Transcranial electrical stimulation and the anxiolytic fabomotizole in the combination therapy of patients with lichen ruber planus

DOI: https://doi.org/10.29296/25877305-2022-05-17
Issue: 
5
Year: 
2022

Professor M. Tlish, MD; P. Osmolovskaya
Kuban State Medical University, Ministry of Health of Russia, Krasnodar

Considering stress as one of the important triggers of lichen ruber planus (LRP), it is promising and expedient to include effective and safe methods aimed at its correction in the therapy of these patients. Objective. To evaluate the efficiency of combination treatment with transcranial electrical stimulation (TES) and the anxiolytic fabomotizole in patients with LRP. Methods. An open, prospective, comparative study involving 67 patients (mean age 44.10±15.78 years) with a common typical form of LRP was conducted. All the patients received the therapy in accordance with the federal clinical practice guidelines (chloroquine 250 mg orally twice daily; topical glucocorticosteroids). Adaptive randomization was used to divide the patients into 2 groups: 1) a study group including 33 (49.3%) patients who were prescribed TES and the anxiolytic fabomotizole in addition to standard therapy; 2) a comparison group consisting of 34 (50.7%) patients who received TES in addition to standard therapy. The therapy results were assessed on days 7, 14, and 21. The examination algorithm included the assessment of clinical manifestations with consideration for the Lichen Planus Severity Index (LPSI); the severity of itching and its impact on the daily life of patients (Behavioral Rating Scale (BRS); the study of the psychoemotional background by using the Dermatology Life Quality Index (DLQI), the Hamilton Anxiety Rating Scale (HAM-A), and the Hamilton Depression Rating Scale (HAM-D). Results. Before starting of the treatment, there were no statistically significant differences (p>0.05) in the groups in terms of the studied indices and scales. On day 7 of therapy, the study group patients achieved significantly more favorable results in terms of the studied parameters (LPSI, DLQI, BRS, HAM-A, and HAM-D). According to the BRS, just on day 14 the study group patients had the median of 0 scores (interquartile range, 0-0), while the comparison group achieved those only on day 21. Conclusion. The combination treatment with TES and fabomotizole in the study group patients with LRP showed higher efficiency than that in the comparison group that had been additionally prescribed only TES.
Keywords: 
dermatology
therapy
lichen ruber planus
transcranial electrical stimulation
fabomotizole

