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TOPLINE:

A survey of US dermatologists revealed low screening rates for common comorbidities in patients with lichen planus (LP), with significant reliance on topical treatments.

METHODOLOGY:

• An anonymous survey with questions about LP management was distributed to 2340 dermatology practitioners in the United States.
• A total of 406 respondents (17.4%) completed the survey and reported treating an average of 2.48 new patients with LP and an average of 2.66 follow-up cases every month. Cutaneous LP was the most common, followed by oral, genital, and nail LP; nearly 65% of cases were mild to moderate.
• Participants included attending physicians (42.4%), resident physicians (40.6%), physician assistants (12.6%), and nurse practitioners (3.0%). Most were in a group practice (36%) or an academic institution/Veterans Affairs setting (35.2%).
• Screening practices for various comorbidities and treatment modalities were evaluated based on reported prescribing patterns.

TAKEAWAY:

• Overall, 67.5% of respondents reported screening patients with LP for comorbidities and screened for an average of 5.12 conditions. Screening decisions and treatment patterns were influenced by training levels and practice type.
• Among those who did screen patients, hepatitis C virus was the most screened condition (91.0%), followed by hepatitis B virus (52.9%), and diabetes mellitus (33.5%). Screening rates were low for thyroid disorders (30.6%), HIV (30.2%), depression (18.7%), anxiety (17.3%), malignancy (16.9%), hypertension (10.1%), and dyslipidemia (9.7%).
• Topical corticosteroids (97.8%), topical calcineurin inhibitors (67.7%), and intralesional corticosteroids (64.8%) were the most commonly prescribed treatments, followed by oral immunosuppressants (50.6%), narrowband UVB (40.7%), and topical vitamin D analogues (33.3%).
• A significant portion of dermatologists (25.6%) believed that US Food and Drug Administration (FDA)–approved treatments for LP exist, although none of the various treatments used for LP are FDA-approved.

IN PRACTICE:

“The relatively low screening rates for many common comorbidities and relatively high screening rates for uncommon conditions highlight a gap in comprehensive, evidence-based management,” and knowledge gaps “extend to the misperception regarding the availability of FDA-approved therapies for LP,” the study authors wrote. They advocated for standardized guidelines for the management of LP “to reduce variability in management practices and improve patient outcomes.”

SOURCE:

The study was led by Savanna I. Vidal, Department of Dermatology, George Washington University School of Medicine and Health Sciences, Washington, DC, and was published online on April 24 in Dermatology and Therapy.

LIMITATIONS:

The survey did not capture the nuances of treatment decisions for specific LP subtypes. The use of gift cards as incentives for the first 200 respondents may have influenced participation patterns. Self-reported data was a limitation.

DISCLOSURES:

No funding was received for this study. Research grants to Vidal and another author from Galderma, Incyte, and Johnson & Johnson supported this work.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.