Case Report
A 12 Years Old Case of Lichen Planus, Successfully Treated with Acitretin, Apremilast and Normal Saline
Faruk SMR*
Corresponding Author: Faruk SMR, Senior Consultant, National Skin Centre, Panthapath, Dhaka, Bangladesh
Received: May 21, 2019; Accepted: June 06, 2019;
Citation: Faruk SMR. (2019) A 12 Years Old Case of Lichen Planus, Successfully Treated with Acitretin, Apremilast and Normal Saline. Dermatol Clin Res, 5(1): 312-313.
Copyrights: ©2019 Faruk SMR. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
 

A 27 years old young unmarried man presented with diffuse pruritic skin lesion on his dorsal surface of both feet. He was suffering for last 12 years. Both the lesions were very pruritic, violaceous, hyperkeratotic, dark colored and little bit oozy due to severe scratch. There was no other similar lesion or the mucosal involvement. His nails and hair were also normal. Patient was in irregular treatment and took topical steroid ointment and antihistamine but not much improvement. According to clinical presentation patient was diagnosed as Lichen planus. No biopsy was taken because the patient did not consent to take biopsy. We did hematological examination and found CBC within normal limit, SGPT and Creatinine found normal, IgE was little bit higher than normal limit. The patient was initially treated with Normal Saline soak 2 times daily and Acitretin 25 mg daily for 2 months with topical steroid. Patient shows better response. After 2 months patient was unable to carry on the actretin therapy due to high treatment cost. After that we started apremilast 30 mg daily for 2 months then we started 30 mg apremilast on alternate days for 3 months. We checked his liver and kidney function by checking the blood parameter which was normal. Patient’s condition was good enough but not totally cured. Then we continued the apremilast treatment another 2 months at the same dose. After 11 months patient was totally cured and shows no major adverse effect except weakness.

 

Keywords: Lichen planus, Apremilast, Acitretin, Pruritic, Violaceous

 

Abbreviations: LP: Lichen Planus; NS: Normal Saline; SGPT: Serum Glutamic Pyruvic Transaminase; CBC: Complete Blood Count

INTRODUCTION

Lichen planus, a papulosquamous disease, in its classical presentation is characterized by pruritic violaceous papules most commonly on the extremities. It also is accompanied by involvement of oral and genital mucous membrane. Course of LP is generally self-limited for a period of several months to years, but it may last long. Persistant LP is a premalignant condition. Lichen planus is non-contagious.

CASE REPORT

A 27 years old young unmarried man presented with diffuse pruritic skin lesion on his dorsal surface of both feet. He was suffering for last 12 years. Both the lesions were very pruritic, violaceous, hyperkeratotic, dark colored and little bit oozy due to severe scratch. There was no other similar lesion or the mucosal involvement. His nails and hair were also normal. Patient was in irregular treatment and took topical steroid ointment and antihistamine but not much improvement. According to clinical presentation patient was diagnosed as Lichen planus. No biopsy was taken because the patient did not consent to take biopsy. We did hematological examination and found CBC within normal limit, SGPT and S. Creatinine found normal, IgE was little bit higher than normal limit. The patient was initially treated with Normal Saline soak 2 times daily and Acitretin 25 mg daily for 2 months with topical steroid. Patient shows better response. After months patient was unable to carry on the actretin therapy due to high treatment cost. After that we started apremilast 30 mg daily for 2 months then we started 30 mg apremilast on alternate days for 3 months. We checked his liver and kidney function by checking the blood parameter which was normal. Patient’s condition was good enough but not totally cured. Then we continued the apremilast treatment another 2 months at the same dose. After 11 months patient was totally cured and shows no major adverse effect except weakness.