Review of the current literature regarding the treatment of lichen planopilaris (LPP) and other lichenoid dermatosis with low-level light therapy (LLLT) |
LLLT has been utilized with success in the treatment of LPP and oral lichen planus |
Description of four patients with LPP who had evident improvement after LTTT treatment |
Moving forward, larger controlled studies are needed to fully elucidate the benefits of LLLT on treatment of LPP |
Introduction
Case Summary
Age (years) | Sex | Diagnosis | Duration (years) | Concurrent treatment | Follow-up (months) | Outcome | LLLT specifications |
---|---|---|---|---|---|---|---|
60 | Female | LPP | 3 | Clobetasol 0.05% lotion/naltrexone 3 mg/day | 6 | Reduction of peripilar casts and clinical improvement | 105 light-emitting diodes cap 650 nm wavelength 5 mW power per light (Tricoglam™) 5 min/day or 20 min × 2/week |
65 | Female | LPP | 3 | Hydroxychloroquine 5 mg/kg/day/clobetasol 0.05% lotion once a day | 6 | Reduction of peripilar casts and clinical improvement | 105 light-emitting diodes cap 650 nm wavelength 5 mW power per light (Tricoglam™) 5 min/day or 20 min × 2/week |
42 | Female | LPP | 6 | Hydroxychloroquine 5 mg/kg/day/clobetasol 0.05% lotion once a day/topical 2% minoxidil Hydroxychloroquine reduced to 2.5 mg/kg/day | 18 | Reduction of peripilar casts and clinical improvement | 272 pulsed laser diode cap 650 nm wavelength with 1360 mW (CapillusPro™) 6 min daily |
28 | Female | LPP | 2 | Hydroxychloroquine 5 mg/kg/day/clobetasol 0.05% lotion once a day | 12 | Reduction of peripilar casts and clinical improvement | 204 light diodes cap 660 nm wavelength 25.5 mW/cm2 irradiance (Capellux I9™) 7 min daily |
Discussion
Authors (year) | Disease process | Type of study | Methods | LLLT specifications | Results |
---|---|---|---|---|---|
Fonda-Pascual et al. [6] | LPP | Prospective study of LLLT for treatment of LPP | 8 subjects (5 female, 3 male) received LLLT 15 min daily for 6 months | 246 red LED λ = 630 nm Exposure = 15 min | All patients had reduction of symptoms, erythema, and perifollicular hyperkeratosis. And an increase in terminal hair thickness |
Gerkowicz et al. [7] | FFA and LPP | Prospective study of sLED as adjuvant therapy | 16 female subjects (8 FFA, 8 LPP) received sLED 1× a week for 10 weeks | Lamp with 78 pulsed diodes λ = 630 ± 5 nm (red light) Power density = 100–120 mW/cm2 Exposure time = 13 min 47 s | FFA and LPP severity improved. sLEDs can be used as adjuvant therapy in these patients |
Dillenburg et al. [8] | Oral LPP | Randomized controlled trial comparing topical clobetasol to LPT | Topical clobetasol 0.05% gel applied 3× per day for 30 days (n = 21) versus LPT 3× per week for 12 total sessions (n = 21) | Continuous wave diode laser λ = 660 nm (red light) Output density = 1000 mW/cm2 | LPT had higher percentage of complete lesion resolution. 4 and 8 weeks after treatment LPT had no recurrence of lesions, while clobetasol exhibited worsening |
Agha-Hosseini et al. [9] | Oral LPP | Randomized clinical trial comparing CO2 laser therapy to LLLT | CO2 laser (n = 13) versus LLLT for 5 sessions every other day (n = 15) | Diode laser with two probes 1st probe: λ = 890 nm (infrared) 2nd probe: wavelength = 633 nm (red) | After 3 months, LLLT had 100% improvement. CO2 had 85% improvement |
El Shenawy and Eldin [10] | Oral LPP | Randomized clinical trial comparing LLLT to topical steroids | Topical 0.1% triamcinolone acetonide Orabase (n = 12) versus LLLT for 2 sessions twice a week (n = 12) | Diode laser λ = 970 nm (infrared) Exposure time = 8 min (4 × 2 min application) | Both groups showed significant decreases in pain scores. Groups had no difference in pain score during pretreatment or follow-up. Corticosteroids showed lower pain scores during post treatment |
Jajarm et al. [11] | Oral LPP | Randomized clinical trial comparing dexamethasone mouthwash to LLLT | LLLT for 2× a week with a maximum of 10 sessions (n = 15) versus dexamethasone mouthwash 4× a day for 30 days (n = 15) | Continuous diode laser λ = 630 nm (red) Exposure time = 2.5 min | LLLT was as effective as dexamethasone mouthwash in reducing appearance of lesion, pain, and lesion severity |
Kazancioglu and Erisen [12] | Oral LPP | Randomized clinical trial comparing LLLT to ozone therapy to topical corticosteroid therapy | LLLT 2× a week for maximum of 10 sessions versus ozone therapy 2× a week for maximum of 10 sessions versus dexamethasone mouthwash 4× a day for 1 month | Continuous diode laser λ = 808 nm Exposure time = 2.5 min | Improvement was seen with LLLT, ozone, and steroids, although ozone and corticosteroids were more effective |
Othman et al. [13] | Oral LPP | Randomized clinical trial comparing LLLT to topical corticosteroids | LLLT 2× a week for maximum 10 sessions (n = 12) versus 0.1% triamcinolone acetonide Orabase for 4 weeks (n = 12) | Continuous diode laser λ = 970 nm Exposure time = 8 min in 4 applications | Steroids improved disease variables more so than LLLT. Light therapy can be used as an alternative treatment when steroids are not indicated |