Efficacité de la photochimiothérapie extracorporelle dans le traitement du lichen plan érosif : étude rétrospective Publication date: Available online 21 June 2019 Source: Annales de Dermatologie et de Vénéréologie Author(s): E. Birckel, D. Lispker, B. Cribier RésuméIntroductionLe lichen plan érosif de la peau et des muqueuses est une maladie invalidante qui a des répercussions sur la qualité de vie des patients et dont la prise en charge n’est pas codifiée. Nous rapportons les données rétrospectives d’efficacité de la photochimiothérapie extracorporelle (PCE) comme traitement du lichen érosif chez 11 patients.Patients et méthodesNous avons traité par PCE dix femmes et un homme ayant un lichen érosif résistant à en moyenne deux traitements antérieurs. La PCE était administrée en deux séances, deux jours consécutifs toutes les deux semaines en début de traitement, puis les cycles étaient espacés. Le critère de jugement principal était l’efficacité clinique partielle ou complète.RésultatsLa PCE a eu un effet positif chez les 11 malades. On constatait 6 rémissions complètes et 5 réponses partielles. La rémission complète était obtenue en 5,5 mois en moyenne ; l’amélioration des symptômes était plus précoce. Les rechutes à l’espacement ou à l’arrêt des séances de PCE étaient fréquentes ; la reprise de la PCE était à nouveau efficace.DiscussionNotre étude renforce les données de la littérature, issues de 28 observations déjà publiées. L’efficacité et l’amélioration des symptômes sont précoces. La PCE est un traitement habituellement bien toléré, avec un seul arrêt volontaire dans notre étude, mais elle impose des contraintes horaires, techniques et de coût. Ces contraintes et la fréquence des rechutes posent la question de la durée du traitement. Le schéma de traitement initial de la PCE ne semble pas modifier le délai pour obtenir la rémission du lichen plan érosif.SummaryIntroductionErosive lichen planus of the skin and mucosa is an invalidating disease that impacts the quality of life of patients and for which there is no codified treatment. Herein we report retrospective efficacy data for extracorporeal photopheresis (ECP) in the treatment of erosive lichen planus in 11 patients.Patients and methodsWe treated 10 women and 1 man with PCE for erosive lichen planus refractory on average to two previous treatments. PCE was administered in two sessions on two successive days every two weeks at the start of treatment, followed by more widely spaced cycles. The primary evaluation criterion was partial or complete clinical efficacy.ResultsPCE had a positive effect on all 11 patients. We noted 6 complete remissions and 5 partial remissions. Complete remission was achieved within a mean 5.5 months, with improvement in symptoms occurring earlier. Relapse was frequent during the intervals between PCE sessions and on discontinuation of treatment but resumption of PCE once again proved effective.DiscussionOur study supports the data in the literature from 28 published cases. Treatment efficacy and improvement in symptoms were rapidly apparent. PCE is generally a well-tolerated treatment, with only one patient dropping out of our study, but it imposes certain scheduling, technical and cost constraints. These constraints and the frequency of relapse underscore the question of treatment duration. The initial therapeutic schedule for PCE does not appear to modify the times required to achieve remission of erosive lichen planus. |
Medicine by Alexandros G. Sfakianakis,Anapafseos 5 Agios Nikolaos 72100 Crete Greece,00302841026182,00306932607174,alsfakia@gmail.com,
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Τετάρτη 10 Ιουλίου 2019
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Medicine by Alexandros G. Sfakianakis,Anapafseos 5 Agios Nikolaos 72100 Crete Greece,00302841026182,00306932607174,alsfakia@gmail.com,
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Ετικέτες
00302841026182,
00306932607174,
alsfakia@gmail.com,
Anapafseos 5 Agios Nikolaos 72100 Crete Greece,
Medicine by Alexandros G. Sfakianakis
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