Final answer:
Symptomatic lichen planus can be treated with topical or oral corticosteroids and in some cases, immune-modulating drugs. Leishmaniasis and other underlying conditions like Crohn's disease require different treatments tailored to their specific impacts on the body.
Step-by-step explanation:
The treatment for symptomatic lichen planus involves several options, depending on the severity and extent of the symptoms. In many cases, topical corticosteroids are the first line of treatment to reduce inflammation and discomfort. If the corticosteroids are ineffective, other options can include systemic medications, such as oral corticosteroids, and, in some severe or resistant cases, immune-modulating drugs may be prescribed. These treatments aim to control symptoms and prevent complications like scarring. Leishmania spp. are a different matter, as they refer to parasites that cause leishmaniasis. While cutaneous leishmaniasis may resolve on its own and treatments primarily aim to prevent scarring, more serious forms are treated with specific antiparasitic medications such as stibogluconate, amphotericin B, and miltefosine. Alternatively, if a patient has an underlying condition, like the one described for David in Clinical Focus Part 1, managing the primary condition is crucial. David's treatment for Crohn's disease with corticosteroids, for instance, is critical in controlling the inflammatory process. However, in his case, due to symptoms such as fever and persistent cough, additional diagnostic measures like a chest X-ray were necessary to identify a possible consolidation of the lung, for which he was prescribed levofloxacin.