History, clinical presentation, therapy, and patient reported outcomes of mucosal lichen planus: a cross-sectional study

Background and Objectives

Mucosal lichen planus (LP) is a chronic inflammatory disease. The patient's journey can be arduous as diagnosis and therapy are challenging.

Patients and Methods

In this cross-sectional study, a wide range of characteristics of the patient's journey were assessed and evaluated from a total of 72 patients with mucosal LP who were treated in the dermatology departments of six German university medical centers between 02/2022 and 07/2023.

Results

On average, 18.1 months elapsed between the onset of symptoms and diagnosis. Until the correct diagnosis was made, an average of 3.1 different physicians of the same or different specialties were consulted. 28.1% of patients also had cutaneous involvement. Therapeutically, 68% of patients received at least one systemic drug. Both topical (90%, 65/72) and systemic (oral, 50% of patients, 36/72; intravenous, 33%, 24/72) glucocorticoids were most frequently used. Systemic agents were most often discontinued due to ineffectiveness (46%, 50/110). Satisfaction with treatment was highest for intravenous and topical glucocorticoids (moderate to high satisfaction: 59% and 36%, respectively), and lowest for retinoids with 8%.

Conclusions

This study indicates that there might be a lack of diagnostic awareness among physicians and the unmet need for effective systemic treatment options.