Oral Lichen Planus and Apremilast: Case Series and Literature Review
Description
Background: Apremilast is a phosphodiesterase-four inhibitor approved for the treatment of psoriasis, psoriatic arthritis, and oral ulcers in Behcet’s disease. The drug has gained increasing popularity in the treatment of lichen planus. Objective: Describe outcomes in patients with oral lichen planus managed with apremilast at our practice and in the literature. Methods: This is a retrospective single-center case series and literature review. “Lichen planus and apremilast” was searched in PubMed and two authors reviewed the abstracts. Additionally, we searched Embase using the query, “apremilast for oral lichen planus”. Results: Six patients were identified; two were treated with "swish-and-spit" apremilast, two with oral 30 mg twice daily, and two received both formulations. All experienced clinical improvement, often exceeding that of topical corticosteroids or other anti-inflammatories. Literature review also identified 58 cases across nine published articles. Limitations: This retrospective case series is limited by small population size, the presence of confounding factors, and recall, selection, and observer bias. Conclusions: Apremilast may be effective and well-tolerated for oral lichen planus, warranting further investigation.
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Institutions
- University of Arizona College of Medicine- PhoenixArizona, Phoenix