Dermatology, Venereology and Andrology Department, Faculty of Medicine, Tanta University, Tanta, Egypt.
Tropical Medicine and Infectious Diseases Department, Faculty of Medicine, Tanta University, Tanta, Egypt.
J Dermatolog Treat. 2022 Nov;33(7):3039-3046. doi: 10.1080/09546634.2022.2104446. Epub 2022 Jul 31.
Lichen planus (LP) is a chronic inflammatory mucocutaneous disease. Systemic corticosteroids are the treatment of choice for generalized LP but their use is limited due to side effects. Oral mini pulse (OMP) therapy represents a good alternative. Also, Methotrexate (MTX) can be used as an alternative and safe modality in LP.
To compare the efficacy and safety of oral MTX versus OMP betamethasone in the treatment of different types of LP.
The study included 40 patients presenting with LP who were randomly divided into two groups. Group A for oral MTX 7.5 mg weekly & group B for OMP betamethasone 3 mg weekly for a maximum of 12 weeks. Basic laboratory investigations were done on both groups. Follow-up investigations were done on the 2nd, 4th, 8th and 12th weeks. The percentage of improvement in each patient was calculated on a scale according to the appearance of new lesions, degree of pruritus/pain, subsidence of cutaneous lesions and clearance of the oral lesion.
In the MTX group, 55% of patients showed excellent improvement, 25% showed good improvement and 20% showed partial improvement. In the OMP group, 85% of patients showed excellent improvement, 10% showed good improvement and 5% showed partial improvement. The reported clinical and laboratory adverse effects were tolerable and didn't lead to the discontinuation of treatment.
OMP betamethasone and low dose MTX may be considered effective and safe lines of treatment for different types of LP and may represent good and safe alternative options for conventional daily corticosteroid therapy.
扁平苔藓（LP）是一种慢性炎症性黏膜疾病。全身性皮质类固醇是治疗广泛性 LP 的首选药物，但由于副作用，其使用受到限制。口服迷你脉冲（OMP）治疗是一种很好的替代方法。此外，甲氨蝶呤（MTX）也可以作为 LP 的替代和安全治疗方法。
比较口服 MTX 与 OMP 倍他米松治疗不同类型 LP 的疗效和安全性。
本研究纳入了 40 名患有 LP 的患者，他们被随机分为两组。A 组口服 MTX 7.5mg 每周，B 组口服 OMP 倍他米松 3mg 每周，最多 12 周。对两组患者均进行了基本的实验室检查。在第 2、4、8 和 12 周进行随访检查。根据新病变的出现、瘙痒/疼痛程度、皮肤病变消退和口腔病变清除情况，对每位患者的改善百分比进行评分。
在 MTX 组中，55%的患者表现出极好的改善，25%的患者表现出良好的改善，20%的患者表现出部分改善。在 OMP 组中，85%的患者表现出极好的改善，10%的患者表现出良好的改善，5%的患者表现出部分改善。报告的临床和实验室不良反应是可以耐受的，不会导致治疗中断。
OMP 倍他米松和低剂量 MTX 可被认为是治疗不同类型 LP 的有效和安全方法，并且可能代表了传统每日皮质类固醇治疗的良好和安全替代选择。
