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History, clinical presentation, therapy, and patient reported outcomes of mucosal lichen planus: a cross-sectional
Neda Cramer1, Daniel Kromer2, Julia M Bootsveld3
1Department of Dermatology, Venereology and Allergology, University Medical Center Göttingen, Göttingen, Germany.
Background And Objectives:
Mucosal lichen planus (LP) is a chronic inflammatory disease. The patient's journey can be arduous as diagnosis and therapy are challenging.
Patients And Methods:
In this cross-sectional study, a wide range of characteristics of the patient's journey were assessed and evaluated from a total of 72 patients with mucosal LP who were treated in the dermatology departments of six German university medical centers between 02/2022 and 07/2023.
Results:
On average, 18.1 months elapsed between the onset of symptoms and diagnosis. Until the correct diagnosis was made, an average of 3.1 different physicians of the same or different specialties were consulted. 28.1% of patients also had cutaneous involvement. Therapeutically, 68% of patients received at least one systemic drug. Both topical (90%, 65/72) and systemic (oral, 50% of patients, 36/72; intravenous, 33%, 24/72) glucocorticoids were most frequently used. Systemic agents were most often discontinued due to ineffectiveness (46%, 50/110). Satisfaction with treatment was highest for intravenous and topical glucocorticoids (moderate to high satisfaction: 59% and 36%, respectively), and lowest for retinoids with 8%.
Conclusions:
This study indicates that there might be a lack of diagnostic awareness among physicians and the unmet need for effective systemic treatment options.
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