Treatment of Generalized Lichen Planus With Alefacept

In a study from 2006, two female patients with recalcitrant generalized lichen planus (LP), a chronic inflammatory autoimmune disease of the skin and mucosa, were treated with alefacept, a dimeric fusion protein approved for moderate to severe plaque psoriasis. The first patient was 25 years old with a 2-year history of LP, and the second was 57 years old with a 1-year history of generalized hypertrophic LP and over 3 years of oral LP. Both had tried multiple treatments without success. After a 12-week course of alefacept (15 mg/week), both patients reported a significant reduction in itching and lesion improvement within 4 weeks. By the end of the treatment, patient 1 was 99% free of new lesions, and patient 2 was 100% free of new lesions, with no residual itching. Follow-up 12 to 20 weeks post-treatment showed both patients remained free of new lesions and had considerable lightening of old lesions. The study concluded that alefacept may be an effective treatment for severe, generalized cutaneous and mucosal LP, with both patients experiencing dramatic improvement and no adverse events reported. Further studies were recommended to confirm these findings and establish the efficacy and safety of alefacept therapy for LP.