Low-dose heparin devoid of anticoagulant activity is capable of inhibiting T lymphocyte heparanase activity, crucial in T cell migration to target tissues. We studied the efficacy of a low dose of enoxaparin (Clexane), a low molecular weight heparin, as monotherapy in 6 females suffering from typical widespread histopathologically proven lichen planus (LP) associated with intense pruritus of several months' duration. Once weekly these patients (pts) were given 3 mg of Clexane s.c.: 3 received 4 injections and 3, 6 injections. In 5 pts the itch disappeared within 2 weeks and within 4-8 weeks there was almost complete regression of the eruption with residual postinflammatory hyperpigmentation. In 1, no effect was observed. In 4 of these 5 pts a posttherapy biopsy specimen was obtained from a lesion adjacent to the pretherapy biopsy site and showed histopathological 'improvement'; in 1 there was mainly postinflammatory hyperpigmentation and in 3, findings of atrophie LP representing LP in resolution. No side effects were observed in any of the subjects treated. These findings indicate that Clexane may be a simple, effective treatment for LP and imply that it may also be beneficial in other types of skin diseases in which the T cell plays an important role.
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|Published - 1996