Iraji Fariba, Faghihi Gita, Asilian Ali, Siadat Amir Hossein, Larijani Fatemeh Taghavi, Akbari Mojtaba
Professor, Skin Diseases and Leishmaniasis Research Center, Isfahan University of Medical Sciences, Isfahan, Iran.
J Res Med Sci. 2011 Dec;16(12):1578-82.
Lichen planus is recognized as an inflammatory disease of the skin with different morphologic patterns. Different treatment modalities, including topical and systemic corticosteroids, methotrexate, cyclosporine, azathioprine, topical calcineurin inhibitors, and psoralen plus UVA (PUVA), have been suggested for lichen planus. Although the efficacy of narrowband UVB (NBUVB) for treatment of lichen planus has been shown, no randomized clinical trial has compared NBUVB versus systemic corticosteroids for treatment of the disease. In the current study, we evaluated the efficacy of NBUVB versus systemic corticosteroids in the treatment of the lichen planus.
Forty-six patients with confirmed diagnosis of lichen planus were randomly selected. The subjects were randomized into two groups of 23 to be treated with either systemic corticosteroids or NBUVB. All of the selected cases had generalized lichen planus that involved at least 20% of the body area and their pruritus was resistant to antihistamine drugs. Patients in the systemic corticosteroids group were treated with prednisolon 0.3 mg/kg for 6 weeks. NBUVB was performed three times a week for 6 weeks. The maximum dose of NBUVB was 9 J/cm(2). Data regarding demographic characteristics of the patients was also collected. All collected data was analyzed using SPSS(15) and statistical tests including analysis of variance (ANOVA), chi-square, and t-test.
46 patients (23 patients in systemic steroid group and 23 patients in NBUVB group) were evaluated. There was a significant difference between the 2 groups regarding the efficacy of the treatment. According to chi-square test, NBUVB was significantly more effective than systemic steroid in treatment of generalized lichen planus (p = 0.008). According to the results, patient satisfaction was also significantly higher in the group treated with NBUVB as compared with the systemic corticosteroids (p = 0.012).
Overall, the results of our study and other previous studies showed that NBUVB may be regarded as an effective treatment for generalized cutaneous lichen planus. This treatment may be especially utilized when there is contraindication for systemic corticosteroids or other immunosuppressive drugs.
扁平苔藓被认为是一种具有不同形态学模式的皮肤炎症性疾病。针对扁平苔藓，已提出了不同的治疗方式，包括局部和全身使用皮质类固醇、甲氨蝶呤、环孢素、硫唑嘌呤、局部钙调神经磷酸酶抑制剂以及补骨脂素加紫外线A（PUVA）。尽管已证明窄谱中波紫外线（NBUVB）治疗扁平苔藓的疗效，但尚无随机临床试验比较NBUVB与全身皮质类固醇治疗该疾病的效果。在本研究中，我们评估了NBUVB与全身皮质类固醇治疗扁平苔藓的疗效。
随机选择46例确诊为扁平苔藓的患者。将受试者随机分为两组，每组23例，分别接受全身皮质类固醇或NBUVB治疗。所有入选病例均为泛发性扁平苔藓，累及身体面积至少20%，且其瘙痒对抗组胺药耐药。全身皮质类固醇组的患者接受泼尼松龙0.3mg/kg治疗6周。NBUVB每周进行3次，共6周。NBUVB的最大剂量为9J/cm²。还收集了患者的人口统计学特征数据。所有收集的数据均使用SPSS（15）进行分析，并采用方差分析（ANOVA）、卡方检验和t检验等统计方法。
对46例患者（全身类固醇组23例，NBUVB组23例）进行了评估。两组在治疗效果方面存在显著差异。根据卡方检验，NBUVB在治疗泛发性扁平苔藓方面明显比全身类固醇更有效（p = 0.008）。根据结果，与全身皮质类固醇治疗组相比，接受NBUVB治疗组的患者满意度也显著更高（p = 0.012）。
总体而言，我们的研究结果和其他先前的研究表明，NBUVB可被视为泛发性皮肤扁平苔藓的有效治疗方法。当存在全身皮质类固醇或其他免疫抑制药物的禁忌证时，尤其可采用这种治疗方法。
