The Efficacy of Platelet-Rich Plasma in Facial Lichen Planus Pigmentosus: A Prospective Pilot Study

Lichen planus pigmentosus (LPP) is an uncommon variant of lichen planus which most commonly affects middle-aged individuals with skin of color. Despite multiple treatment modalities available for LPP, their efficacies are unpredictable and often disappointing. In this study, we aimed to investigate the use of platelet-rich plasma (PRP) as a novel therapy for LPP.

Twelve patients received three sessions of intradermal PRP injection at a 2-week interval. Week 0, 2 and 4 were treatment sessions, while Week 6, 8 and 12 were follow-up visits. Mean melanin index (MI), physician global assessment (PGA) and clinical photographs were assessed at Week 0, 2, 4, 6, 8, and 12, while quartile grading scale (QGS) and patient satisfaction were evaluated at Week 2, 4, 6, 8, and 12. Adverse effects were also recorded.

Initial mean MI was 448.19 (18.76) and declined to 409.64 (19.13) at week 12 (p = 0.045). Clinical improvement as evidenced by an increase in mean QGS from Week 2 to Week 12, and a reduction on average PGA score from 3.04 at baseline to 2.21 at Week 6, 2.04 at Week 8, and 2.23 at Week 12, was observed. At Week 12, 5 patients (41.67%) reported more than 50% improvement of LPP lesions.The adverse effects were minimal, consisting primarily of swelling and bruising, which resolved on their own within a few days without the need for treatment.

We report the first pilot study utilizing PRP for LPP treatment. The pilot study indicated that PRP significantly improved facial LPP lesions with no significant side effects. Further well-designed studies with a larger sample size, longer follow-up duration and possible longer treatment times are necessary to confirm this preliminary observation.

Thai Clinical Trials Registry identification number: TCTR20230202004 (https://www.thaiclinicaltrials.org/show/TCTR20230202004) approved on 02 February 2023.