In a recent interview with *Dermatology Times*, Dr. Adam Friedman, professor and chair of dermatology at George Washington University School of Medicine, discussed findings from a new study on how US dermatologists screen for and treat lichen planus. The study, published in *Dermatology and Therapy*, surveyed over 400 dermatologists and revealed wide differences in how the condition is managed, especially regarding screening for related health issues and treatment choices.
Dr. Friedman described lichen planus as a “wild west” in dermatology. He explained that the lack of official management guidelines and FDA-approved treatments means doctors often rely on their own training and experience. This leads to inconsistent care for this chronic, disabling skin disease.
The study aimed to understand how dermatologists screen for other health problems linked to lichen planus. Research has shown connections between lichen planus and various conditions like thyroid disease, high blood pressure, anxiety, and depression. Despite this, about one-third of the dermatologists surveyed said they do not screen for any comorbidities.
Traditionally, screening for hepatitis C has been common due to older studies linking it to lichen planus. However, Dr. Friedman noted that this link mainly applies to a specific type called oral erosive lichen planus. The study found that while hepatitis C screening was the most common, actual infection rates were low. More common and relevant health issues, such as hypertension and mental health conditions, were often overlooked.
Treatment methods also varied widely. Most dermatologists relied on topical corticosteroids, but fewer used systemic immunosuppressants or phototherapy, even though these treatments have clinical support. Dr. Friedman emphasized that the absence of clear, evidence-based guidelines leaves doctors to depend on personal experience, resulting in uneven care and potential differences in patient outcomes.
Looking ahead, Dr. Friedman said the study provides important insight that could help develop better management strategies and formal guidelines for lichen planus. He stressed the need for greater awareness, more research, and structured treatment approaches to improve patient care.
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