Emerging treatments
Anti-tumor necrosis factor (TNF)-alpha inhibitors
Based on high levels of serum TNF-alpha and systemic T cell activation found in patients with febrile ulceronecrotic Mucha-Habermann disease variant, TNF-alpha inhibitors may play a role as the future therapeutic option for pityriasis lichenoides.[31] Etanercept is already utilized in another type of papulosquamous inflammatory skin disease, psoriasis.[1] It should be considered as potential alternative therapy in treatment-resistant pityriasis lichenoides because it demonstrated a good safety profile in pediatric and adult populations with rheumatoid arthritis and Crohn disease.[1] There is also a report that demonstrates the use of etanercept to treat pityriasis lichenoides.[32] Anti-TNF-alpha inhibitors have not been FDA-approved for pityriasis lichenoides. Caution should be exercised in using these therapies, as there have been several reports of patients on biologic agents (infliximab and adalimumab) who developed pityriasis lichenoides, possibly due to these treatments.[9][10]
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