Prevalence and Treatment Patterns of Lichen Planus.

Background: Lichen planus (LP) is a chronic mucocutaneous inflammatory disease with significant morbidity but data on epidemiology and therapeutics for LP is limited.

Objective: Describe overall prevalence of LP and dermatologist-prescribed LP treatments in US adults.

Methods: Using the Explorys database, we analyzed prevalence of overall LP and dermatologists' utilization of medications of interest.

Results: Among 566,851 eligible patients in the prevalence analysis, there were 1,098 LP cases with a median age of 66 years. Overall crude prevalence of LP was 0.19% (95% CI 0.18-0.21) with higher prevalence in females (prevalence ratio vs. males 1.77, 95% CI 1.53-2.05). Standardized overall prevalence was 0.15%. Most LP patients diagnosed by dermatologists remained untreated after one year (n=1,061, 53%); the most common initial treatment was topical corticosteroids (38%). Treatment continuation after 1 year and switching were most common after initial use of systemic immunosuppressants (28% and 46%, respectively).

Limitations: The lack of a precise diagnosis code for non-oral LP allows for the potential of misclassification; disease severity cannot be established.

Conclusions and relevance: Standardized prevalence of overall LP was 0.15%. For patients requiring systemic immunosuppressive medications, treatment continuation and switching were more common, suggesting that further research into medication selection for LP may be clinically beneficial.