Brief Answer: Repeat Liver Function Test. Detailed Answer: Hi. Thanks for posting you concern at XXXXXXX Lichen planus pemphigoides is a fairly uncommon condition in which the patient develops both lichen planus as well as bullous pemphigoid lesions. Treatment modalities are: -Oral and Topical steroids -Oral Dapsone -Oral Erythromycin, Azathioprine, Methotrexate, Mycophenolate mofetil etc I have treated a few patients of Lichen planus pemphigoides and in my view the condition has a fairly good prognosis. Oral Steroids bring rapid control of the disease which can be sustained with oral dapsone and topical treatment. Dapsone does cause a mild elevation in the Liver enzymes but that is not an indication for stopping it. Hepexa 300mg contains ursodeoxycholic acid which is a bile chelator and is indicated in cholestatic jaundice in which the patient releases bile salts into the blood stream causing itching/pruritis. I don't think there was a need to stop dapsone at all in your case because a mild to moderate elevation is considered to be normal provided your other liver parameters like Bilirubin, SGOT were normal. I would ask for a repeat liver function test before starting hepexa 300. Hepexa is actually not indicated here if your bilirubin levels(direct bilirubin levels) are normal, though it can be combined with medrol if needed, because there is no direct drug-drug interaction between the two. take care regards

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