Vitamin A acid in lichen planus

Since 1971, Vitamin A acid (VAA) has been used for topical treatment of lichen planus (L.p.) at the 2nd Department of Dermatology in Vienna. During this period, 43 patients have been treated in the following way: for a period up to 3 weeks, a 0.05% or 0.1% VAA cream or solution was applied twice daily to the affected skin or mucosa. In the first days of this therapy, a characteristic local reaction of the L.p. lesions could be observed; first an edematous swelling appeared, followed by scaling and regression of efflorescences. Finally, an inflammatory skin reaction also developed. At this juncture, VAA was abandoned and the treatment was continued with steroid-containing ointments. Occlusive dressings were used only in cases of hypertrophic L.p. The same therapy was performed in L.p. of mucous membranes. By this method it was possible to achieve good therapeutical results in all treated cases. However, the frequency of recurrences of L.p. could not be diminished.