Case Study: The Treatment of Lichen Sclerosis with Topical Roflumilast 0.3%

This case report details the successful use of topical roflumilast 0.3% cream for treating a 72-year-old woman with extragenital lichen sclerosus, a condition she had lived with for one year. The patient, with a medical history including melanoma, squamous cell carcinoma, and rosacea, presented with a pruritic, atrophic white plaque on her left anterior thigh. A biopsy confirmed the diagnosis of lichen sclerosus. Due to concerns about potential steroid atrophy and candidal infections, the patient declined corticosteroid therapy. Instead, she was prescribed topical roflumilast, a non-steroidal anti-inflammatory treatment, which was applied once daily. After three months, the patient reported resolution of pruritus and marked improvement in the lesion, with a decrease in the plaque's size and resolution of erythema. There were no adverse reactions, and the patient was advised to continue treatment for maintenance. This case highlights roflumilast 0.3% cream as a promising alternative to corticosteroids for treating extragenital lichen sclerosus, especially for patients who are reluctant or unable to use steroids. Unlike topical steroids, roflumilast does not cause skin atrophy or other steroid-related side effects, making it a viable option for long-term management. Further studies are needed to evaluate its efficacy and safety for both genital and extragenital forms of lichen sclerosus.

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Elevate-Derm Alliance Editorial Committee