Treatment of pityriasis lichenoides chronica

NBUVB: narrowband ultraviolet B; PLC: pityriasis lichenoides chronica.

* PLC is a benign condition that is often asymptomatic and self-limited.

¶ Treatment selection is based upon disease severity, treatment risks and feasibility, and patient preference. Phototherapy requires multiple clinic visits or a home phototherapy unit. Methotrexate has a broader adverse effect profile and is typically reserved for severe or refractory disease. Medium-potency topical corticosteroids may be used as adjuncts to systemic therapy or phototherapy. Topical corticosteroid monotherapy is an alternative initial approach. However, PLC usually involves multiple body areas, making topical therapy difficult.

Δ Tetracyclines should not be used for children under the age of 9 years or pregnant individuals.

◊ Responses are expected within 3 months for oral antibiotics and phototherapy and within 3 to 4 months for methotrexate.

§ There are rare reports of cutaneous lymphoma developing in children and adults with PLC. We perform a full skin examination on patients with PLC at least once yearly and encourage patients to return for evaluation if atypical skin lesions appear. Additionally, patients receiving treatment are followed more frequently to assess the response to treatment.

¥ If response is inadequate, switch to another initial treatment (eg, from an oral antibiotic to oral methotrexate). The best approach to disease refractory to all preferred therapies is unclear. Refer to additional UpToDate content on other therapies for PLC.