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Pathology · single question

A biopsy reveals Civatte bodies (apoptotic keratinocytes), consistent with lichen planus. What is the most appropriate treatment for symptomatic disease?

  1. Clobetasol (a potent topical corticosteroid, standard first-line therapy for symptomatic oral lichen planus)
  2. Acyclovir (an antiviral, appropriate for herpesvirus infections, not lichen planus)
  3. Amoxicillin (an antibiotic, appropriate for bacterial infections, not lichen planus)
  4. Clotrimazole (an antifungal, appropriate for candidiasis, not lichen planus)
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Correct answer: A. Clobetasol (a potent topical corticosteroid, standard first-line therapy for symptomatic oral lichen planus)

Symptomatic oral lichen planus is typically managed with potent topical corticosteroids such as clobetasol, which reduce the inflammatory lymphocytic infiltrate responsible for symptoms and mucosal damage. Acyclovir, amoxicillin, and clotrimazole target entirely different pathogen types (viral, bacterial, fungal respectively) and have no role in lichen planus management.

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