised first-line approach for cutaneous lichen amyloidosis. This protocol applies when that line has not achieved resolution of pruritus and reduction of papules, and a next step is indicated.
Next-Line Approach
For cutaneous lichen amyloidosis that has not responded adequately to phototherapy, an oral retinoid course is the treatment considered at this stage. The clinical goals — reduction of pruritus and flattening of the papules — are assessed over a defined treatment period. Specific agent selection, dosing, and the full protocol are available via the link below.
References
DOI: 10.4103/pigmentinternational.pigmentinternational_
Retinoids − Oral etretinate, 1 mg/kg/day, acitretin, 0.5 mg/kg/day, were reported to reduce pruritus and flatten the papules in LA.
Four to six months treatment is required to see results.
Oral isotretinoin and alitretinoin, were successfully used in LA.
View source ↗