Systematic review of lichen planus treatments for pediatric patients

Summary: Abstract Body: Although corticosteroids are commonly used as first-line therapy of pediatric Lichen Planus (LP), detailed data on specific agents, dosages, and treatment durations are lacking in the current literature; this systematic review seeks to address literature gaps by synthesizing evidence on topical, systemic, and procedural treatments of pediatric classic cutaneous LP. Article databases were searched for treatments of pediatric LP, following PRISMA guidelines. 934 articles were identified for screening and 32 articles were included in the review. Topical steroids were the most frequently reported treatment. 5 studies reported symptom resolution with 4-8 weeks of clobetasol 0.05%. One study reported symptom improvement in 17 patients with triamcinolone acetonide 0.1% ointment for 8 weeks. One clinical trial of 31 patients reported improvement in 68% of patients with fluticasone propionate 0.005% ointment for 8 weeks. Oral prednisolone was reported in 9 studies with dosages ranging from 5mg to 30mg and durations ranging from 2 weeks to 1 year; 66.6% of these studies reported complete symptom resolution. Tacrolimus was reported in 5 studies, all of which resulted in lesion resolution. UVB phototherapy was reported in 5 studies with duration ranging from 15-17 sessions, and 40% of these studies reported complete response. Immunomodulators were reported in 5 studies, including upadacitinib, cyclosporine, sulfasalazine, and azathioprine. Recently published reviews highlight treatment approaches for LP subtypes like oral, nail, and lichen planus pigmentosus, but current literature lacks a comprehensive review of treatment options for classic LP in children. While topical corticosteroids remain the cornerstone of pediatric LP treatment, emerging modalities like immunomodulators and phototherapy hold promise but require further validation. Kareena Garg¹, Ben Gratz², Bahar Lakeh², Nesreen Shahrour², Leonardo Tjahjono³ 1. Department of Dermatology, Georgetown University School of Medicine, Washington, DC, United States. 2. Georgetown University School of Medicine, Washington, DC, United States. 3. Department of Dermatology, The George Washington University School of Medicine and Health Sciences, Washington, DC, United States. Clinical Research: Interventional Research