Prevalence and treatment patterns of lichen planus

Lichen planus (LP) is a chronic mucocutaneous inflammatory disease with significant morbidity but data on epidemiology and therapeutics for LP is limited.

To describe overall prevalence of LP and dermatologist-prescribed LP treatments in US adults.

Using the Explorys database, we analyzed prevalence of overall LP and dermatologists' utilization of medications of interest.

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).

The lack of a precise diagnosis code for nonoral LP allows for the potential of misclassification; disease severity cannot be established.

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.