Etretinate reduces connective tissue degeneration in lichen sclerosus et atrophicus

Retinoids have effects on the metabolism of keratinization and on the metabolism of connective tissue. Recent results have indicated that they may be helpful for treating dermatological diseases which involve marked connective tissue changes such as scleroderma, keloids and actinic skin damage. In addition, retinoids have been shown to reduce the clinical and histological alterations occurring in vulvar lichen sclerosus. For these reasons, etretinate was tried in a patient with extensive lichen sclerosus et atrophicus (LSA). Clinical improvement was seen after three months' treatment, i.e. a decrease in pruritus and softening of the skin. The degenerated zone in the lesional skin was shown by histological analyses to have reduced markedly. The immunohistochemistry, with unaltered staining for type III procollagen and fibronectin, disclosed no signs of enhanced collagen synthesis. Thus the reparation mechanism remained obscure.