Journal of the American Academy of Dermatology · 2024
Prevalence and treatment patterns of lichen planus.
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Pelet Del Toro Natalia, Strunk Andrew, Garg Amit, Han George
Аннотация
BACKGROUND: Lichen planus (LP) is a chronic mucocutaneous inflammatory disease with significant morbidity but data on epidemiology and therapeutics for LP is limited.
OBJECTIVE: To describe overall prevalence of LP and dermatologist-prescribed LP treatments in US adults.
METHODS: Using the Explorys database, we analyzed prevalence of overall LP and dermatologists' utilization of medications of interest.
RESULTS: Among 566,851 eligible patients in the prevalence analysis, there were 1098 LP cases with a median age of 66 years. Overall crude prevalence of LP was 0.19% (95% CI 0.18-0.21) with higher prevalence in females (prevalence ratio vs males 1.77, 95% CI 1.53-2.05). Standardized overall prevalence was 0.15%. Most LP patients diagnosed by dermatologists remained untreated after 1 year (n = 1061, 53%); the most common initial treatment was topical corticosteroids (38%). Treatment continuation after 1 year and switching were most common after initial use of systemic immunosuppressants (28% and 46%, respectively).
LIMITATIONS: The lack of a precise diagnosis code for nonoral LP allows for the potential of misclassification; disease severity cannot be established.
CONCLUSIONS AND RELEVANCE: Standardized prevalence of overall LP was 0.15%. For patients requiring systemic immunosuppressive medications, treatment continuation and switching were more common, suggesting that further research into medication selection for LP may be clinically beneficial.
OBJECTIVE: To describe overall prevalence of LP and dermatologist-prescribed LP treatments in US adults.
METHODS: Using the Explorys database, we analyzed prevalence of overall LP and dermatologists' utilization of medications of interest.
RESULTS: Among 566,851 eligible patients in the prevalence analysis, there were 1098 LP cases with a median age of 66 years. Overall crude prevalence of LP was 0.19% (95% CI 0.18-0.21) with higher prevalence in females (prevalence ratio vs males 1.77, 95% CI 1.53-2.05). Standardized overall prevalence was 0.15%. Most LP patients diagnosed by dermatologists remained untreated after 1 year (n = 1061, 53%); the most common initial treatment was topical corticosteroids (38%). Treatment continuation after 1 year and switching were most common after initial use of systemic immunosuppressants (28% and 46%, respectively).
LIMITATIONS: The lack of a precise diagnosis code for nonoral LP allows for the potential of misclassification; disease severity cannot be established.
CONCLUSIONS AND RELEVANCE: Standardized prevalence of overall LP was 0.15%. For patients requiring systemic immunosuppressive medications, treatment continuation and switching were more common, suggesting that further research into medication selection for LP may be clinically beneficial.