(Disclaimer: This article is for scientific purposes only, in order to protect the patient’s privacy, the relevant information in the following content has been processed) Abstract: The patient has been engaged in outdoor work for a long time, and every summer a piece of brown patch will appear on the body, and it will turn white in the long run, with an increasingly large area. This year, when the weather just started to get warmer, such patches started to appear on the patient’s back and neck again. He came to the dermatology outpatient clinic of the hospital and took the skin flakes for fungal microscopy, which was positive and diagnosed as lichen planus (sweat patches). Through oral antifungal drugs and topical antifungal ointment treatment, the patches on the body subsided. Basic information] Female, 32 years old [Disease type] lichen planus [Hospital] Maanshan Seventeen Metallurgical Hospital [Time of consultation] May 2022 [Treatment plan] medication (itraconazole capsule + sertaconazole nitrate cream + ketoconazole lotion) [Treatment cycle] outpatient treatment for 4 weeks [Treatment effect] lichen planus is cured A. Initial interview Ms. Liu, the patient, is engaged in outdoor work, and due to the summer heat, her body sweats a lot, and her plaque always appears. Due to the hot weather in summer, Ms. Liu was engaged in outdoor work, and because her body sweated a lot, a brownish-gray patch always appeared on her body, which was painless and itchy. 1 month ago, gray and white patches appeared on her neck, so she came to the dermatology clinic for consultation. After examination, the patient was found to have multiple brownish-white patches on the neck and back. Fungal testing was performed on the skin flakes, and mycelium and spores were found, leading to the diagnosis of lichen planus. Due to the large scope of the patient’s rash, oral antifungal Itraconazole capsule and topical application of Sertaconazole nitrate cream were recommended. Itraconazole capsule is a commonly used antifungal drug, which has good antibacterial effect on skin fungi such as lichen planus, onychomycosis, tinea corporis, etc. However, it also has side effects, which will have certain effect on liver function, and will cause liver enzyme elevation after taking it in some patients, so it is necessary to check the liver function before and after the use of the drug. Before treatment, the patient was carefully asked about his medical history, and there was no history of hepatitis or fatty liver, and the liver function test was normal. Thus, itraconazole capsules were allowed to be taken orally and sertaconazole nitrate cream was applied externally. 2 weeks later, liver function was normal and most of the rashes had subsided. It was recommended to continue to apply the cream for 2 weeks to consolidate the therapeutic effect and minimize the recurrence. 2 weeks later, the patient’s back and neck patches basically disappeared. After 2 weeks of oral antifungal medication and 4 weeks of topical application of antifungal ointment, the plaques on the trunk and neck basically subsided. The fungal test was done again, and no fungal hyphae and spores could be found. Oral medication with antifungal drugs did not cause liver function impairment. Since lichen planus recurred frequently on the patient, it was recommended that ketoconazole lotion be used as a body lotion when bathing in order to reduce the fungal colonization of the skin surface and to reduce the recurrence of the disease. Clothes sheets covers and so on should be washed and sunned diligently to reduce the fungus in the environment. Precautions: We are glad that the patients’ symptoms have been improved after treatment, but we still need to remind the patients to pay attention to some matters in daily life: 1, the treatment of lichen planus must follow the doctor’s prescription according to the course of medication, avoiding intermittent medication or stopping the medication by oneself, so as to reduce the recurrence; 2, oral antifungal medicines may cause the elevation of liver enzymes, and need to test the liver function before and after the use of medicines, and should not be used by patients with hepatitis or fatty liver; 3, there are some cases of fungi colonization in lichen planus, but they are not suitable to be used by patients. 3, lichen planus is contagious, the patient’s clothing must be washed separately from the family’s, and the clothing sheets and covers must be washed and sun-dried diligently; 4, you can use ketoconazole lotion when taking a bath to reduce the fungus on the surface of the skin and reduce the recurrence of the disease; 5, avoid strenuous exercise and reduce sweating. Fifth, personal perception of psoriasis fungus most of the Malassezia infection of the skin, resulting in skin diseases, for example, the patient usually does not hurt, itchy, but infectious, leave it alone will grow more and more, therefore, reminding the patient in the early stages of the disease should be treated in a timely manner. In addition, for large sweat patches need to take oral antifungal drugs, because these drugs will affect liver function, so remind the patient before and after the use of drugs need to test liver function. For the patient’s case, it can be seen that the treatment of lichen planus should be according to the course of treatment, and adhere to the medication, so as to reduce the recurrence, at the same time, the clothing must be washed and sunbathed diligently, and can not be mixed with the family’s clothing, in order to minimize the transmission of each other.