scholarly journals Comparative evaluation of oral corticosteroids versus low molecular weight heparin in the treatment of lichen planus

Author(s):  
Narendar Gajula ◽  
Anusha Kalikota ◽  
Vontela Rohit ◽  
Hiba Shakeer

<p class="abstract"><strong>Background:</strong> Lichen planus (LP) is an immunologically mediated inflammatory disorder involving the skin, nails, hair follicles and mucous membranes. Though several drugs and phototherapy are tried and mentioned in the literature, dermatologists are still depending on corticosteroids, which have various serious side effects on long term usage. Thus, in search for an alternative therapy, the present study is conducted to compare the efficacy of systemic corticosteroids and low dose low molecular weight heparin in management of lichen planus.</p><p class="abstract"><strong>Methods:</strong> 60 patients with biopsy proven LP were selected and divided randomly into two groups with 30 patients each. Group 1 was treated with oral corticosteroids and group 2 was treated with low molecular weight heparin for 8 weeks. Follow up was done for a period of 6 months, at monthly intervals in all patients and any relapses if any were noted.<strong></strong></p><p class="abstract"><strong>Results:</strong> 60 patients with biopsy proven LP were selected and divided randomly into two groups with 30 patients each. Group 1 was treated with oral corticosteroids and group 2 was treated with low molecular weight heparin for 8 weeks. Follow up was done for a period of 6 months, at monthly intervals in all patients and any relapses if any were noted.</p><p class="abstract"><strong>Conclusions:</strong> Low dose enoxaparin in the treatment of lichen planus could be considered as an alternative to oral corticosteroids because of equal efficacy and fewer side effects.</p>

1998 ◽  
Vol 38 (4) ◽  
pp. 564-568 ◽  
Author(s):  
Emmilia Hodak ◽  
Gil Yosipovitch ◽  
Michael David ◽  
Arieh Ingber ◽  
Liran Chorev ◽  
...  

2014 ◽  
Vol 9 (1) ◽  
pp. 2-7 ◽  
Author(s):  
MSI Khan ◽  
MN Uddin ◽  
MOR Shah ◽  
L Khondker ◽  
MS Hasan

Introduction: Lichen planus is a common pruritic, inflammatory disease of the skin, mucous membranes, nail and hair follicles. Low dose low molecular weight heparin is administered in the treatment of cutaneous lichen planus. Objective: The objective is to evaluate the efficacy of low dose low molecular weight heparin in the treatment of cutaneous lichen planus. Materials and Methods: An interventional study was carried out in the department of Dermatology and Venereology, Combined Military Hospital (CMH), Dhaka. Total thirty seven patients of cutaneous lichen planus were selected by purposive type non-probability sampling technique. Data were collected by face to face interview and clinical examination. Results: It was observed that before treatment, the score of cutaneous lichen planus lesion was 6.83 ± 1.30 and after treatment was 3.83 ± 1.18 and ‘t’ test was found statistically significant (P<0.05). Improvement was shown in 26 (70.27%) cases. Out of these, response was good in 23 (88.46%), fair in 2 (7.69%) and poor in 1 (3.85%) cases. Conclusion: The study revealed that low dose low molecular weight heparin has remarkable efficacy profile as treatment option for cutaneous lichen planus. DOI: http://dx.doi.org/10.3329/jafmc.v9i1.18717 Journal of Armed Forces Medical College Bangladesh Vol.9(1) 2013: 2-7


2021 ◽  
Vol 23 (3) ◽  
pp. 30-38
Author(s):  
A. V. Bervitskiy ◽  
V. E. Guzhin ◽  
G. I. Moisak ◽  
E. Z. Imamurzaev ◽  
E. V. Amelina ◽  
...  

Introduction. Patients with brain tumors are at increased risk for the development of venous thromboembolism (VTE). The most effective prevention method today is a combination of mechanical compression of the lower extremities and the introduction of low molecular weight heparin (LMWH). In 2018, an algorithm for the prevention of VTE was introduced in our clinic, which implies the early (in the first 48 h after surgery) administration of LMWH.The study objective is to assess the effect of early LMWH administration on the incidence of intracranial hemorrhage (ICH) after removal of brain tumors.Materials and methods. From January 2014 to December 2019, 3266 patients underwent removal of brain tumors. The group 1 included 2057 patients who were treated in the period before the introduction of the VTE prevention algorithm (2014– 2017), the group 2 included 1209 patients who were treated using this algorithm (2018–2019). In each of the groups, the frequency and timing of ICH were assessed. The severity of complications was assessed according to the F.A.L. Ibanez classification. The data were compared between groups 1 and 2, as well as between patients who received LMWH at the time of ICH and those who did not receive.Results. Patients of the group 1 were prescribed LMWH in 14.3 % of cases, on average on the 4th day after surgery. In this group, 26 (1.26 %) patients developed ICH. Patients of the group 2 were prescribed LMWH in 89 % of cases, on average on the 2nd day. In this group, 15 (1.24 %) patients developed ICH. Severe complications were in 6 (85.7 %) of 7 patients who received LMWH at the time of ICH, and in 25 (73.5 %) of 34 patients who did not receive LMWH (p = 0.66).Conclusion. The widespread use of LMWH for the prevention of VTE during the first 48 h after removal of brain tumors did not lead to an increase in the frequency of ICH. At the same time, patients with ICH who developed during the use of LMWH often had a more severe clinical course.


Author(s):  
Mine Altınkaya Çavuş ◽  
Hafize Sav

Objective: The most prominent clinical finding in severe COVID-19 patients is endothelial damage. For these reasons, active administration of anticoagulants (such as heparin) is recommended to patients with severe COVID-19. The purpose of this study is to investigate the effects of different doses of low-molecular weight heparin (LMWH) on severe COVID-19 patients. Methods: This study was performed retrospectively in intensive care unit of a tertiary referral hospital. PCR (polymerase chain reaction) positive (+) patients were included in the study. Patients’ demographic data, length of stay in the hospital and intensive care unit, laboratory values (D-dimer, CRP, creatinine) on the last day of intensive care stay, mortality and invasive mechanical ventilator needs were recorded. Group O: consisted of patients not receiving anticoagulants, and Group 1 received a single daily dose of 40 mg enoxaparin sodium (equivalent to 4000 anti-Xa IU), and Group 2 received 2 daily doses of 1 mg/kg enoxaparin sodium. Results: A total of 191 patients were included in the study. 45% of the patients were female (n: 86), 55% were male. The mean age was found to be 67.6 ± 13.8. Patient numbers; group 0: 12, group 1: 90, group 2: 89. 7-day mortality was 50% in group 0, 22.2% in group 2, and 23.5% in group 3 (p value <0.05). Conclusion: In a recent lung dissection report in critically ill patient with COVID-19; occlusion of pulmonary small vessels and formation of microthrombosis have been demonstrated. Prophylactic doses of LMWH are used more frequently. Some studies have suggested that septic patients may benefit from early diagnosis and specific treatment. As a result; in severe COVID-19 patients with limited mobilization, all doses of LMWH reduce morbidity and mortality.


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