References: 
  1. Ioannides D., Vakirlis E., Kemeny L. et al. European S1 guidelines on the management of lichen planus: a cooperation of the European Dermatology Forum with the European Academy of Dermatology and Venereology. J Eur Acad Dermatol Venereol. 2020; 34 (7): 1403–14. DOI: 10.1111/jdv.16464
  2. Joshi A., Rathi S.K., Manchanda Y. Childhood lichen planus. Indian J Paediatr Dermatol. 2021; 22 (4): 306–15. DOI: 10.4103/ijpd.ijpd_132_20
  3. Gorouhi F., Davari P., Fazel N. Cutaneous and mucosal lichen planus: a comprehensive review of clinical subtypes, risk factors, diagnosis, and prognosis. Sci World J. 2014; 2014: 1–22. DOI: 10.1155/2014/742826
  4. Tatawati A.S., Doshi B.R., Manjunathswamy B.S. A cross-sectional observational study of clinicodermatoscopic features in cutaneous lichen planus in Indian skin. Pigment Int. 2021; 8: 100–8. DOI: 10.4103/Pigmentinternational.Pigmentinternational_
  5. Arnold D.L., Krishnamurthy K. Lichen Planus. [Updated 2020 Aug 10]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2020. URL: https://www.ncbi.nlm.nih.gov/books/NBK526126/
  6. Anisimova I.V., Simonyan L.A. The frequency of the combination of lichen planus with somatic pathology and local adverse factors of the oral cavity. Problems of dentistry. 2019; 15 (1): 16–22 (in Russ.). DOI: 10.18481/2077-7566-2018-15-1-16-22
  7. Kubanov A.A., Perlamutrov Yu.N., Olisova O.Yu. et al. Federal clinical guidelines. RODVK, 2020 (in Russ).]. URL: https://www.cnikvi.ru/docs/clinic,_recs/klinicheskie-rekomendatsii-2019-2020/
  8. Sawant N.S., Vanjari N.A., Khopkar U. et al.. A Study of Depression and Quality of Life in Patients of Lichen Planus. Sci World J. 2015; 2015: 817481. DOI: 10.1155/2015/817481
  9. Radwan-Oczko M., Zwyrtek E., Owczarek J. et al. Psychopathological profile and quality of life of patients with oral lichen planus. J Appl Oral Sci. 2018; 26: 20170146. DOI: 10.1590/1678-7757-2017-0146
  10. Hiremutt D.R., Mhapuskar A.A., Singh P. et.al. Comparison of Anxiety and Depression Scores in Patients with Oral Lichen Planus and Normal Individuals. J Int Clin Dent Res Organ. 2020; 12: 140–7. DOI: 10.4103/jicdro.jicdro_42_19
  11. Tiunova N.V., Lukinyh L.M. Lichen planus of the oral mucosa (etiology, pathogenesis, clinical picture, modern methods of treatment). Monography. Nizhny Novgorod: Publishing house of NGMA, 2013; 116 (in Russ.).
  12. Pshennikova MG. The phenomenon of stress. Emotional stress and its role in pathology (lecture 5). In: Morozov B.B. ed. Actual problems of pathophysiology (selected lectures). M.: Meditsina, 2001 (in Russ.).
  13. Lebedev VP. Transcranial electrical stimulation. Experimental clinical research. Vol. 3. SPb: RAS, Institute of Physiology. I.P. Pavlova, TPP Center, 2009 (in Russ.).
  14. Silina L.V., Yacun S.M. The use of transcranial electrical stimulation in the complex therapy of acne. Palliative medicine and rehabilitation. 2009; 1: 30–2 (in Russ.).
  15. Savchenko E.S., Nazarov R.N., Apchel A.V. et al. Correction of psychovegetative disorders in the process of complex treatment of patients with chronic dermatoses. Clinical researches. 2012; 3 (39): 107–10 (in Russ.).
  16. Sizova V.Yu., Volchanskij E.I. Vegetative and vascular changes in children with atopic dermatitis against the background of the use of transcranial electrical stimulation. Volgograd Medical Scientific Journal. 2011; 1: 25–8 (in Russ.).
  17. Barkova SV. The effectiveness of the use of transcranial electrical stimulation in order to correct the psychophysiological status of patients with lichen planus of the oral mucosa. Bulletin of VolGMU. 2007; 35–7 (in Russ.).
  18. Bekker R.A., Bykov Yu.V. Afobazole (fabomotizole): is it only an anxiolytic? An Israeli-Russian view of the problem. Psychiatry and psychopharmacotherapy named after P.B. Gannushkin. 2017; 4: 12–21 (in Russ.).
  19. Manolache L., Seceleanu-Petrescu D., Benea V. Lichen planus patients and stressful events. JEADV. 2007; 22 (4): 437–41. DOI: 10.1111/j.1468-3083.2007.02458.x
  20. Akay A., Pekcanlar A., Bozdag K.E. et al. Assessment of Depression in subjects with psoriasis vulgaris and lichen planus. JEADV. 2002; 16 (4): 347–52. DOI: 10.1046/j.1468-3083.2002.00467.x
  21. Lundqvist E.N., Wahlin Y.B., Bergdahl M. et al. Psychological health in patients with genital and oral erosive lichen planus. JEADV. 2006; 20 (6): 661–6. DOI: 10.1111/j.1468-3083.2006.01559.x
  22. Dorozhenok I.Y., Snarskaya E.S., Shenberg V.G. Lichen planus and associated psychosomatic disorders. Vestnik dermatologii i venerologii. 2016; 92 (4): 27–32 (in Russ.). DOI: 10.25208/0042-4609-2016-92-4-27-32
  23. Gladkaya A.N., Muzychenko A.P. Comorbid pathology in patients with lichen planus. Innovations in medicine and pharmacy. 2020; 132–5 (in Russ.).
  24. López-Jornet P., Camacho-Alonso F. Quality of life in patients with oral lichen planus. J Eval Clin Pract. 2010; 16 (1): 111–3. DOI: 10.1111/j.1365-2753.2009. 01124.x