Which statement best describes the first-line therapy for erosive lichen planus?

• A. Antivirals
• B. Antibiotics
• C. Corticosteroids
• D. Antifungals

Answer: (C)

Suppressing the local immune-driven inflammation is the aim when treating erosive lichen planus, and anti-inflammatory steroids are the most effective way to do that at the lesion site. Topical corticosteroids are the preferred initial therapy because they directly reduce inflammation in the mucosa, lessen pain, and promote healing with minimal systemic effects. In practice, a high-potency topical steroid like clobetasol propionate, or triamcinolone in an adhesive base, is applied to the affected areas several times a day for a short period and then tapered as symptoms improve. If the disease is widespread or not controlled with topicals, systemic corticosteroids may be considered, but they come with more risks and are not used as the first step in most patients. The other options—antivirals, antibiotics, and antifungals—do not treat the underlying inflammatory process of erosive lichen planus, though they might be used if a secondary infection is present.