Triamcinolone acetate vs. combination of triamcinolone acetate and isotretinoin in treatment of oral lichen planus: a comparative study

Background: There are many treatment modalities being practiced for oral lichen planus and many are under trial. However, none has been able to provide a complete permanent cure. This study aims to see if combination therapy with topical triamcinolone acetate and isotretinoin is superior to topical triamcinolone acetate alone, in treating oral lichen planus.Methods: Patients were randomly divided into 2 groups to receive either triamcinolone (0.5%) only (group A) or 0.5% triamcinolone with 0.1% isotretinoin (group B). Patients applied medication thrice daily and were followed up at, 2 week, 1st month, 2nd month and 3rd months. Size of lesion and symptoms were assessed at each visit. The data was analysed by chi square test. Results: Patients in group B (combination therapy) showed significantly better improvement in symptoms at the end of 2nd week and 1st month as compared to group A. Decrease in lesion size was also better in group B with p values of 0.012, 0.004 and 0.022 at 2 weeks, 1st month and 2nd month respectively. Complete resolution of lesion was obtained in 53.33% people in group B and 26.67% people in group A.Conclusions: Combination of 0.5% triamcinolone acetate and 0.1% isotretinoin is superior to 0.5% triamcinolone acetate alone in treatment of oral lichen planus. It causes quicker relief in symptoms and decreases lesion size faster. Complete resolution of the lesions is also more when combination therapy is used.

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Comparison of low dose oral Methotrexate vs Systemic Corticosteroids for treatment of Oral Lichen Planus

10.53350/pjmhs21155898 ◽

2021 ◽

Vol 15 (5) ◽

pp. 898-901

Author(s):

Tooba Saeed ◽

Saadia Firdous ◽

Shahzad Iqbal Malik ◽

Muhammad Aamir ◽

Yasir Ishaq ◽

...

Keyword(s):

Lichen Planus ◽

Complete Resolution ◽

Oral Lichen Planus ◽

Low Dose ◽

Systemic Corticosteroids ◽

Dose Oral ◽

Group A ◽

Mucosal Lesions ◽

Group B ◽

Oral Lichen

Background: Oral Lichen Planus (OLP) is a relatively common chronic inflammatory mucocutaneous disorder. WHO considers OLP a premalignant lesion. This makes management of OLP important to avoid its malignant transformation. Corticosteroids are considered as the first-line of treatment. Different other treatment modalities are also in use for OLP. But there is no statistically significant data available for a particular therapy. The recent evidences suggest methotrexate may effectively be used in low dose in the treatment of OLP. Aim: To compare the frequency of complete resolution of mucosal lesions of oral lichen planus with low dose oral methotrexate versus systemic corticosteroids. Methods: It was a randomized control trial conducted at Oral & Maxillofacial Surgery Department, King Edward Medical University/Mayo Hospital Lahore in six months. A sample of 60 patients was divided into two sub groups namely Group -A (methotrexate) and Group - B (corticosteroid) using lottery method. More than 75% resolution of mucosal lesions clinically was considered as complete resolution at the end of 8th week. Results: The mean age of the patients was 44.55±12.38 years. On 8th week, frequency of complete resolution of mucosal lesions was 73.3% in Group A and 60% in Group B with an insignificant difference (p-value<0.05). Conclusion: Methotrexate group A showed more complete resolution of mucosal lesions than corticosteroid group B with insignificant statistical difference. Keywords: Oral Lichen Planus, Mucosal lesions, Malignant transformation, Methotrexate, Corticosteroids

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Effectiveness of Aloe Vera Mouthwash in Comparison with Triamcinolone Acetonide 0.1% in Patients with OLP at A TCH

10.53350/pjmhs2115113138 ◽

2021 ◽

Vol 15 (11) ◽

pp. 3138-3140

Author(s):

Tahir Hassan ◽

Muhammad Khurram Shahzad ◽

Nazia Hanif ◽

Madiha Anwar ◽

Ayesha Ambreen ◽

...

