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Comparative efficacy of methotrexate and mini pulse betamethasone in the treatment of lichen planus.

A clinical trial was conducted to evaluate the efficacy of methotrexate and mini pulse betamethasone in the treatment of lichen planus. A total of forty four patients of lichen planus, attending at the department of Dermatology and Venereology, BSMMU, Dhaka, Bangladesh during the period of January 2009 to December 2010 were enrolled in this study. Of them, 23 patients in Group A (case) and 21 patients in Group B (control) were selected. The case was treated with oral methotrexate and the control was treated with betamethasone oral mini-pulse therapy. Efficacy of drugs were measured to assess the improvement of mucocutaneous lesions, to change the colour of the lesions which became violaceous to postinflammatory hyperpigmentation, remission of itching, disappearance of existing lesions and stop appearance of new lession after initiation of treatment at 1st week, 2nd week, 6th week and 12th week. At the end of the present study, it was found that 16(69.6%) patients in cases completely cured the disease, whereas 10(47.6%) patients among the control cured the disease. Data showed that moderate remission was higher among the control 6(28.6%) compared to cases 5(21.7%) and the partial remission was also higher among the control 5(23.8%) compared to cases 2(8.7%). However, the efficacy was better in patients taking methotrexate and it also showed that macular and papular lesion responded well than plaque type lesion. Differences in treatment outcome were seen better in methotrexate group but the difference was not statistically significant.