"Homeopathic Management of Relapsing Lichen Planus: A Case with 12 Years of Chronicity”

A 38-year-old male [Patient ID: 50353] presented with complaints of lichen planus involving multiple body sites, including both legs, forearms, abdomen, back, soles of the feet, and oral mucosa. The condition had begun 12 years ago, had remained in remission for almost a decade, but had relapsed about a year ago with gradual spreading from the legs to other areas. The eruptions were moderately itchy and became worse at night, with burning pain following scratching. Oral involvement caused mild burning and discomfort while eating spicy food, and a small white lacy lesion was seen on the right buccal mucosa. Hyperpigmented patches and dry, rough skin were noted on the legs and feet. There was no history of ulceration or discharge. The disease had been stable for many years but had slowly progressed during the recent relapse, with new lesions occasionally appearing on the abdomen and legs.

Present medication—He was taking Tab Aprexo (Apremilast) 100 mg OD, Levofloxacin once daily, Momate steroid ointment, Venusia lotion, and Veisee soap. These medications offered temporary relief but did not prevent the recurrence of new eruptions.

Past treatment—In the past, he had received methotrexate 7.5 mg (immunosuppressant), aceclofenac, bilastine (antihistamine), and moisturizing creams like Moiz MM, as well as prolonged topical steroid applications for about a year. Despite these, the lesions remained active and were gradually spreading.

Physical generals—He consumed a mixed diet without any strong cravings or aversions. He drank about 3–4 liters of water daily, had average perspiration, was thermally chilly, and maintained satisfactory bowel movements. There was no addiction to alcohol or tobacco. Sleep was refreshing, and overall appetite and thirst were normal.

Personal history—He worked in a pharmacy (Pravi Bio Life), was married, and had two young daughters aged six and three years. He lived in a joint family in Boisar and described his marital life as happy and well supported. His life journey had been generally pleasant, with emotional stability and no major stressors, though he had experienced some professional stress at work. The patient was described as mild, gentle, affectionate, and sensitive, which reflected his overall emotional state and interpersonal relationships.

Family history—Was significant for diabetes mellitus, as both his mother and brother were diabetic. There was no known history of skin disorders, autoimmune diseases, or lichen planus in other family members.

Based on this totality of symptoms, Dr. Shah selected individualized homeopathic treatment suited to his constitution and presenting features. Over the course of follow-ups, the patient showed a steady and sustained improvement.

Follow-ups:

11/03/2023: A few new eruptions appeared on the abdomen, legs, and hands with dryness and itching. Old eruptions remained stable. Oral LP showed no issue. Conventional medicines were reduced.

05/05/2023: New eruptions appeared on the feet, legs, and thighs. Old lesions remained stable. Itching was mainly on the feet, legs, and hands. He had stopped conventional medicines about two months earlier. Trigger: professional stress.

01/07/2023: No new spots appeared. Large patches were improving. Some itching with dryness was present. LP over the left toenail was noted. Constipation with minor bleeding was reported.

29/08/2023: No new spots appeared. Large lesions were improving. Itching was reduced. Nail LP and constipation were better.

29/10/2023: Old spots flared up with increased itching for a week (possible trigger: small quantity of non-veg food). Overall improvement was seen, and constipation was less.

06/01/2024: Itching was absent. Old spots were better. No active lesions were present. Hyperpigmentation and dryness were present.

13/05/2024: No new spots appeared. Old lesions were slightly better. Mild itching was present. He was not on any conventional medicines.

20/09/2024: 50–60% overall improvement was observed. A few new spots appeared on the left leg and feet. Old eruptions had improved. Oral LP had completely healed. Mild dryness and occasional itching on the legs were present.

12/01/2025: 80% better. No new spots or spread were seen. Oral LP had completely healed. Abdominal, chest, and back lesions had resolved. Leg eruptions had significantly improved. Hyperpigmentation was fading.

04/06/2025: One new eruption appeared on the right foot with itching. Old eruptions were inactive. Oral LP was almost healed. Hyperpigmented spots remained.

29/07/2025: No new eruptions appeared. Old lesions were improving. No itching was present. Hyperpigmentation continued to fade.

• Case study written by Dr. Shreya Hedaoo, an associate Doctor to Dr. Rajesh Shah, MD (Hom)