Vestnik Dermatologii i Venerologii (Apr 2018)

THE PATHOGENETIC SUBSTANTIATION OF EFFICIENCY OF PHOTOPHERESIS IN ATYPICAL VARIANTS OF LICHEN PLANUS

  • Yulia V. Molochkova,
  • Aleksandr V. Kil’dyushevskij,
  • Yu. N. Perlamutrov,
  • Aleksej A. Glazkov,
  • Vladimir N. Molochkov

DOI
https://doi.org/10.25208/0042-4609-2018-94-1-51-59
Journal volume & issue
Vol. 94, no. 1
pp. 51 – 59

Abstract

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Lichen planus (LP) is an autoimmune disorder which is characterized by long lasting, recurrent course of a disease and by poor response to treatment (including systemic corticosteroids and cytostatics). Cutaneous and mucosal LP may present in atypical forms, several can transform to cancer with statistical confidence. Earlier, we have confirmed high clinical efficacy of photopheresis — method of adoptive immunotherapy in treatment of patients with typical LP.Target: research of clinical efficacy of photopheresis in complex trearment of atypical forms of cutaneous and mucosal LP.Materials and methods. There had been carried out a study of the clinical and immunological efficacy in two groups of patients: patients receiving complex therapy, which includes photopheresis with routine therapy (delagil, doxycycline and topical corticosteroids (I groupe — 23 patients) and receiving complex therapy, which includes photopheresis with single injection of methotrexate in dose of 10 mg with routine therapy ( II groupe — 18 patients).Results. In I group of patients immunological disorders were similar with results of earlier immunological studies in patients with lypical LP, among them increase in the number of CD16+-cells. In the II groupe immunological disorders were characterized by the rise of amount and activity of CD3+CD8+-lymphocytes. The high efficacy of Group I patient treatment was accompanied by the restoration of their tolerance to the skin antigenic structures, while maintaining the possibility for transendothelial migration of CD16 + cells. The effect of the treatment in Group II patients was also pronounced; however, due to the use of methotrexate, no normalization of the patients’ immune parameters was observed.Conclusion. The data obtained confirms the high clinical efficacy of photopheresis in both groups of patients and its pathogenic validity in patients suffering from atypical lichen ruber planus.

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