Keyword(s):

Triamcinolone Acetonide ◽

Lichen Planus ◽

Oral Lichen Planus ◽

Tertiary Care ◽

Aloe Vera ◽

Care Hospital ◽

Group A ◽

Group B ◽

Mouth Wash ◽

Oral Lichen

Objective: To compare the efficacy of Aloe Vera Mouthwash versus 0.1% Triamcinolone Acetonide in patients presenting with oral lichen planus at a tertiary care hospital. Introduction: Oral lichen planus is a chronic immune mediated dermatosis with periods of remissions and relapses. There are many treatment options to treat this condition; aloe vera mouth wash is one of the newer and safer options. Methodology: A total of 100 patients with oral lichen planus (OLP) were randomly divided into two groups (group A and B, each having 50 patients).The patients in group A were given aloe vera mouth wash and in group B were given triamcinolone acetonide paste (0.1%). Efficacy was observed after 2 months of treatment completion. Results: Overall Efficacy was noted in 58(58%) of all study cases. In group A 37 patients (74%) showed efficacy and in group B 21 patients (42%) showed efficacy.More efficacy was noted in female patients (87%) treated with Aloe Vera Mouth wash than those of treated with triamcinolone acetate paste (45%). Patients belonging to old age group (36-50 year) showed more efficacy (75%) to aloe vera mouth wash than that of triamcinolone acetonide paste (36%) Conclusion: In our population Aloe vera mouth wash is more efficacious than triamcinolone acetonide (0.1%) in the treatment of oral lichen planus Keywords: Oral lichen planus, Aloe vera, Triamcinolone acetonide

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Oral lichen planus and its recent management: A review

Update Dental College Journal ◽

10.3329/updcj.v10i2.50179 ◽

2020 ◽

Vol 10 (2) ◽

pp. 29-34

Author(s):

Md Ashif Iqbal ◽

Suraiya Yesmin ◽

Fathimath Maaisha ◽

Shaama Ibrahim ◽

Puja Gotame

Keyword(s):

Lichen Planus ◽

Oral Lichen Planus ◽

Cost Effective ◽

Premalignant Lesions ◽

Treatment Modalities ◽

Cochrane Library ◽

Long Run ◽

Dermatological Disease ◽

Keywords Lichen Planus ◽

Oral Lichen

Background: Oral Lichen Planus (OLP) is one of the most common dermatological disease which is present in the oral cavity. It is a chronic autoimmune, mucocutaneous disease that affects oral mucosa as well as the skin, genital mucosa and other sites of the body.Method: In this review study, various databases such as Google Scholar, PubMed Central, Hinari and Cochrane library were searched for articles with keywords lichen planus, oral lichen planus, premalignant lesions, management of Lichen planus. Articles were searched from January 2015 to 5th November 2020.Result: From the 34 articles obtained after reviewing the abstracts, most relevant 32articles were evaluated in this study.Conclusion: The etiology, pathophysiology, clinical presentation, histopathological features, diagnosis and various management for oral lichen planus is discussed. This article also compares the existing and the most recent treatment modalities that are available throughout the world that are discussed in the literatures. However, more intensive studies must be carried out to find the best treatments which are cost-effective in the long run. Update Dent. Coll. j: 2020; 10 (2): 29-34

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Efficacy evaluation of photodynamic therapy for oral lichen planus: a systematic review and meta-analysis

BMC Oral Health ◽

10.1186/s12903-020-01260-x ◽

2020 ◽

Vol 20 (1) ◽

Author(s):

Yuqing He ◽

Jiaxin Deng ◽

Yi Zhao ◽

Huiqian Tao ◽

Hongxia Dan ◽

...

