Efficacy

Topical retinoic acid

We found a few open studies lacking details on dosage and clinical evaluation, and two studies comparing 0-1% retinoic acid with placebo. The first was not randomised.26 Of 23 patients with atrophic-erosive lesions treated with tretinoin, 71% improved compared with 29% in 15 patients receiving the vehicle. Relapses were common after 3 months.

The second study27 was randomised and double-blind and included 10 patients in each group, all with plaque-like LP lesions. After 4 months of therapy, nine patients in the tretinoin group had improved or were cured compared with four in the placebo group. The diminution of the lesions was 91% in the tretinoin group and 21% in the placebo group.

Isotretinoin gel

One RCT compared isotretinoin gel with excipient alone for 2 months in 20 patients.28 The improvement in scores was 90% and 10%, respectively.

Etretinate

We found five open studies and one small RCT.3 The five open studies included 58 patients. The initial dosage ranged from 0-6 to 1 mg/kg/day, for various durations. A good outcome (without precise criteria) was reportedly obtained in four of the five studies. In one study of 10 patients, efficacy was minimal and was considered to be outweighed by side-effects. The RCT29 included 28 patients with severe oral LP who were treated with etretinate, 75 mg/day, or placebo for 2 months, followed by crossover to etretinate in nine cases. Improvement (reduction of more than 50% of the erosions and infiltration) was observed in 93% of lesions in the etretinate

Do retinoids improve oral LP?

Do systemic corticosteroids improve oral LP?

group compared with 5% of controls. Three months after the end of treatment 66% of the patients had relapsed.

Oral tretinoin and oral isotretinoin

We found only three open studies of different dosages of oral tretinoin and anecdotal reports of oral isotretinoin.3

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