***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: Sixty-five patients with lichen planus were included in a multicenter trial of acitretin . At the end of an 8-week placebo-controlled , double-blind phase , a significantly higher number of patients treated with 30 mg/day acitretin ( 64 % ) showed remission or marked improvement compared with placebo ( 13 % ) . Furthermore , during the subsequent 8-week open phase , 83 % of previously placebo-treated patients responded favorably to acitretin therapy . Typical retinoid adverse reactions were present in all patients on active drug . Laboratory studies did not show any clinical ly significant changes . This study shows that acitretin is an effective and acceptable therapy for severe cases of lichen planus Summary .— Thirty‐four patients with lichen planus were treated in a double‐blind trial in which either 500 mg of griseofulvin‐FP or a placebo was issued to the patients on a r and om distribution basis . A significant difference was found between the results obtained with griseofulvin and those with the placebo . The favourable response to the treatment was accompanied by more or less typical histopathological features . No untoward effects , or recurrence in lesions were noted in the course of the trial BACKGROUND Oral sulfasalazine has been reported to be effective in patients with idiopathic cutaneous lichen planus ( LP ) . OBJECTIVES Our purpose was to evaluate the efficacy of this drug in the treatment of generalized cutaneous lichen planus ( GLP ) . In this study , we evaluated the effectiveness of the anti-inflammatory drug sulfasalazine for the treatment of GLP . METHODS A total of 52 patients with GLP presenting at the outpatient clinic were enrolled in this double-blind , r and omized , placebo-controlled , prospect i ve study . Of these patients , 44 completed the period of study . The patients were r and omly divided into two groups . One group received placebo and the other was given sulfasalazine maximum 2.5 g/day . The patients were evaluated at the third and sixth weeks of treatment for improvement rate and occurrence of complications . RESULTS After 6 weeks of treatment , the rate of cutaneous lesions improvement was 9.6 % ( two patients ) in the placebo group and 82.6 % ( 19 patients ) in the sulfasalazine group . The improvement rate of pruritus was 14.3 % in the placebo group and 91.3 % in the sulfasalazine group . Side-effects which were mild and tolerable were detected in 30.7 % of patients , but three patients left the study because of side effects . Most of the reported side-effects included gastrointestinal upset and headache . CONCLUSIONS Statistically , sulfasalazine was more effective than placebo in reducing cutaneous lesions and improving pruritus after 6 weeks of treatment . According to our study , sulfasalazine is a relatively safe and effective treatment option and may be an alternative therapy for the treatment of generalized lichen planus The objectives of this study were to compare the adverse outcome of methotrexate and mini pulse betamethasone therapy in the treatment of lichen planus . It was a clinical trial conducted in the department of Dermatology and Venereology , Bangab and hu Sheikh Mujib Medical University , Dhaka , from January 2009 to December 2010 . Forty four patients of lichen planus were included in the study . Patients in Group-A , ( n = 23 ) were treated with methotrexate ( 10 mg ) single morning dose and group-B ( n = 21 ) were treated with mini pulse betamethasone ( 5 mg ) single morning dose on 2 consecutive days during the period of 12 weeks . Adverse outcomes were measured by clinical examination and laboratory investigations during follow up visits . Anemia 3 ( 14.2 % ) and edema 12 ( 57.1 % ) developed in group-B but none in group-A. In group-B , dyspepsia 15 ( 71.4 % ) , acne 10 ( 47.6 % ) , mooning face 8 ( 38.1 % ) , striae 8 ( 38.1 % ) and hypertrichosis 4 ( 19.0 % ) developed but none in group-A. Intermittent diarrhoea , headache , nausea and fatigue complained in both groups of patients but the percentage of complaints was higher among group-B compared to group-A. Menstrual abnormality developed in group-B 5(71.4 % ) but none in group-A. Laboratory investigations showed abnormality in platelet count and SGPT in group-A but none in group-B. The adverse effects of methotrexate on haematological parameter and liver functions were mild and could be prevented by reducing the dose but the adverse effects of betamethasone were unavoidable . The overall adverse effects were less in group-A than group-B. Therefore , methotrexate can be used as an alternative safer option for the treatment of lichen planus The CONSORT ( Consoli date d St and ards of Reporting Trials ) Statement , including a checklist and a flow diagram , was developed to help authors improve their reporting of r