Mrs S.T 40 years old female got registered for the treatment of extensive lichen planus 16th september 2011.

At the time of first visit she had hypertropied lesions on extremities, abdomen and back. There were many hyper pigmented spots left after the active lesions. It was found out that she was taking methotrexate, a immuno suppressive medicine. Dr Shah explained the side effects of the medicines and she was advised to slowly taper the medicines and stop it. She was also explained the possibility of a flare up after stopping those medicines.

After thorough case taking she was prescribed with a constitutional medicine and research based medicines from Dr Shah. She was prescribed 2 months medicines.

At 2 months follow up (Nov 11) She presented with the same complaints without much changes noticed. She had gradually stopped the immuno suppressive medicines as suggested by Dr Shah. She was given the next batch of medicines for 2 months.

At 4 months follow up (Jan 12) She presented with a rapid flare up since 1 month. Many of the old lesions which were healed were coming back. Not only the old lesions there were few eruptions on new places which were never involved. A proper counselling was given and the rebound effect of stopping immuno suppressive medicines were explained. In follow up good sign was that the leathery eruptions have become little flat. Same medicines were continued with increased potency.

At 6 months follow up (Mar 12) She came with 20 % improvement in the lesions. The rate of spread has reduced though some new eruptions were still coming. More importantly the severe itching had reduced by 50%. She was now hopeful of recovery.

At 8 months follow up (May 12) She presented with 80% improvement. All the lesions were becoming flat and itching was completely gone. She was concerned about the dark hyper pigmentation marks left.

At 12 months follow up (July 12) Again she presented with a flare up in extremities. This time the eruptions were not leathery but reddish with lot of itching. Her case was reviewed and it was found out she had used certain chemicals for bleach on the extremities. Her prescription was changed.

After 2 months (Sept 12) The condition was status quo. There was no improvement in the new lesions. The old spots had healed completely and the hyper pigmentation was reduced by 40%. Again the prescription was changed.

After 2 months (Nov 12) She came with 40% improvement in new lesions and complete recovery in old eruptions. The hyperpigmentation marks were better by 80%.

After 2 months (Jan 13) She presented with 80% improvement in the new lesions. The active lesions were completely gone. Few hyper pigmented marks were left. She was advised to continue the medicines for 4 months to see complete recovery.

Uploaded on 24th May 2013 by Dr. S. B.