Advances in the management of lichen amyloidosis

Lichen amyloidosis (LA) is a chronic, intensely pruritic dermatosis that significantly impairs quality of life. Conventional therapies, including topical corticosteroids, antihistamines, and laser-based treatments, often provide inconsistent benefit and frequent relapse. This review aims to synthesize recent advances in LA management and highlight emerging therapeutic strategies with the potential to improve treatment efficacy and durability. A scoping review was conducted using PubMed, Google Scholar, SciFinder, and Scopus through July 2025. Search terms included “lichen amyloidosis,” “cutaneous amyloidosis,” and treatment-related keywords (“biologics,” “JAK inhibitors,” “lasers”), combined with Boolean operators. Eligible studies included case reports describing emerging or experimental therapies for LA. Novel treatment approaches identified included serial electrobrasion, fractional CO2 laser therapy, cryotherapy, Janus kinase (JAK) inhibitors (upadacitinib, abrocitinib, baricitinib, tofacitinib), and biologic agents (dupilumab, nemolizumab). JAK inhibitors were associated with rapid pruritic relief, significant lesion improvement, and favorable tolerability. Biologic therapies demonstrated efficacy in refractory disease, particularly among patients with concomitant atopic dermatitis. Procedural interventions improved symptoms and lesion morphology but often required multiple sessions and were occasionally associated with pigmentary alterations. Most available evidence consists of case reports, limiting generalizability and preventing standardized treatment recommendations. Advances in immunomodulatory and procedural therapies are expanding treatment options for refractory LA. Mechanism-based systemic therapies show promise for durable pruritus control and disease improvement, underscoring the need for larger prospective studies to guide therapeutic decision-making and optimize long-term outcomes.

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