and omized controlled trials . Its primary focus was on individually r and omized trials with 2 parallel groups that assess the possible superiority of one treatment compared with another but is now being extended to other trial design s. Noninferiority and equivalence trials have method ological features that differ from superiority trials and present particular difficulties in design , conduct , analysis , and interpretation . Although the rationale for such trials occurs frequently , those design ed and described specifically as noninferiority or equivalence trials appear less commonly in the medical literature . The quality of reporting of those that are published is often inadequate . In this article , we present an adapted CONSORT checklist  for reporting noninferiority and equivalence trials and provide illustrative examples and explanations for those items amended from the original CONSORT checklist . The intent is to improve reporting of noninferiority and equivalence trials , enabling readers to assess the validity of their results and conclusions BACKGROUND : Topical calcipotriol is a vitamin D3 analogue which influences keratinocyte proliferation and differentiation . Its efficacy in cutaneous lichen planus has not been well evaluated . METHODS : This is a r and omized open‐label trial comparing the effectiveness of calcipotriol 50 μg/g versus betamethasone 0.1 % ointments twice daily for 12 weeks in patients with cutaneous lichen planus , with respect to thickness , pigmentation , clearance and pruritus . Patient self‐ assessment was made at 0 , 4 , 8 and 12 weeks post r and omization using visual analogue scales ( VAS ) . Clinical assessment was made at week 12 and adverse events noted . Clinical response was defined as 75 % or more for lesion flattening and absent or minimal pigmentation , and 50 % or more for clearance . RESULTS : A total of 31 patients were r and omized : 15 to calcipotriol and 16 to betamethasone . Clinical ly assessed lesion flattening occurred in approximately half the patients . With calcipotriol , there were two responses for pigmentation and one for clearance but none with betamethasone . Patient VAS indicated a gradual improvement in all measures but with little difference between the treatments . The largest difference indicated a 12‐point disadvantage to calcipotriol for thickness but this was not statistically significant ( p=0.09 ) . Side effects reported were erythema ( one patient ) and increased pruritus ( two patients ) , all with calcipotriol . CONCLUSION : Calcipotriol appears no more effective than betamethasone . The course of the disease appears to be affected in the same way by both treatments OBJECTIVE : To test the feasibility of creating a valid and reliable checklist with the following features : appropriate for assessing both r and omised and non-r and omised studies ; provision of both an overall score for study quality and a profile of scores not only for the quality of reporting , internal validity ( bias and confounding ) and power , but also for external validity . DESIGN : A pilot version was first developed , based on epidemiological principles , review s , and existing checklists for r and omised studies . Face and content validity were assessed by three experienced review ers and reliability was determined using two raters assessing 10 r and omised and 10 non-r and omised studies . Using different raters , the checklist was revised and tested for internal consistency ( Kuder-Richardson 20 ) , test-retest and inter-rater reliability ( Spearman correlation coefficient and sign rank test ; kappa statistics ) , criterion validity , and respondent burden . MAIN RESULTS : The performance of the checklist improved considerably after revision of a pilot version . The Quality Index had high internal consistency ( KR-20 : 0.89 ) as did the subscales apart from external validity ( KR-20 : 0.54 ) . Test-retest ( r 0.88 ) and inter-rater ( r 0.75 ) reliability of the Quality Index were good . Reliability of the subscales varied from good ( bias ) to poor ( external validity ) . The Quality Index correlated highly with an existing , established instrument for assessing r and omised studies ( r 0.90 ) . There was little difference between its performance with non-r and omised and with r and omised studies . Raters took about 20 minutes to assess each paper ( range 10 to 45 minutes ) . CONCLUSIONS : This study has shown that it is feasible to develop a checklist that can be used to assess the method ological quality not only of r and omised controlled trials but also non-r and omised studies . It has also shown that it is possible to produce a checklist that provides a profile of the paper , alerting review ers to its particular method ological strengths and weaknesses . Further work is required to improve the checklist and the training of