Keyword(s):

Systematic Review ◽

Methylene Blue ◽

Photodynamic Therapy ◽

Diode Laser ◽

Lichen Planus ◽

Oral Lichen Planus ◽

Meta Analysis ◽

Lesion Size ◽

Cochrane Library ◽

Oral Lichen

Abstract Background Photodynamic therapy (PDT) is a new option for oral lichen planus (OLP) management; however, there are different opinions on the efficacy of PDT for OLP. The aim of this study was to comprehensively assess the efficacy of PDT in the treatment of OLP and compare PDT with steroid therapy. Methods A systematic review and meta-analysis were conducted to assess the curative effect of PDT. Five electronic databases were searched, PubMed, Web of Science, the Cochrane Library, Embase, and EBSCO up to 1 December, 2019. Random and fixed effects models for pooled estimates calculation were used and the Meta package of R was applied. Results Pooled estimates revealed that, after PDT, the lesion size decreased by 1.53 cm2 (95% confidence interval (CI): 0.71–2.35) after PDT and the partial response (PR) was 0.77 (95% CI: 0.65–0.85). The visual analogue scale (VAS) score decreased by 3.82 (95% CI: 2.80–4.85) and the Thongprasom sign score decreased by 1.33 (95% CI: 0.56–2.10) after PDT. Subgroup analyses revealed that the 5-aminolevulinic acid (5-ALA) was more effective than methylene blue (MB), with a PR of 0.87 (95% CI: 0.80–0.91). The topical use of 5-ALA yielded a better response than gargling methylene blue. In terms of VAS, the diode laser showed a better clinical PR in the treatment of OLP. In terms of changes in lesion size, the efficacy of the semiconductor laser was higher than that of the diode laser. PDT had a similar efficacy to topical corticosteroids, as shown by pooled estimates of five randomised controlled trials with 139 lesions. Conclusion This systematic review indicates that PDT is an effective treatment modality for the management of OLP. PDT is as effective as topical corticosteroid in the treatment of OLP and could be used for cases resistant to steroids or when steroids are contraindicated.

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Combination Therapy Of Tadalafil And Pentoxifylline In Severe Erectile Dysfunction; A Prospective Randomized Trial

Polish Journal of Surgery ◽

10.1515/pjs-2015-0075 ◽

2015 ◽

Vol 87 (8) ◽

Cited By ~ 2

Author(s):

Santosh Kumar ◽

Rajesh Roat ◽

Swati Agrawal ◽

Kumar Jayant ◽

Ravimohan S. Mavuduru ◽

...

Keyword(s):

Erectile Dysfunction ◽

Combination Therapy ◽

Erectile Function ◽

T Test ◽

P Value ◽

Chi Square ◽

Significant Difference ◽

Chi Square Test ◽

Group A ◽

Group B

Abstractwas to assess efficacy of Tadalafil alone versus Tadalafil plus Pentoxifylline in the treatment of erectile dysfunction by using self administered IIEF-5 questionnaire.Two hundred and thirty seven patients presenting with ED at andrology OPD were evaluated for ED by a self administered IIEF (International Index of Erectile Function) questionnaire. Patients were systematically randomized by computer generated random table into two groups groups namely, group A: Tadalafil only group, group B: combination of Tadalafil + Pentoxifyl-line. All the patients were re-assessed by IIEF-5 questionnaire after 8 weeks of medical therapy. Statistical analysis was performed using student’s unpaired t-test, paired t-test, chi square test. p-value < 0.05 was considered statistically significant.Two hundred and thirty seven patients were included in the present study, in group A: 92 patients (78.6%) showed improvement in their IIEF score after 8 weeks of tadalafil treatment. While in group B, overall 104 patients(86.6%) showed improvement after combination of Tadalafil and Pentoxifylline. There was a statistically significant difference of percentage change in IIEF score was seen in group B (group A 90.7±15.2%, group B 95.6±13.4%; p value – 0.014). We found this difference even more statistically significant in patients with severe ED (group A 72.7±47.2%, group B 132.3±54.3%; p value – 0.000). There was no significant difference in between the two groups with regards to occur-rence of side effects.Both tadalafil and combination of Tadalafil + Pentoxifylline improve erectile function in patients of ED. Patients with severe ED showed much significant improvement in erectile function with combination therapy.

