Extragenital lichen sclerosus: a case report and successful treatment with the combination of narrowband ultraviolet-B phototherapy and acitretin

Authors

  • Pattareewan Rojanapanthu Division of Dermatology, Phramongkutklao Hospital, Bangkok
  • Julphat Intarasupt Division of Dermatology, Phramongkutklao Hospital, Bangkok

Keywords:

extragenital lichen sclerosus, narrowband ultraviolet B phototherapy

Abstract

Extragenital lichen sclerosus is a rare benign chronic inflammatory dermatosis. The pathogenesis is not fully elucidated. The characteristic findings are porcelain-white papules that may coalesce into a scar-like pattern. We report a 70-year-old Thai woman who presented with a five-year-history of asymptomatic whitish spots on the trunk and both thighs. The lesions gradually increased in numbers and size. Skin biopsy was compatible with lichen sclerosus. The initial treatment with topical steroid and topical calcipotriol were unsuccessful. Finally, we used a combination therapy of narrowband ultraviolet B phototherapy (NB-UVB) and acitretin with excellent outcome.

References

1. Hallopeau H. Leçons cliniques sur les maladies cutanées et syphilitique. L’Union Medicale 1887; 43: 742 –747.

2. Lacarrubba F, Pellacani G, Verzì AE, Pippione M, Micali G. Extragenital lichen sclerosus: Clinical, dermoscopic, confocal microscopy and histologic correlation. J Am Acad Dermatol 2015; 72: S50-2

3. Sauder MB, Linzon-Smith J, Beecker J. Extragenital bullous lichen sclerosus. J Am Acad Dermatol 2014; 71: 981-4.

4. Patel B, Gupta R, Vora VR. Extra Genital Lichen Sclerosus et Atrophicus With Cutaneous Distribution and Morphology Simulating Lichen Planus. Indian J Dermatol 2015; 60: 105.

5. Fistarol SK, Itin PH. Diagnosis and treatment of lichen sclerosus: an update. Am J Clin Dermatol 2013; 14: 27–47.

6. Colbert RL, Chiang MP, Carlin CS, Fleming M. Progressive Extragenital Lichen Sclerosus Successfully Treated With Narrowband UV-B Phototherapy. Arch Dermatol 2007; 143: 19-20.

7. Ganesan L, Parmar H, Das JK, Gangopadhyay A. Extragenital Lichen Sclerosus et Atrophicus. Indian J Dermatol 2015; 60: 420.

8. Sander CS, Ali I, Dean D, Thiele JJ, Wojnarowska F. Oxidative stress is implicated in the pathogenesis of lichen sclerosus. Br J Dermatol 2004; 151: 627-35.

9. Knio Z, Kurban M, Abbas O. Lichen sclerosis: clinicopathological study of 60 cases from Lebanon. Int J Dermatol 2016; 55: 1076-81.

10. Larre Borges A, Tiodorovic-Zivkovic D, Lallas A, et al. Clinical, dermoscopic and histopathologic features of genital and extragenital lichen sclerosus. J Eur Acad Dermatol Venereol 2013; 27: 1433-9.

11. Anderson K, Ascanio NM, Kinney MA, Krowchuk DP, Jorizzo JL. A retrospective analysis of pediatric patients with lichen sclerosus treated with a standard protocol of class I topical corticosteroid and topical calcineurin inhibitor. J Dermatolog Treat 2015; 3: 1-3.

12. Kirtschig G, Cooper S, Aberer W, et al. Evidencebased (S3) Guideline on (anogenital) Lichen sclerosus. J Eur Acad Dermatol Venereol 2017; 31: e81-e83.

13. Kirtschig G. Lichen Sclerosus-Presentation, Diagnosis and Management. Dtsch Arztebl Int 2016; 113: 337-43.

14. Bookout AL. Extragenital lichen sclerosus treated with desoximetasone and calcitriol. J Am Acad Dermatol 2011; 64: AB53.

Published

2017-12-01

How to Cite

Rojanapanthu, P., & Intarasupt, J. (2017). Extragenital lichen sclerosus: a case report and successful treatment with the combination of narrowband ultraviolet-B phototherapy and acitretin. Thai Journal of Dermatology, 33(4), 336–341. Retrieved from https://he02.tci-thaijo.org/index.php/TJD/article/view/159129