raters in the assessment of external validity BACKGROUND : Lichen planus is recognized as an inflammatory disease of the skin with different morphologic patterns . Different treatment modalities , including topical and systemic corticosteroids , methotrexate , cyclosporine , azathioprine , topical calcineurin inhibitors , and psoralen plus UVA ( PUVA ) , have been suggested for lichen planus . Although the efficacy of narrowb and UVB ( NBUVB ) for treatment of lichen planus has been shown , no r and omized clinical trial has compared NBUVB versus systemic corticosteroids for treatment of the disease . In the current study , we evaluated the efficacy of NBUVB versus systemic corticosteroids in the treatment of the lichen planus . METHODS : Forty-six patients with confirmed diagnosis of lichen planus were r and omly selected . The subjects were r and omized into two groups of 23 to be treated with either systemic corticosteroids or NBUVB . All of the selected cases had generalized lichen planus that involved at least 20 % of the body area and their pruritus was resistant to antihistamine drugs . Patients in the systemic corticosteroids group were treated with prednisolon 0.3 mg/kg for 6 weeks . NBUVB was performed three times a week for 6 weeks . The maximum dose of NBUVB was 9 J/cm2 . Data regarding demographic characteristics of the patients was also collected . All collected data was analyzed using SPSS15 and statistical tests including analysis of variance ( ANOVA ) , chi-square , and t-test . RESULTS : 46 patients ( 23 patients in systemic steroid group and 23 patients in NBUVB group ) were evaluated . There was a significant difference between the 2 groups regarding the efficacy of the treatment . According to chi-square test , NBUVB was significantly more effective than systemic steroid in treatment of generalized lichen planus ( p = 0.008 ) . According to the results , patient satisfaction was also significantly higher in the group treated with NBUVB as compared with the systemic corticosteroids ( p = 0.012 ) . CONCLUSIONS : Overall , the results of our study and other previous studies showed that NBUVB may be regarded as an effective treatment for generalized cutaneous lichen planus . This treatment may be especially utilized when there is contraindication for systemic corticosteroids or other immunosuppressive drugs Background : The aim of this study was to evaluate and compare the therapeutic efficacy of subcutaneous enoxaparin versus oral prednisone ( as a st and ard treatment ) in patients with disseminated lichen planus . Material s and Methods : In this parallel r and omized clinical trial study , overall 48 patients completed the study . 25 patients were treated with subcutaneous enoxaparin 5 mg weekly and 23 patients with 0.5 mg/kg prednisone orally daily until complete remission or a maximum of 8 weeks . The results of itching severity , extent of active lesions and drug side effects were compared . In remission , patients were followed for 6 months for recurrent lesions . Results : In enoxaparin group , 8 patients ( 32 % ) had complete remission and 10 patients ( 40 % ) had partial improvement . In the oral prednisone group , 16 patients ( 69.6 % ) had complete remission and 6 patients ( 26.1 % ) had partial improvement ( P = 0.005 ) . Average size of active lesions in both groups decreased significantly after treatment , but analysis of covariance showed that the mean lesion size after treatment in the oral prednisone group was significantly lower than the enoxaparin group ( P = 0.005 ) . The relapse rate from improved patients in the enoxaparin group was 6 ( 33 % ) and in oral prednisone group was 9 ( 40.9 % , P = 0.083 ) . In the enoxaparin group no serious complications was seen . But 22 % in the oral prednisone group show side effect , the most common complications were dyspepsia . Conclusion : Low dose enoxaparin on lichen Planus have th 
    Output:
    
Acitretin , sulfasalazine , and griseofulvin were associated with increased overall response rates in comparison with placebo .
Narrow-b and ultraviolet B radiation ( NBUVB ) was more effective than 6 weeks ’ low-dose prednisolone in achieving a complete response , and prednisolone was more effective than enoxaparin .
Hydroxychloroquine was more effective than griseofulvin in achieving an overall response .
Betamethasone valerate 0.1 % ointment had comparable efficacy to  calcipotriol ointment .
Methotrexate was effective , with a nonsignificant difference in the complete response rate in comparison with oral betamethasone .
In nonr and omized controlled trials , oral psoralen plus ultraviolet A photochemotherapy ( PUVA ) had comparable efficacy to a PUVA bath and NBUVB .
Psoralen plus sunlight exposure ( PUVASOL ) and betamethasone dipropionate 0.05 % cream were effective relative to a short course of oral metronidazole .