LICHEN PLANUS Treatment

Lichen planus causes unbearable irritation. It should probably be regarded as a special form of neurodermatitis since most patients have a background of emotional difficulty. There are some cases, however, which result from ;physical cause such as a reaction to anti-malarial drugs or to gold therapy When the eruption is a sequel to psychological upset it is self-limiting ; it last for a period of months or years ; the more acute the onset the more rapid is the course, and disappearance of the lesions is heralded by their intense pigmentation It is traditional to give mercury by mouth, for example 4 ml. of a solution of mercuric chloride in chloroform water thrice daily; and latterly isoniazic aminosalicylate tablets, one tablet (0.1 g.) per 20 lb. body weight, have beer recommended but the natural tendency for the disease to regress makes the true worth difficult to assess. An investigation of the circumstances of the patient's emotional life may suggest practical means of alleviating difficulties at home or at work, and there may be an indication for a radical change in the ( patient's way of life since some patients are shouldering an unmanageable burden of responsibility or are burning the candle at both ends for financial or other reasons. Betamethasone valerate and fluocinolone acetonide under polythene film occlusion are very effective and usually avoid the need to give corticosteroids orally, but it should be emphasized that considerable corticosteroid absorption can result from this method. Chronic localized patches—especially of the warty variety—are best treated by injecting corticosteroids into the lesions.