Document Type : Original Article
Authors
1 Associate Professor, Department of Oral & Maxillofacial Medicine, School of Dentistry, Tehran University of Medical Science, Tehran, Iran
2 Professor, Department of Oral & Maxillofacial Medicine, School of Dentistry, Tehran University of Medical Science, Tehran, Iran
3 Professor , Drug Design and Development Research Center, The Institute of Pharmaceutical Sciences (TIPS), Tehran University of Medical Sciences, Tehran, Iran
4 Associate Professor Department of Oral Medicine, School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran
Abstract
Background: There are many therapeutic modalities for oral lichen planus under trial; however, none has resulted in complete remission of lesions yet. The aim of this study was to evaluate the combination therapy with topical triamcinolone acetate comparing to topical triamcinolone acetate alone in the treatment of oral lichen planus.
Methods: Patients were randomly divided into the two groups to receive either 0.1% triamcinolone alone (group TO) or 0.1% triamcinolone with 0.05% retinoic acid (group TRO). Participants were instructed to apply medication thrice daily and were visited at baseline and after 1, 2, 3, and four weeks of treatment. The size of lesions and symptoms were recorded at each session. Relaps was followed up in a 2-month period. Data were analyzed using Mann–Whitney U-test and through SPSS 13.0 software.
Result: The decrease in pain and burning sensation in both groups was similar four weeks after the treatment (P=0.71). All patients in the TRO group (100%) and 85% of patients in the TO group were improved to score 1 & 0. The decrease in the size of keratosis, atrophic, and erosive form of lesions were different in the two groups significantly (p <0.0001). In the 2nd month follow up, 10% of the TRO group and 15% of the TO group had relapsed which was not statistically significant (P=1).
Conclusion:According to the results, retinoid improves the efficacy of the corticosteroid in the suppression of inflammation in oral lichen planus patients and combination of them improves lichen planus lesions more than triamcinolone acetonide alone.
Keywords
- Ismail SB, Kumar SK, Zain RB. Oral lichen planus and lichenoid reactions: etiopathogenesis, diagnosis, management, and malignant transformation. J Oral Sci 2007; 49(2):89-106.
- Alrashdan MS, Cirillo N, McCullough M. Oral lichen planus: a literature review and update. Arch Dermatol Res 2016; 308(8):539-51.
- Lavanya N, Jayanthi P, Rao UK, Ranganathan K. Oral lichen planus: An update on pathogenesis and treatment. J Oral Maxillofac Pathol 2011; 15(2):127-32.
- Carrozzo M, Uboldi de Capri M, Dametto E, Fasano ME, Arduino P, Broccoletti R, et al. Tumor necrosis factor-alpha and interferon-gamma polymorphisms contribute to susceptibility to oral lichen planus. J Invest Dermatol 2004; 122(1):87-94.
- Carrozzo M, Thorpe R. Oral lichen planus: a review. Minerva Stomatol 2009; 58(10):519-37.
- Nisa SU, Saggu TK. To estimate the efficacy of 0.1% tacrolimus with Colgate Oraguard-B paste for the treatment of patients with symptomatic oral lichen planus. Indian J Dent 2016; 7(1):23-27.
- Monajjemzadeh F, Gholizadeh N, Yousefzadeh Mobaraki N, Jelvehgari M. Physicochemical and in vitro mucoadhesive properties of microparticles/discs of betamethasone for the management of oral lichen planus. Pharm Dev Technol 2016; 21(8):996-1005.
- Al Haj Zen A, Nawrot DA, Howarth A, et al. The Retinoid Agonist Tazarotene Promotes Angiogenesis and Wound Healing. Mol Ther. 2016;24(10):1745-1759.
- Laeijendecker R, Tank B, Dekker SK, Neumann HA. A comparison of the treatment of orallichen planus with topical tacrolimus and triamcinolone acetonide ointment. Acta Derm Venereol 2006; 86(3):227-9.
- Thongprasom K, Dhanuthai. Steroids in the treatment of lichen planus: a review. J Oral Sci 2008; 50(4):377-85.
- Sahebjamee M, Arbabi Kalati F. Management of oral lichen planus. Archives of Iranian medicine 2005; 8(4):252-6.
- 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(2):108-13.
- Mabire D, Adelinet CH, Csoka IC. Retinoic acid mimetic anilides. [cited 2019 Oct 20] Available from: https://patents.google.com/patent/US6936626B2/en.
- Dalirsani Z, Taghavi Zenouz A, Mehdipour M, Alavi F, Javadzadeh Y. Comparison of the effect of combination of triamcinolone acetonide and vitamin a mouthwash with triamcinolone mouthwash alone on oral lichen planus. J Dent Res Dent Clin Dent Prospects 2010; 4(1):21-4.
- Gholizadeh N, Emami Razavi A, Mohammadpour H, Tavakol F, Sheykhbahaei N. Association of MAPK and its regulatory miRNAs (603, 4301, 8485, and 4731) with the malignant transformation of oral lichen planus. Mol Biol Rep 2020; 47(2):1223-32.
- Mattila R. Molecular markers of oral lichen planus [dissertation]. Turku, Finland: University of Turku; 2009.
- de Sousa FA, Paradella TC. Malignant potential of oral lichen planus: a meta-analysis. Revista Odonto Ciência 2009; 24(2):194-7.
- Mattsson U, Magnusson B, Jonell M. Squamous cell carcinoma in a patient with oral lichen plants treated with topical of application tacrolimus. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2010; 110(1):e19-25.
- Greenberg MS, Glick M, Ship JA. Burket’s Oral Medicine. 11th ed. USA: PMPH USA; 2008.
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