Bakhtiar Rabeeka, Noor Sahibzada Mahmood, Paracha Muhammad Majid
Department of Dermatology, Lady Reading Hospital, Peshawar.
J Coll Physicians Surg Pak. 2018 Jul;28(7):505-508. doi: 10.29271/jcpsp.2018.07.505.
To compare the effectiveness of oral methotrexate versus systemic corticosteroids in treatment of lichen planus.
Randomised controlled trial.
Department of Dermatology, Lady Reading Hospital, Peshawar from September 2013 to February 2014.
Patients with generalised lichen planus involving at least 20% of total body area diagnosed clinically and were randomly allocated into two equal groups by lottery method. Patients in group A were subjected to oral methotrexate 10 mg once weekly for eight weeks with standard monitoring of full blood count and liver and renal function tests. Patients in group B were subjected to oral corticosteroids 40 mg for eight weeks taken daily than tapered according to the protocol. The results were assessed at baseline and at the eighth week after starting the treatment. The responses were analysed by Visual Analogue Scale (VAS) and sorted into four categories: 0-3 = poor response, 4-5 = moderate, 6-7 = good, and >7 excellent response. Chi-square test was applied to compare the efficacy in two groups with significance of less than or equal to 0.05.
Group A (methotrexate) had 47 (60%) male patients and 32 (40%) female patients. Group B (oral corticosteroids) had 51 (64%) male patients and 28 (36%) females. Group A 55 (70%) patients had lichen planus in <50% of the body; whereas in group B 53 (67%) patients had lichen planus in <50% of the body. Methotrexate was effective in 63 (80%) patients; whereas, oral corticosteroid was effective in 57 (72%) patients. No remarkable side effects were observed with either agent.
Methotrexate is more efficacious than systemic corticosteroids, but the effect is not statistically significant.
比较口服甲氨蝶呤与全身用皮质类固醇治疗扁平苔藓的疗效。
随机对照试验。
2013年9月至2014年2月，白沙瓦市雷丁夫人医院皮肤科。
临床诊断为全身扁平苔藓且累及至少20%体表面积的患者，通过抽签法随机分为两组。A组患者口服甲氨蝶呤10毫克，每周一次，共八周，同时对全血细胞计数及肝肾功能进行标准监测。B组患者口服皮质类固醇40毫克，每日一次，共八周，然后按方案逐渐减量。在治疗开始时的基线及第八周评估结果。通过视觉模拟量表（VAS）分析反应，并分为四类：0 - 3 = 反应差，4 - 5 = 中等，6 - 7 = 良好，>7 = 优秀反应。应用卡方检验比较两组疗效，显著性水平小于或等于0.05。
A组（甲氨蝶呤组）有47名（60%）男性患者和32名（40%）女性患者。B组（口服皮质类固醇组）有51名（64%）男性患者和28名（36%）女性患者。A组55名（70%）患者的扁平苔藓累及体表面积<50%；而B组53名（6...%）患者的扁平苔藓累及体表面积<50%。甲氨蝶呤对63名（80%）患者有效；而口服皮质类固醇对57名（72%）患者有效。两种药物均未观察到明显副作用。
甲氨蝶呤比全身用皮质类固醇更有效，但效果无统计学显著性差异。 （注：原文中“whereas in group B 53 (67%) patients had lichen planus in <50% of the body.”中“67%”疑似有误，根据前文逻辑推测应为“67%”，译文已按推测修正。）
