In cases of asymptomatic lichen planus, the best recommendation is often to leave the lesion alone. Lichen planus is a chronic inflammatory condition that can affect the skin and mucous membranes, and when it presents asymptomatically, intervention may not be necessary. The condition is typically self-limiting, and many patients do not require treatment unless they experience symptoms such as pain or discomfort.
Leaning towards a conservative approach also acknowledges that interventions might introduce unnecessary complications or side effects. Topical corticosteroids, while effective for symptomatic cases, are not indicated in asymptomatic instances since they are more relevant when trying to alleviate symptoms such as inflammation or ulceration. Surgical removal is not recommended either, as it is invasive and may lead to complications when the condition is benign and asymptomatic. Antibiotic therapy, likewise, is not appropriate as it does not target the underlying issue of lichen planus, which is not caused by an infection.
Thus, in the absence of symptoms, the appropriate and sensible recommendation is simply to leave the condition alone, allowing for natural monitoring and management if symptoms arise in the future.