Bathwater PUVA therapy for palmar lichen planus resistant to corticotherapy

Abstract

Lichen planus is a chronic and idiopathic mucocutaneous inflammatory disease, with a rare palmar variant that is difficult to diagnose due to its atypical clinical presentation. It presents with multiple therapeutic options; one of them, PUVA bath therapy, which presents good results and few adverse effects, unlike traditional corticosteroid therapy. A 70-year-old male patient presents with 6-month scaly violet-brown plaques in the palmar surface with histopathological diagnosis of lichen planus, initially treated with topical steroids and urea without improvement. Consequently, treatment with PUVA bath therapy resulted in 90% improvement without reporting adverse effects after 3 months of follow-up, making it a useful and safe therapeutic option in refractory cases.