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Topical NAVS naphthalan for the treatment of oral lichen planus and recurrent aphthous stomatitis: A double blind, randomized, parallel group study

PLoS ONE ◽

10.1371/journal.pone.0249862 ◽

2021 ◽

Vol 16 (4) ◽

pp. e0249862

Author(s):

Ana Andabak Rogulj ◽

Iva Z. Alajbeg ◽

Vlaho Brailo ◽

Ivana Škrinjar ◽

Ivona Žužul ◽

...

Keyword(s):

Lichen Planus ◽

Oral Lichen Planus ◽

Recurrent Aphthous Stomatitis ◽

Aphthous Stomatitis ◽

Secondary Outcome ◽

Double Blind ◽

Link Type ◽

Lesion Diameter ◽

Group A ◽

Oral Lichen

Aim To evaluate the effectiveness of non-aromatic very rich in steranes (NAVS) naphthalan in the treatment of oral lichen planus (OLP) and recurrent aphthous stomatitis (RAS). Null hypothesis was that there would be no difference between NAVS and topical steroids in the treatment of OLP and RAS. Methods The study consisted of two sub-trials conducted as randomized, double-blind controlled studies: first included OLP patients and second patients with RAS. Patients received either NAVS or 0.05% betamethasone dipropionate. Primary outcomes were activity score (OLP patients), No of lesions and lesion diameter (RAS patients) and pain intensity (VAS) while secondary outcome included the impact of the disease on quality of life assessed by Oral health impact profile (OHIP 14). Results No significant differences in terms of OLP clinical signs (p = 0.84, η2 = 0.001) and responses on the OHIP-14 (p = 0.81, η2 = 0.002) or on VAS (p = 0.14, η2 = 0.079) between NAVS and betamethasone groups were observed. In RAS patients, no significant differences between the groups in terms of lesion number (at days 3 and 5, p = 0.33 and p = 0.98, respectively), lesion diameter (days 3 and 5, p = 0.24 and p = 0.84, respectively) were observed. However, in NAVS group a significant reduction of lesions diameter was observed on the 3rd day, while in betamethasone group a significant reduction in lesions diameter was evident only after the 5th day. No significant differences in VAS (p > 0.05) and the OHIP-14 (p > 0.05) between groups were found. Conclusion No evidence of differences between the two compared interventions was found. Registration Retrospective registration of this trial was conducted in ClinicalTrials.gov on September 30, 2016; trial registration number: NCT02920658. https://clinicaltrials.gov/ct2/show/NCT02920658?term=NAVS&draw=2&rank=4.

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A comparative study to evaluate the effects of intranasal steroid spray, isotonic saline nasal irrigation and combination therapy in patients with allergic rhinitis

International Journal of Otorhinolaryngology and Head and Neck Surgery ◽

10.18203/issn.2454-5929.ijohns20212123 ◽

2021 ◽

Vol 7 (6) ◽

pp. 1004

Author(s):

Smitha Soubhagya Gangaraju ◽

Nikitha Pillai ◽

Vijaylaxmi Manthal

Keyword(s):

Allergic Rhinitis ◽

Combination Therapy ◽

Isotonic Saline ◽

Treatment Modalities ◽

Nasal Irrigation ◽

Intranasal Corticosteroids ◽

Nasal Symptoms ◽

Before And After ◽

Group A ◽

Group B

Background: Allergic rhinitis (AR) is characterized by inflammatory changes in the nasal mucosa caused by exposure to inhaled allergens. AR clinically having 2 or more symptoms of anterior or posterior rhinorrhea, sneezing, nasal blockage or itching of the nose during two or more consecutive days for more than 1 hour on most days which are caused by allergen exposure leading to an IgE mediated reaction. Nasal steroids and antihistamines are considered as gold standard treatment of choice in moderate to severe AR. This study was taken to evaluate the efficacy of intranasal steroid spray, isotonic saline nasal irrigation, combination therapy and to compare all 3 treatment modalities.Methods: 75 patients of AR who met inclusion criteria were sequentially divided into 3 groups. Group A was intranasal steroid spray, group B was isotonic saline nasal irrigation, group C was combination of both intranasal steroid spray and saline nasal irrigation. Total nasal symptoms score was compared before and after 1 month of treatment.Results: Mean total nasal symptoms score before treatment in groups A, B and C was found to be 13.72, 12.96 and 13.68 respectively and after 1 month of treatment total nasal symptoms score was seen 8.28, 8.76 and 3.72 respectively.Conclusions: The combined use of saline nasal irrigation along with intranasal corticosteroids is found to be more effective in reducing the symptoms of patients with allergic rhinitis when compared to individual therapies.

