Novel Insights from Clinical Practice

Duplaine A. · Cogrel O.

Author affiliations

Department of Dermatology, Hôpital Saint-André, CHU de Bordeaux, Bordeaux, France

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Article / Publication Details

First-Page Preview

Received: January 09, 2022
Accepted: March 12, 2022
Published online: April 27, 2022

Number of Print Pages: 4
Number of Figures: 1
Number of Tables: 1

ISSN: 2296-9195 (Print)
eISSN: 2296-9160 (Online)

For additional information: https://www.karger.com/SAD

Abstract

Introduction: Recent expert recommendations suggest mycophenolate mofetil (MMF) as a third-line therapy, in severe corticosteroid-dependent or corticosteroid-resistant nail lichen planus (NLP). However, there is currently no literature to support MMF use in this indication. This is a retrospective monocentric French case series of 5 patients with severe corticodependant or corticoresistant NLP treated by oral MMF (2–3 g/day), between 2013 and 2021. Case Presentation: The primary outcome was therapeutic success in a target fingernail. All 5 patients showed some clinical improvement, ranging from mild improvement (1/5) to clinical cure (2/5). Clinical improvement was more significant when the drug was taken for a longer period (24 months vs. 4 months) and at a higher dose (3 g/day vs. 2 g/day). Relapse occurred after stopping or tapering the MMF dose. MMF was well tolerated. Discussion/Conclusion: MMF may be a treatment to consider for severe corticosteroid-dependent or corticosteroid-resistant NLP. The long-term safety of this treatment warrants further investigation.

© 2022 S. Karger AG, Basel

References Le Cleach L, Chosidow O. Clinical practice. Lichen planus. N Engl J Med. 2012;366:723–32. Hrin ML, Bashyam AM, Huang WW, Feldman SR. Mycophenolate mofetil for the treatment of cutaneous lichen planus: a retrospective case series. J Am Acad Dermatol. 2021 Apr;84(4):1091–4. Frieling U, Bonsmann G, Schwarz T, Luger TA, Beissert S. Treatment of severe lichen planus with mycophenolate mofetil. J Am Acad Dermatol. 2003;49:1063–6. Iorizzo M, Tosti A, Starace M, Baran R, Daniel CR 3rd, Di Chiacchio N, et al. Isolated nail lichen planus: an expert consensus on treatment of the classical form. J Am Acad Dermatol. 2020;83(6):1717–23. Page S, Tait CP. Mycophenolic acid in dermatology a century after its discovery. Australas J Dermatol. 2015;56(1):77–83. Phan K, Smith SD. Mycophenolate mofetil and atopic dermatitis: systematic review and meta-analysis. J Dermatolog Treat. 2020;31:810–4. Article / Publication Details

First-Page Preview

Received: January 09, 2022
Accepted: March 12, 2022
Published online: April 27, 2022

Number of Print Pages: 4
Number of Figures: 1
Number of Tables: 1

ISSN: 2296-9195 (Print)
eISSN: 2296-9160 (Online)

For additional information: https://www.karger.com/SAD

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