Second-Line Treatment of Cutaneous Lichen Planus
When cutaneous lichen planus does not respond adequately to initial management, a structured second-line approach is required. This protocol addresses that escalation step.
Clinical Situation
This protocol is indicated for patients with cutaneous lichen planus at the second-line treatment stage — where the condition warrants escalation beyond first-line measures and a more targeted intervention is needed.
Second-Line Treatment Approach
Second-line options include phototherapy-based strategies and certain topical or systemic agents. The full protocol specifies which interventions apply, in what sequence, and under what conditions — access it below.
References
DOI: 10.1111/jdv.16464
- Broadband or narrowband UVB.
- Combination of UV and acitretin
- Topical calcineurin inhibitors (tacrolimus, pimecrolimus – twice/day for 1–2 months)
- Sulphasalazine, initial dose of 1.5 g/day increased by 0.5 g/week to 3 g/day for 4–16 weeks
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