A comparative study of methotrexate & low molecular weight heparin for the treatment of generalized lichen planus

• Author Details:   
• Snehal Lunge
• Shivakumar Patil
• BS Manjunathswamy

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Background: Lichen planus is a difficult condition to treat and is often disappointing for dermatologist. Many a times it’s associated with relapse. There is long list of topical & systemic therapies for its treatment.
Aim & Objectives: the objective of this study was to compare the efficacy and safety of methotrexate and low molecular weight heparin in generalized lichen planus patients along with 6 months follow up. In this study 40 patients with generalized lichen planus were enrolled after basic evaluation 20 patients(11 males, 9 females) were started on low dose methotrexate & 20 patients(11 males, 9 females) on low molecular weight heparin. The response rate were appraised after once a week for 16 to 24 weeks for both methotrexate & low molecular weight heparin. Six month follow up was done for evaluating the recurrence rate.
At the end of 16 to 24 weeks of treatment with methotrexate 19 of 20 patients showed 90% improvement, 1 patient did not tolerate methotrexate after 4 weeks because of its adverse effects. Only 3 patients were showed relapse after discontinuation of therapy at 3, 2.6, 2 months respectively.
At the end of 16 to 24 weeks of treatment with low molecular weight heparin complete remission of skin lesions in 13 of 20 patients with 80% improvement. Also 7 patients showed relapse after discontinuation of therapy at 2, 3, 3.6, 1.6, 4, 2, 6 months respectively.
Conclusion: Overall we want to emphasized that low dose oral methotrexate is effective & is a reasonably safe option for generalized LP. There was better tolerance by patients with low recurrence rate than subcutaneous low molecular weight heparin.

Keywords:  Generalized Lichen planus, Methotrexate, Low molecular weight Heparin