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Standard therapeutic approaches include various topical treatments (including topical corticosteroids, calcineurin inhibitors, vitamin D analogs) and phototherapy modalities, as well as systemic corticosteroids and systemic retinoids. While localized skin lesions are easily managed with standard modalities, generalized forms and in particular involvement of hair follicles, nails and mucosa, as well as eyes are often challenging. This review proposes an evidence\u2010based and differential therapeutic regime, taking into account many new emerging systemic therapies to help clinicians optimize treatment according to the type, extent and severity of the disease. An individual therapeutic ladder has been developed for each location, starting with standard modalities and ranking alternative systemic treatments (mainly methotrexate and hydroxychloroquine, as well as cyclosporine, azathioprine and mycophenolate mofetil) according to efficacy, evidence level and side\u2010effect profile.<\/jats:p>","DOI":"10.1111\/ddg.12141","type":"journal-article","created":{"date-parts":[[2013,8,26]],"date-time":"2013-08-26T09:33:04Z","timestamp":1377509584000},"page":"981-991","source":"Crossref","is-referenced-by-count":35,"title":["Individualizing treatment and choice of medication in lichen planus: a step by step approach"],"prefix":"10.1111","volume":"11","author":[{"given":"Ioannis","family":"Manousaridis","sequence":"first","affiliation":[{"name":"Department of Dermatology, Venereology and Allergology, University Medical Centre Mannheim University of Heidelberg  Mannheim 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