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Year : 2000  |  Volume : 66  |  Issue : 1  |  Page : 34-35

Lichen planus treated with betamethasone oral mini-pulse therapy

Correspondence Address:
Rashmi Mittal

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Source of Support: None, Conflict of Interest: None

PMID: 20877018

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Ten Patients, 6 males and 4 females between 7-60 years of age having lichen planus for I month to 2 years were treated with betamethasone 5mg orally on two consecutive days in a week for 3 months. There was excellent (75-100%) response in 6 (60%) patients and good (50-75%) in 4 (40%) patients. None of the patients had significant side effects of the therapy and there were no treat­ment failures. Betamethasone on two consecutive days in a week as oral mini pulse therapy may be a safe, effective and a better therapeutic alternative for the treatment of lichen planus.

Keywords: Lichen planus, Oral mini-pulse, Betamethasone

How to cite this article:
Mittal R, Manchanda Y. Lichen planus treated with betamethasone oral mini-pulse therapy. Indian J Dermatol Venereol Leprol 2000;66:34-5

How to cite this URL:
Mittal R, Manchanda Y. Lichen planus treated with betamethasone oral mini-pulse therapy. Indian J Dermatol Venereol Leprol [serial online] 2000 [cited 2020 Nov 29];66:34-5. Available from:

  Introduction Top

Lichen planus is usually a milder disease and corticosteroid is the drug of choice for its treatment.[1] However, when the disease is severe/extensive, corticosteroids in higher doses for a prolonged pe­riod may be required to control the disease and if they are used in a daily dosage they are likely to cause severe side effects [2] Therefore, we evaluated betamethasone 5mg administered orally on two consecutive days in a week as oral mini pulse therapy to treat lichen planus.

  Materials and Methods Top

Ten patients 6 males and 4 females between 7-60 years (mean age 26 years) who had the dis­ease for 1 month to 2 years were taken up for this study. The diagnosis in each patient was made on the basis of presence of characteristic, itchy, flat topped, violaceous papules and or mucosal lesions in a white lacy pattern. It was confirmed by skin or mucosal biopsy showing features of lichen planus. The patients were thoroughly evaluated to rule out any other cutaneous or systemic disease. Each pa­tient had haemogram, renal and liver function tests, blood sugar, urinalysis, stool for occult blood, chest X-ray and ophthalmological examination done be­fore starting the therapy. Blood pressure and body weight were also recorded. Betamethasone 5mg was administered on two consecutive days in a week orally after breakfast to each patient for a period of 3 months. The patients were clinically evaluated every month to assess the healing of the lesions and improvement in the symptoms. The blood pres­sure, body weight and estimation of blood sugar were done every month to look for any changes in these parameters, while the other investigations were repeated at the end of 3 months. The response to therapy was considered to be excellent, if there was 75-100% flattening of the lesions and no symp­toms; good, if the improvement was 50-75% and poor, if it was less than 50%.

  Results Top

Out of ten patients, 7 had only skin lesions and 1 had skin as well as mucosal lesions. Two pa­tients had only mucosal lesions. Six (60%) patients, 5 having skin lesions and 1 with skin and mucosal lesions had excellent (75-100%) response while 4(40%) patients, 2 each with only skin and only mucosal lesions had good (50-75%) response to the therapy. None of the patients had poor response or treatment failure. Itching in all the patients had completely subsided in 3 weeks. Two patients had weight gain of 5 kgs each and one developed mild cushingoid features. There were no other side ef­fects of the therapy in any of the patients. Labora­tory parameters did not reveal any abnormality.

  Discussion Top

Corticosteroids (betamethasone) in a dose of 5mg on two consecutive days orally as mini-pulse therapy has been used in corticosteroid responsive diseases like vitiligo and alopecia areata with good results and minimal side effects. [3],[4] In this study we have used corticosteroids in the same regimen to treat lichen planus. The response was excellent in 6 (60%) patients and good in 4 (40%) patients. There were no significant side effects of the therapy and no treatment failures. Though the number of pa­tients included in this study is too small to draw to any conclusion, it seems to be a better, safer and effective therapeutic modality in this disease. There­fore, it needs to be evaluated in a larger number of patients to establish its effectiveness, safety and superiority over the other existing therapeutic mo­dalities

  References Top

1.Black MM. Lichen planus and lichenoid disorders. In: Cham­pion RH, Burton JL, Ebling FIG, eds. Textbook of Dermatology. 5th edn. Oxford: Blackwell Scientific Publications, 1992: 1689­-1690.  Back to cited text no. 1    
2.Gallant C, Kenny P. Oral glucocorticoids and their complica­tions. A review. I Am Acad Dermatol 1986; 14: 161 - 177.  Back to cited text no. 2    
3.Pasricha IS, Khaitan BK. Oral mini-pulse therapy with betamethasone in vitiligo patients having extensive or fast-spread­ing disease. Int J Dermatol 1993; 32: 753-757.  Back to cited text no. 3    
4.Pasricha IS, Kumrah L. Alopecia totalis treated with oral mini­pulse therapy with betamethasone. Indian J Dermatol Venereol Leprol 1996 ; 62:106 -109.  Back to cited text no. 4    


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