Treatment of extragenital lichen sclerosus in adults

UVA1: ultraviolet A1; NBUVB: narrowband ultraviolet B.

* Not strictly defined. Limited disease may be considered disease involving less than 10% of the body surface area.

¶ Refer to UpToDate content on the management of extragenital lichen sclerosus for details on the initiation, dose titration, tapering, and monitoring of therapy. Doses of oral or subcutaneous methotrexate usually range from 10 to 25 mg per week. Folic acid 1 mg per day should be taken during methotrexate therapy. Initial prednisone doses of 1 mg/kg per day or 40 to 60 mg per day are usually sufficient.

Δ UVA1 is preferred, where available.

◊ Early signs of improvement include reduced erythema, reduced development of new lesions, and slowing of lesion enlargement.

§ Not strictly defined. Slow progression may be considered the development of only a few new lesions or limited lesion expansion over 2 months.