Hostname: page-component-78c5997874-xbtfd Total loading time: 0 Render date: 2024-11-13T08:08:15.045Z Has data issue: false hasContentIssue false
  • English
  • Français

Efficacy of steroidal vs non-steroidal agents in oral lichen planus: a randomised, open-label study

Published online by Cambridge University Press:  05 December 2016

A R Singh ,
A Rai ,
M Aftab ,
S Jain  and
M Singh
A R Singh*
Affiliation:
Department of ENT, Head & Neck Surgery, Moti Lal Nehru Medical College, Allahabad, India
A Rai
Affiliation:
Department of ENT, Head & Neck Surgery, Moti Lal Nehru Medical College, Allahabad, India
M Aftab
Affiliation:
Department of ENT, Head & Neck Surgery, Moti Lal Nehru Medical College, Allahabad, India
S Jain
Affiliation:
Department of ENT, Head & Neck Surgery, Moti Lal Nehru Medical College, Allahabad, India
M Singh
Affiliation:
Department of ENT, Head & Neck Surgery, Moti Lal Nehru Medical College, Allahabad, India
*
Address for correspondence: Dr A R Singh, Department of ENT, Head & Neck Surgery, Moti Lal Nehru Medical College, Allahabad UP-211001, India E-mail: arpitarajan17@gmail.com
Get access Rights & Permissions [Opens in a new window]

Abstract

Objective:

This study compared the therapeutic efficacy of steroidal and non-steroidal agents for treating oral lichen planus.

Methods:

Forty patients with clinical and/or histologically proven oral lichen planus were randomly placed into four groups and treated with topical triamcinolone, oral dapsone, topical tacrolimus or topical retinoid for three months. Pre- and post-treatment symptoms and signs were scored for each patient.

Results:

Patients in all treatment groups showed significant clinical improvement after three months (p < 0.05), with steroidal and non-steroidal agents having equal efficacy. Furthermore, of the non-steroidal drugs, oral dapsone had greater efficacy than topical retinoid (p < 0.05). However, no significant differences in outcome were recorded for oral dapsone vs topical tacrolimus (p > 0.05) and for topical retinoid vs topical tacrolimus (p > 0.05).

Conclusion:

Non-steroidal drugs such as dapsone, tacrolimus and retinoid are as efficacious as steroidal drugs for treating oral lichen planus, and avoid the side effects associated with steroids.

