Ten patients with generalized lichen planus were treated with oral 8-methoxypsoralen photochemotherapy (PUVA) in a bilateral comparison study. Five patients (50%) cleared completely on both sides and required no maintenance treatment after a follow-up of up to 4 years. Three other patients (30%) improved at least 50% of their previous involvement. Most of the patients experienced symptomatic improvement of the treated side by the second week of the treatment. Two patients reacted adversely and exacerbated while receiving treatment to one side of the body. While preliminary, this bilateral comparison study demonstrates that PUVA is an effective therapy for generalized, symptomatic lichen planus and suggests that maintenance therapy might not be required once complete clearance is attained. Caution should be exercised, however, since some patients might develop an exacerbation of their disease with PUVA.