griseofulvin and Lichen-Planus

Cutaneous lichen planus (CLP) is an inflammatory dermatosis. Its chronic relapsing course and frequently spontaneous regression hamper the assessment of treatment effectiveness.. To evaluate the efficacy of available treatment modalities for CLP.. PubMed, Cochrane Central Register of Controlled Trials (CENTRAL), ClinicalTrials.gov registry.. We performed a systematic review of the current literature. All randomized controlled trials, nonrandomized case-control studies, and cohort studies with more than one treatment arm were included. The primary outcomes were complete response and time to complete response. The secondary outcomes were partial response, relapse, time to relapse, reduction of itch, the adverse event rate, and withdrawal due to adverse events.. Sixteen studies met the inclusion criteria, of which 11 were randomized controlled trials. Most trials had a small sample size. In the rare studies in which variants other than generalized or classic lichen planus were included, they could not be analyzed separately. Body-of-evidence quality ranged from very low to moderate. Acitretin, sulfasalazine, and griseofulvin were associated with increased overall response rates in comparison with placebo. Narrow-band ultraviolet B radiation (NBUVB) was more effective than 6 weeks' low-dose prednisolone in achieving a complete response, and prednisolone was more effective than enoxaparin. Hydroxychloroquine was more effective than griseofulvin in achieving an overall response. Betamethasone valerate 0.1% ointment had comparable efficacy to calcipotriol ointment. Methotrexate was effective, with a nonsignificant difference in the complete response rate in comparison with oral betamethasone. In nonrandomized controlled trials, oral psoralen plus ultraviolet A photochemotherapy (PUVA) had comparable efficacy to a PUVA bath and NBUVB. Psoralen plus sunlight exposure (PUVASOL) and betamethasone dipropionate 0.05% cream were effective relative to a short course of oral metronidazole.. Several effective treatment options are available for CLP. Further well-designed studies are warranted to investigate the efficacy of topical glucocorticoids-the current first-line therapy-as well as other treatment modalities, and the treatment of different variants of CLP.

Topics: Acitretin; Administration, Cutaneous; Anti-Inflammatory Agents, Non-Steroidal; Antifungal Agents; Calcitriol; Dermatologic Agents; Enoxaparin; Female; Fibrinolytic Agents; Ficusin; Glucocorticoids; Griseofulvin; Humans; Keratolytic Agents; Lichen Planus; Male; Non-Randomized Controlled Trials as Topic; Photochemotherapy; Photosensitizing Agents; PUVA Therapy; Randomized Controlled Trials as Topic; Sulfasalazine; Treatment Outcome

Topics: Adrenal Cortex Hormones; Cyclosporine; Dapsone; Griseofulvin; Humans; Immunosuppressive Agents; Lichen Planus; Metronidazole; Phenytoin; PUVA Therapy; Retinoids

Topics: Adrenal Cortex Hormones; Griseofulvin; Hormones; Humans; Immunotherapy; Lichen Planus; Liver Extracts; Penicillin G; Penicillin G Benzathine; Tetracyclines; Vitamin A

Thirty-one patients who had lichen planus treated with griseofulvin were randomly selected for review from a group of patients with lichen planus seen at the Mayo Clinic between January 1976 and June 1980; two patients were excluded because of lack of adequate follow-up. Of the 11 patients with only oral lesions, 6 showed a marked improvement or complete remission. Of the 18 patients with lichen planus involving one or more sites with or without oral lesions, 15 had cutaneous lesions. Three of the 15 had improvement of their cutaneous lesions; however, 1 of the 3 continued to develop new lesions, although old ones were improving. In patients with recalcitrant, symptomatic oral lichen planus, a trial of griseofulvin would seem justified. Success in patients with cutaneous lichen planus is less likely; however, griseofulvin may afford relief in selected patients. This study indicates that further prospective studies are needed to clarify the efficacy of griseofulvin in lichen planus.

Topics: Adult; Aged; Clinical Trials as Topic; Female; Griseofulvin; Humans; Lichen Planus; Male; Middle Aged; Mouth Diseases; Retrospective Studies; Skin

In a double-blind trial on 44 patients having lichen planus, 500 mg griseofulvin-FP daily for 8 weeks produced significantly better results compared to a placebo. The clinical improvement was accompanied by corresponding histological changes.

Topics: Adolescent; Adult; Aged; Child; Clinical Trials as Topic; Double-Blind Method; Female; Griseofulvin; Humans; Lichen Planus; Male; Middle Aged; Skin; Time Factors

Topics: Adolescent; Adult; Aged; Aspirin; Bismuth; Child; Child, Preschool; Chloroquine; Chronic Disease; Clinical Trials as Topic; Drug Combinations; Drug Evaluation; Female; Griseofulvin; Humans; Isoniazid; Lichen Planus; Male; Middle Aged; Prednisolone

Topics: Adolescent; Adult; Child; Clinical Trials as Topic; Female; Griseofulvin; Humans; Lichen Planus; Male; Middle Aged; Placebos; Recurrence; Skin

Topics: Adult; Alopecia Areata; Antifungal Agents; Astringents; Griseofulvin; Humans; Lichen Planus; Male; Tinea; Zinc Sulfate

An open trial was conducted of systemic griseofulvin in the treatment of oral lichen planus. Eleven patients completed the trial. Symptomatic benefit was noted in 21% of the twenty-three patients starting the trial, but there was no clinical improvement, and about one half of the group starting the trial suffered adverse drug reactions.

