Comparative efficacy of hydroxychloroquine and griseofulvin in the treatment of lichen planus

Background Lichen planus (LP) is an unpredictable disease that typically persists for 1 to 2 years, but which may follow a chronic, relapsing course over many years. Management of LP can be challenging and discouraging for both the patient and physician. Objectives To compare the efficacy of hydroxychloroquine and griseofulvin in the treatment of LP. Patients and methods 80 cases of age group 20-60 years were selected for the study during the period of July 2007 to June 2009 in the Department of Dermatology and Venereology of three different hospitals in Bangladesh. All cases were diagnosed clinically and confirmed by histopathological examination of skin. The patients were randomly divided into 2 equal groups. Group A was given hydroxychloroquine 400 mg daily and group B was given griseofulvin 500mg daily for a period of 6 months. Results 53 (66%) male and 27 (34%) female were included in the study. The mean age in group A was 39.03±12.28 years and in group B was 42.87±11.16 years (p=0.146). The mean duration of the disease in group A was 4.37±3.87 months and in group B was 4.35±3.32 months (p=0.975). In group A clinical responders were 28 (70%): complete response in 7 (17.5%) and moderate improvement in 21 (52.5%) and in group B clinical responders were 17 (42.5%): complete response in 2 (5%) and moderate improvement in 15 (37.5%) [p=0.027]. Conclusion In this study both hydroxychloroquine and griseofulvin showed clinical improvement but hydroxychloroquine showed a relatively better response than griseofulvin in the treatment of LP.