Lichen planus is a chronic inflammatory disease that affects the lining of the mouth, genitals, and other mucosal surfaces, giving rise to characteristic white patches in the affected areas. If the white patches develop into erosive ulcers of the mouth, gums, vulva, and vagina, the disease is considered to be "erosive lichen planus." This condition is thought to be an autoimmune disorder, and treatment aims to reduce symptoms.
Corticosteroids
Physicians often prescribe corticosteroids for the treatment of erosive lichen planus. These drugs are powerful anti-inflammatory agents. The patients apply corticosteroid gel or ointment to the ulcers. Some patients might have to take the oral form of the medication in order to treat more widespread cases of the disease. If the lesions do not improve with the ointment or oral forms of corticosteroids, the drugs may be administered via injection.
Calcineurin Inhibitors
A special class of drugs, caleineurin inhibitors, has been shown to help eradicate the lesions associated with erosive lichen planus, states DermNet NZ. These drugs work by suppressing the body's immune response. Cream or ointment can be applied directly to lesions found in the mouth, genitals, and other affected regions. Some of these drugs have also been added to certain mouthwashes to treat the oral form of the disease.
Methotrexate
The drug methotrexate has been shown to improve the lesions associated with erosive lichen planus, according to DermNet NZ. Like other drugs given for this condition, it decreases the body's immune response.The drug may be taken long-term if needed, and some patients take folic acid with methotrexate to reduce the risk of side effects.
Non-Pharmacological Treatments
Patients suffering from erosive lichen planus can aid in treating the disease by performing some basic daily tasks. For oral lesions, patients need to practice good oral hygiene, including brushing frequently and using dental floss, and to have regular visits to the dentist. If the erosive ulcers are located on the genitals, then the patient should gently wash the region with water or with a cleanser that doesn't contain soap, like aqueous cream. Petrolatum, which is a soothing, non-irritating cream, can also be applied to the ulcers.