Topics: Administration, Oral; Griseofulvin; Headache; Humans; Lichen Planus; Mouth Diseases; Nausea; Tablets; Treatment Failure

Lichen planus is one of the most common dermatologic diseases involving the skin and oral mucous membranes. It may occur anywhere in the oral cavity. Erosive lichen planus has been reported to undergo malignant transformation, making definitive diagnosis, treatment, and followup essential. The purpose of this study was to establish the effectiveness of griseofulvin therapy on erosive lichen planus and to provide an alternative to steroid therapy. The results of this study revealed that griseofulvin had little or no effect on pain, pigmentation, or disappearance of erosive lichen planus and did not protect the patient from further recurrences.

Topics: Adult; Aged; Female; Griseofulvin; Humans; Lichen Planus; Male; Middle Aged; Mouth Diseases; Pain; Recurrence

A 53-year-old woman initially had lichen planus primarily on her extremities. Approximately 1 year later, lesions consistent with erythema dyschromicum perstans were observed. Both diseases cleared with griseofulvin therapy but returned after discontinuation of the drug. Retreatment with griseofulvin again resulted in clearing.

Topics: Biopsy; Epidermis; Erythema; Female; Griseofulvin; Humans; Lichen Planus; Middle Aged; Prednisone; Skin Pigmentation

Topics: Griseofulvin; Humans; Lichen Planus; Male; Middle Aged; Mouth Diseases

Lichen planus of the oral cavity produces significant functional and symptomatic problems for elderly patients. Oral lesions often occur in the absence of concomitant skin lesions. Unlike cutaneous lesions, oral lesions of lichen planus may become a chronic, recurring problem that is difficult to control. The diagnostic features of lichen planus of the oral cavity are reviewed and treatment strategies presented. Periodic follow-up is recommended to monitor the disease process and to observe for the development of early squamous cell carcinoma.

Topics: Administration, Topical; Aged; Anti-Inflammatory Agents; Female; Glucocorticoids; Griseofulvin; Humans; Lichen Planus; Male; Mouth Diseases; Mouth Mucosa; Vitamin A

Seven patients with lichen planus of the oral mucosa (four with erosive and three with reticular types of the disease) were studied; they were treated with 500 mg of griseofulvin twice daily for 2 1/2 months. In no case was improvement observed; on the contrary, in four patients (two with erosive and two with reticular forms) the condition worsened.

Topics: Adult; Aged; Female; Follow-Up Studies; Griseofulvin; Humans; Lichen Planus; Male; Middle Aged; Mouth Diseases

We report three cases of erosive oral lichen planus treated with griseofulvin, 500 mg. twice a day. Subjective improvement was noticed in 3 weeks by two patients and at 6 weeks by the third patient. Objective improvement, however, was delayed and became apparent at 6 to 10 weeks. Continued improvement or remission without exacerbation was noted in all patients. There were no significant hematologic, hepatic, or other side effects in any patient, and complete blood count and blood chemistries remained normal at 1-month as well as 6-month intervals during therapy. All patients did, however, report mild, transient gastrointestinal discomfort during the first 2 days of therapy, and one patient mentioned a mild headache. These remitted after approximately 2 to 4 days. We believe that these preliminary findings warrant additional trials of griseofulvin therapy in the treatment of severely symptomatic oral lichen planus. The adverse effects of this agent appear considerably less than those of systemic steroids.

Topics: Aged; Female; Griseofulvin; Humans; Lichen Planus; Middle Aged; Mouth Diseases; Time Factors

Diffuse lichen planus, a rare disorder in children, was observed in an 8-year-old boy. Effective therapy in this disease remains a problem and currently relies predominantly on the use of the corticosteroids. The complications attendant with corticosteroid administration in children are discussed and a review of alternate modes of therapy for lichen planus is presented.

Topics: Adrenal Cortex Hormones; Adrenal Insufficiency; Child; Griseofulvin; Growth Disorders; Humans; Lichen Planus; Male; Pruritus; PUVA Therapy; Tretinoin; Vitamin A

Topics: Adult; Griseofulvin; Humans; Lichen Planus; Male; Nails

Topics: Adolescent; Adult; Biopsy; Female; Follow-Up Studies; Griseofulvin; Humans; Lichen Planus; Male; Middle Aged; Remission, Spontaneous

Topics: Adolescent; Adult; Aged; Child; Griseofulvin; Humans; Lichen Planus; Middle Aged

Topics: Female; Griseofulvin; Humans; Lichen Planus; Middle Aged; Nails; Triamcinolone

Topics: Griseofulvin; Humans; Lichen Planus