Outcomes of oral lichen planus and oral lichenoid lesions treated with topical corticosteroid

Abstract

Objective. To determine corticosteroid treatment effectiveness in patients with Oral Lichen Planus/Oral Lichenoid Lesions (OLP/OLL). Material and methods. Twenty-one OLP and eighty-one OLL patients received 0.05% clobetasol propionate (CP) or 0.05% triamcinolone acetonide (TA) in aqueous solution (AS) or orabase (OB), evaluating responses to treatment and follow-up compliance. Results. Lesions were atrophic (72/102; 70.6%), extensive (58/100; 58%), producing eating difficulties (62/102; 60.8%) and spontaneous pain (30/102; 29.4%); 50 patients (49%) received CP-AS. The mean±sd percentage of follow-ups attended was 43±32%. Symptom remission was achieved in 46% of patients receiving CP-AS, 36.36% of those receiving TA-AS, 20% of those receiving CP-OB, and 25% of those receiving TA-OB. Follow-up compliance was poor in 66.7% of patients. Among 51 patients with continuous symptoms, 64.7% evidenced total remission at treatment completion; among 33 with intermittent symptoms, 73.1% had outbreaks 2-3 times/year and 51.5% controlled outbreaks with <6 corticosteroid applications. Adverse effects were observed in 7 patients (6.8%) (moon face, hirsutism, capillary fragility) in induction stage, subsiding with dose; among 15 patients under maintenance treatment for >6 months, 1 showed hypothalamic–pituitary–adrenal (HPA) axis inhibition but not adrenal insufficiency. Conclusions. Our treatment proved highly effective and safe. Recall programs are desirable to enhance follow-up compliance.

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