Different Treatment Modalities of Oral Lichen Planus—A Narrative Review (original) (raw)
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Therapeutic Management of Oral Lichen Planus: A Review for the Clinicians
World Journal of Dentistry, 2011
Lichen planus is a chronic, noninfectious, inflammatory disease of skin and mucous membrane. Intraorally the buccal mucosa, tongue and gingiva are the sites commonly involved. It affects women more often than men in a ratio 3:2. It has well-recognized clinical signs and symptoms, the symptoms may range from none, through mild discomfort to severe burning sensation. In comparison with cutaneous form, the oral lesions are more resistant to therapy and are less likely to undergo spontaneous remission. Treatment is administered mainly to resolve symptoms and discomfort. Choice of treatment may vary from patient to patient depending on the severity of the lesion and systemic condition of the patient. A variety of agents have been employed to treat oral lichen planus, but corticosteroid remains the mainstay of treatment. However, in the recent past, newer drugs like Tacrolimus have shown promising results. In view of fact that there is a risk of malignant transformation of atrophic and er...
Review: recent trends in management of oral lichen planus
International Journal of Basic & Clinical Pharmacology
Oral lichen planus (OLP) is a chronic mucocutaneous inflammatory disease, associated with altered cell‐mediated immunological function. It has been characterised by long‐term evolution, repeated exacerbations, sometimes painful and resistant to treatment, or even all of these. OLP significantly affects quality of patient's life. There is a higher risk of malignant transformation accompanied with OLP and similar appearing oral lichenoid lesions. Current OLP therapy aims at eliminating all mucosal‐related lesions reduce symptomatology and decrease the risk of oral cancer. This review summarizes recent treatment modalities used in the management of OLP which includes corticosteroids, immunomodulatory agents, retinoids, ultraviolet irradiation and/or laser therapy, herbal remedies. In addition, focus is also given upon adopting holistic approach in such patients by emphasizing on stress management.
Novel therapies for oral lichen planus
Journal of Oral Pathology & Medicine, 2013
Oral lichen planus (OLP) is a chronic mucocutaneous disorder commonly found in middle-aged women. Despite the progress in research and advance in knowledge on OLP, a successful management is still difficult to achieve. The main aim of OLP treatment is to control the symptoms of the affected patients. Steroids and other immunosuppressive drugs have been recommended and widely used in the treatment of OLP. Topical corticosteroids are the mainstay of OLP treatment, but strong evidence on their effectiveness is lacking. The effectiveness of alternative ways of managing OLP has been recently reported. Topical aloe vera, topical pimecrolimus and oral curcuminoids are the most promising of the new treatment modalities. Other interesting modalities are topically applied thalidomide and amlexanox. Nevertheless, the careful assessment between the risks and benefits of these drugs is crucial and larger and wellconducted trials need to confirm the above encouraging results.
Journal of Oral Pathology & Medicine, 2003
Background: Topical corticosteroids are the mainstay treatment for oral lichen planus (OLP), but some authors suggest that systemic corticosteroid therapy is the only way to control acute presentation of OLP.Methods: Forty-nine patients with histologically proven atrophic–erosive OLP were divided into two groups matched for age and sex. The test group (26 patients) was treated systemically with prednisone (50 mg/day), and afterwards with clobetasol ointment in an adhesive medium plus antimicotics, whereas the control group (23 patients) was only treated topically with clobetasol plus antimycotics.Results: Complete remission of signs was obtained in 68.2% of the test group and 69.6% of the control group, respectively (P = 0.94). Similar results were obtained for symptoms. Follow-up showed no significant differences between the two groups. One-third of the patients of the test group versus none in the control group experienced systemic side-effects (P = 0.003).Conclusions: The most suitable corticosteroid therapy in the management of OLP is the topical therapy, which is easier and more cost-effective than the systemic therapy followed by topical therapy.
