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Lichen planus generalized treatment prednisolone famotidine diprobate
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Tab Predlid prednisolone 40mg tapering dose OD ABF
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Prescription Decoded
Doctor: Dr. Malay Haldar, M.B.B.S., D.V.D.
Specialist: Skin & Venereal Diseases
Patient: Arpan Roychowdhury | Age: 24 yrs | M/F | Date: 24/3/26
Diagnosis
Lichen Planus (Generalized)
A chronic inflammatory autoimmune skin condition causing itchy, flat-topped, purplish papules/plaques. The "generalized" tag means it is widespread across the body surface.
Rx (Medications)
| # | Medication | Dose & Frequency | Duration | Purpose |
|---|---|---|---|---|
| 1 | Tab. Predlid (Prednisolone) 40 mg | 3 tabs once daily after breakfast (OD ABF) | 7 days | Oral corticosteroid — suppresses immune-mediated inflammation of lichen planus |
| ↓ Taper to 2 tabs OD ABF | 7 days | Dose tapering to avoid adrenal suppression | ||
| ↓ Further taper to 1 tab OD ABF | 7 days | Final taper before stopping | ||
| 2 | Tab. Famocid (Famotidine) 40 mg | 1 tab, once daily (OD) | 3 weeks | H₂-blocker — gastric protection against steroid-induced acidity/ulcers |
| 3 | Diprobate Plus Cream (Betamethasone dipropionate + Neomycin/Tolnaftate) | Apply twice daily (BD) | 1 month | Potent topical corticosteroid cream applied to affected skin areas to reduce local inflammation and itch |
| 4 | Tab. Zian (Cetirizine) 10 mg (written as 180 mg — likely 10 mg Cetirizine, "Zian" brand) | 1 tab at night | 1 month | Antihistamine — controls itching (pruritus), a major symptom of lichen planus |
| 5 | PPBS | — | — | Instruction to check Post-Prandial Blood Sugar — important monitoring since high-dose steroids can raise blood glucose |
Key Points to Note
- Prednisolone tapering schedule — 3 tabs → 2 tabs → 1 tab, each for 7 days (total 21 days of steroids). Never stop abruptly.
- Famotidine is given alongside steroids to protect the stomach lining.
- PPBS (Post-Prandial Blood Sugar) monitoring is advised because systemic steroids can cause steroid-induced hyperglycemia, especially over 3 weeks.
- Diprobate Plus Cream should be applied only on affected areas — avoid face and skin folds unless directed, as potent steroids can cause skin thinning.
- Cetirizine at night helps with nocturnal itching and its mild sedative effect aids sleep.
Disclaimer: This is a transcription and explanation for informational purposes only. Always follow your doctor's exact instructions and consult Dr. Haldar if you have any doubts.
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