Keywords

DapsoneLichen PlanusOralRetinoidsTacrolimusTriamcinolone
Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 131 , Issue 1 , January 2017 , pp. 69 - 76
Copyright
Copyright © JLO (1984) Limited 2016 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1 Sugerman, PB, Savage, NW, Walsh, LJ, Zhao, ZZ, Zhou, XJ, Khan, A et al. The pathogenesis of oral lichen planus. Crit Rev Oral Biol Med 2002;13:350–65Google Scholar
2 Scully, C, Elkom, M. Lichen planus: review and update on pathogenesis. J Oral Pathol Med 1985;14:431–58Google Scholar
3 McCreary, CE, McCartan, BE. Clinical management of lichen planus. Br J Oral Maxillofac Surg 1999;37:338–43Google Scholar
4 Scully, C, Beyli, M, Ferreiro, MC, Ficarra, G, Gill, Y, Griffiths, M et al. Update on oral lichen planus: etiopathogenesis and management. Crit Rev Oral Biol Med 1998;9:86–122 Google Scholar
5 Patil, S, Khandelwal, S, Sinha, N, Kaswan, S, Rahman, F, Tipu, S. Treatment modalities of oral lichen planus: an update. J Oral Diag 2012;1:47–52 Google Scholar
6 Vincent, SD, Fotos, PG, Baker, KA, Williams, TP. Oral lichen planus: clinical, historical and therapeutic features of 100 cases. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 1990;70:165–71CrossRefGoogle ScholarPubMed
7 Lozada-Nur, F, Huang, MZ, Zhou, GA. Open preliminary clinical trial of clobetasol propionate ointment in adhesive paste for treatment of chronic oral vesiculoerosive disease. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 1991;71:283–7Google Scholar
8 Chatterjee, K, Bhattacharya, S, Mukherjee, CG, Mazumdar, A. A retrospective study of oral lichen planus in paediatric population. J Oral Maxillofac Pathol 2012;16:363–7Google Scholar
9 Sugarman, PB, Porter, SR. Oral lichen planus clinical presentation. Medscape. In: http://emedicine.medscape.com/article/1078327-clinical [20 October 2016]Google Scholar
10 Andreasen, JO. Oral Lichen Planus: A Clinical Evaluation Of 115 Cases. Oral Surg Oral Med Oral Pathol 1968;25:31–42 Google Scholar
11 Bajaj, DR, Khoso, NA, Devrajani, BR, Matlani, BL, Lohana, P. Oral lichen planus: a clinical study. J Coll Physicians Surg Pak 2010:20:154–7Google ScholarPubMed
12 Lodi, G, Scully, C, Carrozzo, M, Griffiths, M, Sugerman, PB, Thongprasom, K. Current controversies in oral lichen planus: report of an international consensus meeting. Part 2. Clinical management and malignant transformation. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2005:100:164–78Google Scholar
13 Fitzpatrick, SG, Hirsch, SA, Gordon, SC. Malignant transformation of oral lichen planus and other lichenoid lesions: a systematic review. J Am Dent Assoc 2014;145:45–6Google Scholar
14 Thongprasom, K, Carrozzo, M, Furness, S, Lodi, G. Interventions for treating oral lichen planus. Cochrane Database Syst Rev 2011;(7);CD001168Google Scholar
15 Eisen, D. Therapy of oral lichen planus. Crit Rev Oral Biol Med 1993:4:141–58CrossRefGoogle ScholarPubMed
16 Raj, AC, Shreelatha, KT, Balan, A. Dapsone in the treatment of resistant oral erosive lichen planus: a clinical study. J Indian Acad Oral Med Radiol 2012;24:20–23 Google Scholar
17 Kaliakatsou, F, Hodgson, TA, Lewsey, JD, Hegarty, AM, Murphy, AG, Porter, SR. Management of recalcitrant ulcerative oral lichen planus with topical tacrolimus. J Am Acad Dermatol 2002;46:35–41 CrossRefGoogle ScholarPubMed
18 Piattelli, A, Carinci, F, Iezzi, G, Perrotti, V, Goteri, G, Fioroni, M et al. Oral lichen planus treated with 13-cis-retinoic acid (isotretinoin): effects on the apoptotic process. Clin Oral Investig 2007;11:283–8Google Scholar
19 Petruzzi, M, De Benedittis, M, Grassi, R, Cassano, N, Vena, G, Serpico, R. Oral lichen planus: a preliminary study of treatment with tazarotene. Oral Dis 2002;8:291–5Google Scholar
20 Matthews, RW, Pinkney, RC, Scully, C. The management of intransigent desquamative gingivitis with dapsone. Ann Dent 1989;48:41–3Google ScholarPubMed
21 Samycia, M, Lin AN. Efficacy of topical calcineurin inhibitors in lichen planus. J Cutan Med Surg 2012;16:221–9Google Scholar
22 Azizi, A, Lawaf, S. The comparison of efficacy of adcortyl ointment and topical tacrolimus in treatment of erosive oral lichen planus. J Dent Res Dent Clin Dent Prospects 2007;1:99–102 Google ScholarPubMed
23 Giustina, TA, Stewart, JCB, Ellis, Cn. Topical application of isotretinoin gel improves oral lichen planus. Arch Dermatol 1986;122:534–6CrossRefGoogle ScholarPubMed
24 Eisen, D. Evaluating and treating patients with oral lichen planus. Dermatol Ther 2002;15:206–17CrossRefGoogle Scholar
25 Chopra, A, Mittal, RR, Kaur, B. Dapsone versus corticosteroids in lichen planus. Indian J Dermatol Venereol Leprol 1999;65:66–8Google ScholarPubMed
26 Kutcher, AH, Zegarelli, EV, Hauptman, J, Ragosta, JM. Lack of toxicity or side reactions accompanying topical kenalog therapy of oral lesions. Oral Surg Oral Med Oral Pathol 1966;22:27–31 CrossRefGoogle Scholar
27 Byrd, JA, Mark, D, Davis, P, Bruce, AJ, Drage, LA, Rogers, RS. Response of oral lichen planus to topical tacrolimus in 37 patients. Arch Dermatol 2004;140:1508–12Google Scholar
28 Malik, U, Gupta, S, Malik, S, Vashisth, S, Zaheeruddin. Raju, MS. Treatment of symptomatic oral lichen planus (OLP) with 0.1 % tacrolimus powder in Oraguard-B: a pilot prospective study. Saudi Dent J 2012;24:143–8Google Scholar
29 Sahebjamee, M, Amanlou, M, Bakhshi, M. Efficacy of topical retinoic acid compared with topical triamcinolone acetonide in the treatment of oral lichen planus. Acta Medica Iranica 2004;42:108–13Google Scholar
30 Hersle, K, Mobacken, H, Sloberg, K, Thilander, H. Severe oral lichen planus: treatment with an aromatic retinoid (etretinate). Br J Dermatol 2002;106:77–80 Google Scholar