Embryologic homologies and empiric use led to the advocacy of topical androgens for LS. Long clinical experience and anecdotal reports attest to the popularity and apparent success of topical testosterone in the treatment of LS (9,18-21) and there are a few patients whose successful treatment has included low-dose oral testosterone. But, with the advent of the very potent topical corticosteroid, clobetasol, and with reports of its effectiveness (20), topical testosterone has little or no support in recent publications (21-23), but should not be dismissed. An appropriate clinical study to evaluate the efficacy of topical testosterone would be difficult to mount: withholding clobetasol would not be appropriate, but the criteria for determining the benefit of both agents together as opposed to the corticosteroid alone would be hard to construct (23).
Vitamin A, formerly, and the oral retinoid, acitretin, recently, have also been advocated in the treatment of LS and the latter may interact with nuclear receptors to alter gene expression (24).
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