Melnyk T. Complex therapy of lichen planus considering the levels of metabolic processes and endotoxicosis in the organism of patients

The aim of the work was to improve the efficacy of diagnosis and treatment of lichen planus (LP) based on comprehensive study of hyperhomocysteinemia, endotoxic and pro-oxidant metabolic disorders as well as their relationship with the severity of disease and effectiveness of pharmacotherapy. To achieve the aim of the study, 95 patients with lichen planus aged 21-75 years underwent multimodal investigation and therapy. The patients with LP were found to develop unfavourable metabolic pattern characterized by increased levels of homocysteine, medium molecular weight peptides, products of lipid peroxidation of malonic dialdehyde, diene conjugates, carbonyl groups of oxidative modification of proteins, depletion in reduced glutathione content, decreased activity of antioxidant enzymes superoxide dismutase and blood. Based on the results of the study, an improved method of multimodal treatment in patients with LP was developed taking into account the existence of metabolic disorders, i.e. in addition to standard therapeutic regimen, study patients received multivitamin preparation decamevit containing folic acid, pyridoxine and cyanocobalamin, which are known to have hypohomocysteinemic effect, as well as sorbent silica dioxide and antioxidant alpha-lipoic acid. Addition of decamevit, alpha-lipoic acid and atoxyl resulted in significant decrease of the levels of homocysteine, medium molecular weight peptides, malonic dialdehyde, diene conjugates, carbonyl groups of proteins and increased content of reduced glutathione, catalase and superoxide dismutase activit. Such positive changes were registered in all study patients regardless of the area of lesion, severity of disease and its duration. Correction of hyperhomocysteinemia, endotoxicosis and pro-oxidant status proved to increase therapeutic efficacy of LP treatment.