OBJECTIVE: To establish the effectiveness and safety of topical aspirin on patients with persistent lichen simplex chronicus (LSC) despite corticosteroid therapy
METHODS: Fifty-four male and female patients with LSC who underwent topical corticosteroid therapy in the past were randomized to receive 3 percent aspirin ointment for two weeks followed by placebo ointment for two weeks or placebo first followed by aspirin with a crossover design after a 2-week washout period on a preselected involved area. Outcomes looked for were pruritus by visual analogue scale (VAS), activities of daily living score (ADLS), size of lesion, number of skin markings and photographic assessment score (PAS). All comparisons were done both on per protocol and intention-to-treat bases.
RESULTS: Data were complete for 42 (77.8 percent) subjects. On per protocol analysis, there were significantly greater reductions in lesion size and number of skin markings on aspirin use than on placebo use (p=0.005 and p0.001, respectively). Proportions of subjects with improved signs and symptoms were all significantly greater in the aspirin group than in the placebo group (69 percent versus 9.5 percent by VAS, 85.7 percent versus 19 percent by ADLS and 100 percent versus 4.8 percent by PAS; all 0.001). Intention-to-treat analysis of the results had similar findings. One adverse event of transient burning sensation after topical aspirin use was reported.
CONCLUSION: Topical aspirin can be safely used for two weeks and is significantly more effective than topical placebo in decreasing pruritus and impairment of activities of daily living, as well as in improving the size and morphology of LSC lesions.