Therapeutic Synergy: Triple Regimen with Calcipotriol, Clobetasol Propionate and Phototherapy in Generalized Lichen Planus in an Adolescent
Castillo Mariolga
*
Postgrado de Dermatología, Universidad de Carabobo – Ciudad Hospitalaria “Dr. Enrique Tejera”, Valencia, Venezuela.
Pinzon Mayra
Postgrado de Dermatología, Universidad de Carabobo – Ciudad Hospitalaria “Dr. Enrique Tejera”, Valencia, Venezuela.
Álvarez Lina
Postgrado de Dermatología, Universidad de Carabobo – Ciudad Hospitalaria “Dr. Enrique Tejera”, Valencia, Venezuela.
Endara Marcia
Servicio de Dermatología Postgrado de Dermatología, Universidad de Carabobo – Ciudad Hospitalaria “Dr. Enrique Tejera”, Valencia, Venezuela.
Vivas Sandra
Servicio de Dermatología Postgrado de Dermatología, Universidad de Carabobo – Ciudad Hospitalaria “Dr. Enrique Tejera”, Valencia, Venezuela.
*Author to whom correspondence should be addressed.
Abstract
Objective: To highlight the synergistic efficacy of high-potency topical corticosteroids, vitamin D analogues, and narrow-band UVB (NB-UVB) phototherapy in achieving rapid clinical remission of pruritus and lesions, while minimising the morbidity and adverse effects associated with conventional systemic therapies in paediatric patients.
Case Report: A 14-year-old male adolescent presented with a generalised, bilateral, and symmetrical dermatosis of three months' duration, characterised by purpuric papules that coalesced to form plaques with fine scales and pruritus. Dermoscopy revealed Wickham striae, and onychoscopy showed leukonychia of the third and fourth fingernails of the right hand. With psoriasis vulgaris and eruptive LP considered in the differential diagnosis, skin biopsy confirmed LP. Combination therapy was initiated with topical clobetasol propionate 0.05% at night for 21 days, calcipotriol 0.005% in the morning for two months, and narrow-band UVB phototherapy twice weekly for two months. The patient had a satisfactory clinical course, with remission of pruritus and resolution of the lesions, leaving residual post-inflammatory hyperpigmentation.
Conclusion: The combination of high-potency corticosteroids, topical calcipotriol, and phototherapy may represent an effective and well-tolerated alternative for generalised lichen planus in paediatric patients. This regimen may provide synergistic effects that accelerate clinical remission while minimising long-term adverse effects.
Keywords: Clobetasol, lichen planus, pediatrics, phototherapy