Nodular Lichen (Lichen Ruber Planus): Therapy

General measures

  • Avoid dehydration and irritation of the skin by balancing skin care. Suitable care products are oily skin care products.
  • Avoiding strong mechanical stress on the skin.
  • Avoid synthetic underwear. This is not very breathable and promotes a moist environment. Instead, wear loose cotton clothing.
  • Nicotine restriction (refrain from tobacco use), including avoidance of passive smoking for children.
  • Limited alcohol consumption (men: max. 25 g alcohol per day; women: max. 12 g alcohol per day).
  • Aim for normal weight! Obesity promotes the area and friction in the intertrigines (skin areas including in the armpit, in the groin region, in the back of the knee).Determination of BMI (body mass index, body mass index) or body composition by means of electrical impedance analysis and, if necessary, participation in a medically supervised weight loss program.
  • Avoidance of psychosocial stress:
    • Stress
  • Avoidance of environmental stress:
    • Avoidance of chemical and mechanical skin irritation.

Conventional non-surgical therapy methods

  • One possible form of treatment is PUVA (psoralen plus UV-A) as PUVA bath therapy. This involves applying a substance called psoralen to the affected skin area, which sensitizes the skin to sunlight and UV radiation, and then irradiating it with UVA light.
  • Indication: for extensive, especially disseminated (“scattering”) forms of lichen ruber planus.
  • Contraindications: increased photosensitivity, increased risk of skin cancer, ciclosporin (cyclosporin A), pregnancy / lactation; relative: seizure disorders, photosensitizing drugs, skin malignancies in the anamnesis, limitation of physical / psychological resilience, compliance ↓; relative for PUVA: severe liver damage, Z. n. therapy with ionizing radiation, arsenic, high cumulative UVA dose.
  • Side effects: Skin irritation with erythema (skin redness), itching; hyperpigmentation, blistering; oral PUVA: nausea.
  • Furthermore, re-PUVA therapy (PUVA + acitretin) or systemic PUVA therapy is possible.
  • The therapy shows success in about 80-90% of cases.

Psychotherapy