What is the role of phototherapy in the treatment of pityriasis lichenoides?

Updated: Sep 11, 2020
  • Author: Jeffrey P Callen, MD; Chief Editor: Dirk M Elston, MD  more...
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Answer

No randomized controlled trials have been performed in Mucha-Habermann disease. Since the disease course tends towards self-resolution, evaluation of treatments without adequate controls cannot result in rational recommendations. Nevertheless, a number of open trials have reported success with light therapy and oral medications.

Phototherapy has been reported useful in the treatment of subacute or chronic disease. [45] Psoralen plus UV-A (PUVA) therapy (150-200 J/cm2) has been reported, with as many as 4 treatments per week to a total of 30-35 treatments, depending on the patient's skin type. UV-A without psoralens and UV-B may result in clearing. Relapses are not uncommon. Narrow-band ultraviolet B phototherapy and photodynamic therapy have also been reported as effective. [46, 47, 48, 49, 50]

Case reports suggest the use of multiple oral medications including tetracycline, [15] azithromycin, erythromycin, sulfonamides, dapsone, chloroquine, streptomycin, isoniazid, penicillin, methotrexate (MTX), [51, 52] etretinate, and pentoxifylline. Potent topical corticosteroids may be useful if few lesions are present. Systemic corticosteroids and cyclosporin [53] may have a role in severe cases of PLEVA, but consideration of the systemic adverse effects of these medications is warranted. Despite a lack of randomized controlled trials, oral tetracycline and erythromycin have been prescribed most often in case series.


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