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Oral lichen planus treated with alitretinoin (Alitoc®): A case report
( Sewon Hwang ),( Jihong Lim ),( Yuri Woo ),( Miri Kim ),( Hyun Jeong Park ) 대한피부과학회 2016 대한피부과학회 학술발표대회집 Vol.68 No.1
Lichen planus (LP) is a chronic inflammatory mucocutaneous disease. Oral lesions, compared with cutaneous lesions, rarely undergo spontaneous remission. Clinical classification of oral LP consists of 3 types of lesions: reticular, atrophic or erythematous and erosive LP. Alitretinoin is an endogenous vitamin A derivative, 9-cis-retinoic acid. It is a pan-agonist of both known nuclear retinoid receptor families: retinoic acid receptors (RAR) and retinoid X receptors (RXR). Alitretinoin, compared to acitretin or isotretinoin, is expected to be more effective in retinoid-responsive dermatoses such as LP due to its dual receptor activity. We present a case of 48-year-old man who had painful erythematous crusted erosions on the lip for 6 months. Histopathologically, the lesion showed hyperkeratosis in the epidermis and lichenoid perivascular lymphohistiocytic infiltration in the dermis. He was diagnosed with oral LP. He was treated with oral steroid and cyclosporin combined with topical tacrolimus for 6 months but the lesion remained without much improvement. Oral steroid and cyclosporine were discontinued and oral alitretinoin (Alitoc®) was started in a dose of 30mg daily. Within 3 weeks of taking oral alitretinoin (Alitoc®), the erythematous scales had disappeared without noticeable adverse effect. To our knowledge, this is the first case report of oral LP treated with alitretinoin in the Korean literature.