Patrone P, Stinco G, La Pia E, Frattasio A, De Francesco V
Institute of Dermatology, DPMSC, University of Udine, Gemona Hospital, 33013 Gemona, Italy.
Eur J Dermatol. 1998 Jun;8(4):243-4.
Erosive lichen planus is known to be relatively unresponsive to medical treatment. Surgery could be an alternative treatment for this disease. We report the case of a 68-year-old man with a 10-year history of painful, disabling, ulcerative lesions on the soles of both feet. All previous topical and oral treatments had failed and his condition was gradually worsening. Cyclosporine A was administered twice. The first time, systemic cyclosporine A gave a marked but only temporary improvement. The second time, treatment with cyclosporine A was begun 10 days before the ulcer on his left sole was covered with a Thiersch split-skin graft. The grafting was successful, so cyclosporine A was gradually reduced to smaller maintenance doses and 10 months later it was completely withdrawn. The patient refused to undergo surgery on his right foot thus providing the opportunity to compare the results. At the present time, eighteen months following grafting and ten months after total withdrawal of cyclosporine A, the condition of the left sole is stable and free from pain while the ungrafted ulcer on his right sole is still painful and has increased in size.
糜烂性扁平苔藓已知对药物治疗反应相对较差。手术可能是这种疾病的一种替代治疗方法。我们报告了一例68岁男性病例，其双足底出现疼痛、致残性溃疡性病变已有10年病史。之前所有的局部和口服治疗均失败，且他的病情逐渐恶化。两次给予环孢素A治疗。第一次，全身性环孢素A治疗带来了显著但只是暂时的改善。第二次，在其左足底溃疡处覆盖邮票植皮术前10天开始使用环孢素A治疗。植皮成功，因此环孢素A逐渐减至较小的维持剂量，10个月后完全停用。患者拒绝接受右足手术，从而提供了比较结果的机会。目前，在植皮后18个月以及环孢素A完全停用10个月后，左足底情况稳定且无疼痛，而右足底未植皮的溃疡仍疼痛且面积增大。
