Background: Treatment of oral erosive lichen planus is considered a therapeutic challenge. Various systemic and topical agents aimed at controlling the symptoms, rather than curing the lesions, have been used with varying results. Objective: To evaluate the response to treatment with antimalarial drugs in patients with oral erosive lichen planus. Methods: Eight patients diagnosed with oral erosive lichen planus were treated with antimalarial agents. The first clinical evaluation was made after a month of treatment and then every 2-3 months. Baseline ophthalmologic examinations were performed, and laboratory values were monitored before and during treatment. Results: All studied patients who had previously been resistant to other treatments responded favorably. Pain relief and reduced erythema and erosions were observed after of a mean of 2.4 months. Conclusion: Antimalarials may be useful for the treatment of oral erosive lichen planus. They are easily administered and affordable, with few adverse effects.

1.
Cheng S, Kirtschig G, Cooper S, Thornhill M, Leonardi-Bee J, Murphy R: Interventions for erosive lichen planus affecting mucosal sites. Cochrane Database Syst Rev 2012;2: CD008092.
2.
Lodi G, Scully C, Carrozzo M, Griffiths M, Sugerman PB, Thongprasom K: Current controversies in oral lichen planus: report of an international consensus meeting. 2. Clinical management and malignant transformation. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2005;100:164-178.
3.
Thongprasom K, Dhanuthai K: Steroids in the treatment of lichen planus: a review. J Oral Sci 2008;50:377-385.
4.
Davari P, Hsiao H-H, Fazel N: Mucosal lichen planus: an evidence-based treatment update. Am J Clin Dermatol 2014;15:181-195.
5.
Ochsendorf FR: Use of antimalarials in dermatology. J Dtsch Dermatol Ges 2010;8:829-844; quiz 845.
6.
Rodriguez-Caruncho C, Bielsa Marsol I: Antimalarials in dermatology: mechanism of action, indications, and side effects. Actas Dermosifiliogr 2014;105:243-252.
7.
Manousaridis I, Manousaridis K, Peitsch WK, Schneider SW: Individualizing treatment and choice of medication in lichen planus: a step by step approach. J Dtsch Dermatol Ges 2013;11:981-991.
8.
Eisen D: Hydroxychloroquine sulfate (Plaquenil) improves oral lichen planus: an open trial. J Am Acad Dermatol 1993;28:609-612.
9.
Bondeson J, Sundler R: Antimalarial drugs inhibit phospholipase A2 activation and induction of interleukin 1beta and tumor necrosis factor alpha in macrophages: implications for their mode of action in rheumatoid arthritis. Gen Pharmacol 1998;30:357-366.
10.
Jiménez Palop M: Antimalarials: an update in rheumatic diseases. Reumatol Clin 2006;2:190-201.
11.
Zhu Y, Li J, Bai Y, Wang X, Duan N, Jiang H, et al: Hydroxychloroquine decreases the upregulated frequencies of Tregs in patients with oral lichen planus. Clin Oral Investig 2014;18:1903-1911.
12.
Kalia S, Dutz JP: New concepts in antimalarial use and mode of action in dermatology. Dermatol Ther 2007;20:160-174.
13.
De Argila D, Gonzalo A, Pimentel J, Rovira I: Isolated lichen planus of the lip successfully treated with chloroquine phosphate. Dermatology 1997;195:284-285.
14.
Hersle K, Mobacken H, Sloberg K, Thilander H: Severe oral lichen planus: treatment with an aromatic retinoid (etretinate). Br J Dermatol 1982;106:77-80.
15.
Collins MR, James WD, Rodman OG: Etretinate photosensitivity. J Am Acad Dermatol 1986;14:274.
16.
McDonagh AJ, Harrington CI: Pseudoporphyria complicating etretinate therapy. Clin Exp Dermatol 1989;14:437-438.
17.
Seishima M, Shibuya Y, Kato G, Watanabe K: Photoleukomelanoderma possibly caused by etretinate in a patient with psoriasis. Acta Derm Venereol 2010;90:85-86.
18.
Madan V, Griffiths CEM: Systemic ciclosporin and tacrolimus in dermatology. Dermatol Ther 2007;20:239-250.
19.
Wolfe F, Marmor MF: Rates and predictors of hydroxychloroquine retinal toxicity in patients with rheumatoid arthritis and systemic lupus erythematosus. Arthritis Care Res 2010;62:775-784.
20.
Jewell ML, McCauliffe DP: Patients with cutaneous lupus erythematosus who smoke are less responsive to antimalarial treatment. J Am Acad Dermatol 2000;42:983-987.
21.
Piette EW, Foering KP, Chang AY, Okawa J, Ten Have TR, Feng R, et al: Impact of smoking in cutaneous lupus erythematosus. Arch Dermatol 2012;148:317-322.
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