Erosive lichen planus of the soles: Effective response to prednisone

Abstract

BackgroundErosive lichen planus (LP) of the soles is a rare variant of LP, characterized by chronic, painful, and disabling plantar ulcerations. Herein, we report a case with complete healing following treatment with systemic steroids.Case reportA 38-year-old woman was referred with painful and disabling erosive bilateral plantar LP, which she had experienced for 6 weeks. A 1 mg/kg/day, oral prednisone therapy led to rapid improvement and complete healing within 3 weeks, with a sustained result under a low dose maintenance therapy.DiscussionUlcerative plantar LP is significantly known to be unresponsive to several topical and systemic therapies. Surgical excision and grafting is the treatment of choice. Systemic steroids are reported to have inefficient or partial results; both on cutaneous healing and on maintenance of the result. Our patient achieved complete cicatrisation with a sustained result of 3 months under a low dose of prednisone (5 mg/day).

Ulcerating Lichen Planopilaris – Successful Treatment by Surgery

“…Oral lichen planus is often ulcerative [ 12 ]. Treatment of ulcerative plantar lichen planus needs systemic immunosuppression and often surgery [ 13 ][ 14 ].…”

Palmoplantar Lichen Planus with Papular Oral Lesions: Case Report and a Brief Review of the Literature

“…14 Actually, variants of palmoplantar LP, with other clinical manifestations of LP may appear contemporaneously in an individual. [3][4][5]9,15,16 There are case reports indicating hyperkeratotic palmoplantar plaques accompanying oral manifestations and typical cutaneous lesions of LP. 4,15 Likewise, plantar ulcero-erosive lesions of LP have been described with longitudinal melanonychia, reticular oral LP, and post inflammatory hyperpigmentation.…”

“…4,15 Likewise, plantar ulcero-erosive lesions of LP have been described with longitudinal melanonychia, reticular oral LP, and post inflammatory hyperpigmentation. 9,16 Up to date the most comprehensive investigation regarding palmoplantar LP has been held by Sanchez-Peres et al 5 Although it can't be figured out which combinations of clinical presentations their patients had displayed, they reported that simultaneous appearance rate of LP in the palmoplantar region and elsewhere was 26%. In this study the palmoplantar lesions were classified according to prevailing morphological patterns, as the erythematous scaly variant was the most common type observed, occurring in three-quarters of the patients, and the hyperkeratotic pattern was the second most prevalent one, described in the remaining one-quarter.…”

Oral, Esophageal and Cutaneous Lichen Ruber Planus Controlled with Alitretinoin: Case Report and Review of the Literature

“…Up to date 10 cases have been described [27,28,29,30,31,32,33,34,35]. Erosive LP is a painful variant of LP with eroded or ulcerated lesions mainly in mucocutaneous sites which is often difficult to treat and may lead to scarring [36,37,38]. Lichen planus pemphigoides refers to a cross-over syndrome of LP and bullous pemphigoid [5] and associations with drug intake have been described (PUVA [39], UVB, paracetamol or ibuprofen [40], simvastatin [41] and ramipril [42,43]).…”