Derya UÇMAK, Mehmet HARMAN, Gökçen BALCI

The effectiveness of treatment with enoxaparin in lichen planus

Amaç: Heparin analoglarının düşük dozlarının antiproliferatif ve immünmodülatör etkilerinin olduğu bilinmektedir. Bu çalışmanın amacı; liken planusta düşük doz enoxaparinin etkinliğini değerlendirmektir. Gereç ve yöntem: Liken planus tanısı alan 21 hasta 12 hafta boyunca tedavi edildi. Hastalara her hafta 3 mg enoxaparin subkutan enjeksiyonla yapıldı. Etki ve güvenlik verileri kaydedildi. Bulgular: Tam iyileşme hastaların 15’ inde (%71), belirgin düzelme 4’ ünde (%19) tespit edildi. Hastaların 2’sinde (%9) tedaviye yanıt alınmadı. Tedavi sonucunda en iyi yanıt, liken planusun akut generalize tipinde görüldü. Sonuç: Sonuç olarak enoxaparin tedavisinin liken planusta etkili bir tedavi seçeneği olabileceği kanaatine varıldı.

Liken planusda enoxaparin tedavisinin etkinliği

Objectives: As it is known, the low doses of Heparin’s analogues have the antiproliferative and immunomodula- tor activities. This research aims to evaluate the activity of enoxaparin by using the low doses. Materials and methods: 21 patients with lichen planus diagnosis have been cured within 12 weeks. 3 mg of enoxaparin has been used for subcutaneus injection to all of patients weekly. The efficient and reliable data has been saved. Results: The perfect recovery has been observed 15 (71%) of 21 patients, the distinct recovery has been ob- served 4 (19%) of 21 patients. The treatment has not given response on 2 (9%) of 21 patients. The best score has been received on acute generalized type of Lichen Planus. Conclusions: As the result; it has been reported that enoxaparin treatment can be an effective choice in Lichen Planus medication.

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1. Stefanidou MP, Ioannidou DJ, Panayiotides JG, Tosca AD. Low molecular weight heparin; a novel alternative therapeu- tic approach for lichen planus. Br J Dermatol 1999; 141(6): 1040-5.
2. Ferahbas A, Uksal U, Kutlugun C, Kontas O. Low-molecular- weight heparin (enoxaparin) in the treatment of lichen pla- nus. J Eur Acad Dermatol Venereol 2003; 17(5): 604-5.
3. Hodak E, Yosipovitch G, David M, et al. Low-dose low-molecu- lar-weight heparin (enoxaparin) is beneficial in lichen planus: a preliminary report. J Am Acad Dermatol 1998; 38(4): 564-8.
4. Tosca A, Varelzidis A, Michalopoulos M, Georgala S, Stratigos J. In situ identification of mononuclear cells in lichen planus. Dermatologica 1983; 167(3): 113-20.
5. Ingber A, Trattner A, Cohen IR, Mekori YA. Low doses of low molecular weight heparin in vivo inhibits the elicitation of con- tact hypersensitivity. Acta Derm Venereol 1994; 74(6): 454-6.
6. Lider O, Mekori YA, Miller T, et al. Inhibition of T lymphocyte heparanase by heparin prevents T cell migration andT cell- mediated immunity. Eur J Immunol 1990; 20(3): 493-9.
7. Hochart H, Jenkins PV, Smith OP, White B. Low-molecular weight and unfractionated heparins induce a downregulation of inflammation: decreased levels of proinflammatory cyto- kines and nuclearfactor-kappaB in LPS-stimulated human monocytes. Br J Haematol 2006; 133(1): 62-7.
8. Porter SR, Kirby A, Olsen I, Barrett W. Immunologic aspects of dermal and oral lichen planus: a review. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 1997; 83(3): 358-66.
9. Akdeniz S, Harman M, Atmaca S, Yaldiz M. The management of lichen planus with low- molecular-weight heparin (enoxa- parin). Int J Clin Pract 2005; 59(11): 1268-71.
10. Yaşar S, Serdar ZA, Göktay F, et al. The successful treatment of palmoplantar hyperkeratotic lichen planus with enoxapa- rin. Indian J Dermatol Venereol Leprol 2011;77(1):64-6.