Lichen Planus

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It is an extremely pruritic chronic inflammatory skin condition. 

Clinical presentation 

• Primary lesions are violaceous, shiny flat-topped papules
• Coalesce and evolve into scaly plaques
• Distributed over inner wrists, arms and thighs as well as sacral area.
• Post inflammatory hyperpigmentation is common.
• Scarring alopecia may result from lichen planopilaris (severe)

Pharmacological Treatment 

C: loratadine (PO) 10mg 24hourly for 2-4weeks 

AND 

C: betamethasone valerate ointment (topical) 0.1% 12hrly for 2–4 weeks 

OR 

D: clobetasol propionate ointment (topical) 0.05%–0.1% twice daily for 2–4weeks 

AND 

for extensive involvement 

A: prednisolone (PO) 0.5-1 mg/kg 24hourly for 3-4weeks then taper 

For recalcitrant cases 

S: methotrexate (PO) 7.5- 20mg weekly for not less than 6months