What is the best possible treatment for lichen planus?

Hello,

Welcome to icliniq.com.

I went through your query.

Lichen planus is a chronic and self-limiting disease. It has been seen that skin lesions subside within 9 to 12 months in about 50 percent of the cases. Since you are still developing fresh lesions, you will have to take a course of tablet Prednisolone 20 mg daily for six weeks, which can be reduced gradually. You seem to have severe itching, which is not responding much to Levocetirizine. I would recommend you take the tablet Hydroxyzine 25 mg twice daily till the itch subsides. Along with this apply Clobetasol propionate on the itchy areas. But if a large surface area is involved, dilute it in a moisturizing lotion in a ratio of 1:4. This will surely help you.

Thanks and regards.

Hello,

Welcome back to icliniq.com.

I have reviewed the attached photographs (attachments removed to protect patient's identity).

In the first two pictures, I can see dark-colored pigmented areas. While in the third one, I can appreciate a thick hyperpigmented plaque. I had already told you that pigmentation will take up to one year to resolve in 50 percent of the individuals and a little longer in the rest of the individuals.

I suggest you follow the instructions mentioned below.

1. For only pigmented areas, apply Melalite-XL cream (a combination of Tretinoin, Hydroquinone, and Mometasone) at bedtime.
2. Continue this for five to six weeks and revert. You will notice a lightening of the pigmentation.
3. For the thick lesions go for intralesional Triamcinolone acetonide injections 40 mg/mL every three weeks. Three to four injections will be required to resolve it.

Hope this helps.

Thank you.