Year : 2017  |  Volume : 10  |  Issue : 2  |  Page : 149-155

Evaluation of safety and efficacy of low-dose methotrexate as an alternative treatment option to systemic corticosteroids in generalized lichen planus

Department of Dermatology, Smt Kashibai Navale Medical College and General Hospital, Pune, Maharashtra, India

Correspondence Address:
Yuvraj Eknath More
Department of Dermatology, Smt Kashibai Navale Medical College and General Hospital, Narhe, Off Mumbai Bypass, Pune - 411  041, Maharashtra
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/0975-2870.202094

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Introduction: Lichen planus (LP) is a common, chronic, inflammatory pruritic disorder involving the skin, mucous membranes, nails, and hair follicles. Systemic corticosteroids have long been treatment of choice for generalized LP. However, use of corticosteroids is limited due to multiple side effects. Methotrexate (MTX) can be used as alternative and safe modality in generalized LP. Materials and Methods: Twenty-two cases of generalized LP with comorbidities such as diabetes mellitus and hypertension and steroid-resistant and patients with side effects of long-term corticosteroids were included in this study. MTX was initiated at the dose of 7.5 mg/week. Clinical evaluation for improvement in lesions and pruritus was performed at 2nd, 4th, 8th, and 12th weeks. Results: After 12 weeks, 80% patients had excellent improvement. Patients with an excellent response were followed up. In the 6-month follow-up, four patients showed recurrence while all the remaining 12 showed complete remission. Conclusion: Results of this small study suggest that the use of weekly oral MTX can be highly effective and tolerable treatment alternative for generalized LP.

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