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Lichen Spinulosus Medication

  • Author: Christopher R Gorman, MD; Chief Editor: William D James, MD  more...
 
Updated: Sep 23, 2015
 

Medication Summary

The goal of treatment for lichen spinulosus is to improve the cosmetic disfigurement caused by the disorder.

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Keratolytic Agents

Class Summary

Topical lactic acid creams have provided the most successful therapy to date. Salicylic acid gel and urea containing lotions also have been reported to help soften the horny papules. Gentle abrasion with a pad, soft brush, or luffa pad can be tried to remove the horny spines.

Ammonium lactate (Lac-Hydrin)

 

Ammonium lactate contains lactic acid, an alpha-hydroxy acid with keratolytic action, thus facilitating release of comedones. It is available in 12% and 5% strengths. The 12% form may cause irritation on the face. Ammonium lactate causes disadhesion of corneocytes. It is found in a variety of topical emollient lotions. It may be combined with 10-20% urea cream or be used with salicylic acid gel.

Salicylic acid topical (cream, lotion, or gel)

 

Salicylic acid topical is a beta-hydroxy acid reported to soften papules. By dissolving intercellular cement substance, it produces desquamation of the horny layer of skin, while not affecting the structure of viable epidermis. It comes as a cream, lotion, or gel.

Urea

 

Urea promotes hydration and removal of excess keratin.

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Topical Retinoid

Class Summary

These agents stimulate cellular retinoid receptors and help normalize keratinocyte differentiation and are comedolytic. In addition, they have anti-inflammatory properties. The third-generation retinoids include topical adapalene and tazarotene.

Adapalene (Differin)

 

Adapalene inhibits microcomedo formation. It decreases cohesiveness of keratinocyesin sebaceous follicles, which allows for easy removal. It has anti-inflammatory properties. Adapalene is available as a cream, lotion, or gel.

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Contributor Information and Disclosures
Author

Christopher R Gorman, MD Avenues Dermatology, Private Practice

Christopher R Gorman, MD is a member of the following medical societies: Alpha Omega Alpha

Disclosure: Nothing to disclose.

Specialty Editor Board

Richard P Vinson, MD Assistant Clinical Professor, Department of Dermatology, Texas Tech University Health Sciences Center, Paul L Foster School of Medicine; Consulting Staff, Mountain View Dermatology, PA

Richard P Vinson, MD is a member of the following medical societies: American Academy of Dermatology, Texas Medical Association, Association of Military Dermatologists, Texas Dermatological Society

Disclosure: Nothing to disclose.

Rosalie Elenitsas, MD Herman Beerman Professor of Dermatology, University of Pennsylvania School of Medicine; Director, Penn Cutaneous Pathology Services, Department of Dermatology, University of Pennsylvania Health System

Rosalie Elenitsas, MD is a member of the following medical societies: American Academy of Dermatology, American Medical Association, American Society of Dermatopathology, Pennsylvania Academy of Dermatology

Disclosure: Received royalty from Lippincott Williams Wilkins for textbook editor.

Chief Editor

William D James, MD Paul R Gross Professor of Dermatology, Vice-Chairman, Residency Program Director, Department of Dermatology, University of Pennsylvania School of Medicine

William D James, MD is a member of the following medical societies: American Academy of Dermatology, Society for Investigative Dermatology

Disclosure: Nothing to disclose.

Additional Contributors

James J Nordlund, MD Professor Emeritus, Department of Dermatology, University of Cincinnati College of Medicine

James J Nordlund, MD is a member of the following medical societies: American Academy of Dermatology, Sigma Xi, Society for Investigative Dermatology

Disclosure: Nothing to disclose.

Acknowledgements

Acknowledgments

Medscape Drugs & Diseases wishes to recognize Stephen W White, MD† for his original contributions to this article.

References
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  11. Kim SH, Kang JH, Seo JK, Hwang SW, Sung HS, Lee D. Successful treatment of lichen spinulosus with topical tacalcitol cream. Pediatr Dermatol. Sep-Oct/2010. 27(5):546-7. [Medline].

  12. Uehara A, Abe M, Shimizu A, Motegi SI, Amano H, Ishikawa O. Successful treatment of lichen spinulosus with topical adapalene. Eur J Dermatol. 2015 Jun 17. [Medline].

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  14. Tilly JJ, Drolet BA, Esterly NB. Lichenoid eruptions in children. J Am Acad Dermatol. 2004 Oct. 51(4):606-24. [Medline].

 
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Lichen spinulosus on the abdomen.
Close-up view.
 
 
 
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