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Effective Treatment of Oral Erosive Lichen Planus With Thalidomide
Charles Camisa, MD;
Jennifer Levin Popovsky, MD
Cleveland Clinic Foundation, Cleveland, Ohio
Arch Dermatol. 2000;136:1442-1443.
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REPORT OF A CASE
A 70-year-old man presented with a 2-year history of bloody gums and fetid breath. He was initially treated with topical corticosteroids and courses of oral prednisone starting at 60 mg/d and tapered over several weeks. When this treatment failed to produce any durable clinical improvement, he was treated sequentially with griseofulvin, dapsone, azathioprine, etretinate, and cyclosporine. His current medication was cyclophosphamide, 100 mg/d for 5 months. He reported that the only therapy that decreased his pain, swelling, and bleeding was the prednisone and brief courses of azithromycin, which had been discovered serendipitously while he was being treated for an upper respiratory infection.
Examination showed erosions and ulcerations of the hard palate; severe desquamative gingivitis, involving facial (Figure 1A) and palatal gingiva; and atrophy and striae of the buccal mucosa (Figure 2A) and tongue. A biopsy specimen from involved buccal . . . [Full Text of this Article]
THERAPEUTIC CHALLENGE
SOLUTION
COMMENT
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