Recent Advancements in Oral Lichen Planus Management: An Overview
World Journal of Dentistry, 2018
Introduction: Lichen planus is a chronic inflammatory, autoimmune, mucocutaneous disease of which the etiology is unknown. In Greek "lichen" means tree moss and "planus" means flat. It affects the skin, mucous membrane, nails, and hair. It is seen in 1 to 2% of the population. As the exact causative factor for oral lichen planus (OLP) is a matter of conflict, the failure to achieve proper or specific treatment for it may be reason for its incomplete regression. Corticosteroids are the mainstay of OLP but because of their adverse effects various other agents have been tried in the treatment of OLP. Aim: The aim of this review is to provide an update on the recent advances in the treatment of OLP. Results: An electronic search was conducted across Medline, Cochrane, Web of Science databases, and Google Scholar for the purpose of literature analysis on the mentioned topic. The studies were reviewed and compared. This article summarizes the recent advances in the treatment of OLP. Conclusion: Oral lichen planus has been an advanced researched oral potentially malignant disorder over the years. The newer treatment modalities have been considered to be beneficial with lesser amount of side effects than corticosteroids like amlexanox (AX), aloe vera gel, green tea, curcumin, propolis, and lycopene. Clinical significance: Oral lichen planus is seen in 1 to 2% of the population who come with varied symptoms or may be asymptomatic. Although treatment options are plenty, the mainstay of treatment is corticosteroids. However, the use of alternate therapeutics is proven to be effective with lesser side effects.
Oral lichen planus: A review study
Journal of Pakistan Association of Dermatologists, 2022
Lichen planus (LP) is a chronic inflammatory condition affecting the skin and the mucous membrane. LP is a multifactorial condition and the pathogenesis depends mainly on the evoked cellular immunity. Most cases develop on the oral mucosa. Oral lichen planus (OLP) has several clinical patterns and the symptoms range from no symptoms to aches and burning sensations. The histopathological picture is considered a characteristic feature of OLO. OLP is incurable and the treatment aims to reduce the patient's complaints and enhance the quality of the patient's life. Although there is no uniform protocol for treatment, corticosteroids and adjuvant treatment are commonly used for OLP management. Malignant transformation is suspected in each OLP, despite the type and location of the OLP inside the mouth. Periodic follow up is required. Updating the data about the OLP is always needed to improve the outcomes of management.
Treatment of oral lichen planus. Systematic review and therapeutic guide
Medicina clinica, 2017
In this systematic review, 55 structured articles on the therapeutic efficacy against pain and clinical signs of oral lichen planus (OLP) were analysed. The literature search was developed according to the criteria of the PRISMA system, selecting the tests performed using one of the following methodological designs: drug (active ingredient) vs. drug in different excipient or concentration, drug vs. different active principle, drug vs. phytotherapy and drug vs. treatment with phototherapy. Based on the results, an algorithm is proposed to guide the treatment of OLP in its atrophic and erosive clinical forms. The use of clobetasol propionate at 0.025-0.05% of topical application as the first therapeutic alternative is highlighted. Secondly, 0.1% tacrolimus and 1% pimecrolimus also formulated for its topical regimen. And finally, we address the use of systemic corticosteroids and the application of diode lasers.
Oral lichen planus: clinical features, etiology, treatment and management; a review of literature
Journal of dental research, dental clinics, dental prospects, 2010
Lichen planus is a chronic inflammatory mucocutaneous disease. Mucosal lesions are classified into six clinical forms and there is malignant potential for two forms of OLP; therefore, follow-up should be considered. There are many un-established etiological factors for OLP and some different treatment modalities are based on etiology. The aims of current OLP therapy are to eliminate mucosal erythema and ulceration, alleviate symptoms and reduce the risk of oral cancer. We have used review papers, case reports, cohort studies, and case-and-control studies published from 1985 to 2010 to prepare this review of literature.
Treatment modalities of oral lichen planus: an update
JORDI - Journal of Oral Diagnosis, 2016
Oral lichen planus is an immunologically based, chronic, inflammatory, mucocutaneous disorder of undetermined etiology. It is a relatively common disorder affecting stratified squamous epithelia. It is of special importance due to its malignant potential and can be a source of morbidity. The management of oral lichen planus should therefore address both the transformation rate as well as the patient symptoms. Care and management of such patients challenges even the most experienced clinician. There is currently no cure for OLP. Treatment is aimed primarily at reducing the length and severity of symptomatic outbreaks. The review critically analyses the various options in the literature and discusses the practical management from the Indian perspective.