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Comparison of oral Nano-Curcumin with oral prednisolone on oral lichen planus: a randomized double-blinded clinical trial

BMC Complementary Medicine and Therapies ◽

10.1186/s12906-020-03128-7 ◽

2020 ◽

Vol 20 (1) ◽

Author(s):

Seyed Javad Kia ◽

Maryam Basirat ◽

Tahereh Mortezaie ◽

Mahdieh-Sadat Moosavi

Keyword(s):

Clinical Trial ◽

Lichen Planus ◽

Oral Lichen Planus ◽

Lesion Size ◽

Burning Sensation ◽

Therapeutic Effects ◽

First Choice ◽

Significant Difference ◽

Double Blinded ◽

Oral Lichen

Abstract Background Oral lichen planus (OLP) is a mucocutaneous autoimmune disease with T-cell mediation. Corticosteroids are considered as a first choice in OLP and should be used for a long period with a subsequent increase in dose since the disease has a chronic and recalcitrant nature. There have been efforts to use alternative therapies due to the Corticosteroid’s side effects. Curcumin is a non-toxic natural product with different effects on various oral diseases. It demonstrates antioxidant, anti-inflammatory, antimicrobial, and anticarcinogenic activities. It seems that Curcumin can be used as a proper alternative for Corticosteroid treatments. To overcome limitations in the bioavailability of Curcumin, the therapeutic effect of oral Nano-Curcumin was evaluated for the first time. Methods Sixty OLP patients were included in this double-blinded randomized clinical trial. The patients were randomly divided into two groups and received either ‘Nano-Curcumin 80 mg’ or ‘Prednisolone 10 mg’ treatments for 1 month. The patients should take one capsule after having their breakfast. The VAS scale was used to analyze pain severity and burning sensation. To assess lesion size the Thongprasom scale was employed. Repeated measures and independent t-tests, as well as LSD paired-test, were used to analyze the data. Results Data from 57 patients were analyzed. The level of pain, burning sensation, and OLP lesions decreased in both groups of Curcumin and Prednisolone and no statistically significant difference was observed between the two groups. Conclusion Despite many studies conducted to find an effective approach for managing OLP, the results have often been unsatisfactory. In comparison with previous studies, current results clarify the importance of Nano-Curcumin bioavailability in therapeutic effects. Pain VAS and lesion size were decreased with oral Curcumin. The results have shown that oral Curcumin can be used as an alternative therapy for OLP in patients with the contraindicated Corticosteroids or should be used with caution. Oral Curcumin can be used in preventing the recurrence of OLP lesions after the treatment and initial control. Moreover, the amount of Curcumin dose is more important than its use duration in improving OLP. Trial registration IRCT, IRCT20100101002950N5. Registered 9 February 2019, https://www.irct.ir/trial/36704.

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Efficacy evaluation of the photodynamic therapy for oral lichen planus: a systematic review and meta-analysis

10.21203/rs.3.rs-16818/v1 ◽

2020 ◽

Author(s):

Yuqing He ◽

Jiaxin Deng ◽

Yi Zhao ◽

Huiqian Tao ◽

Hongxia Dan ◽

...

Keyword(s):

Systematic Review ◽

Methylene Blue ◽

Photodynamic Therapy ◽

Partial Response ◽

Diode Laser ◽

Lichen Planus ◽

Oral Lichen Planus ◽

Meta Analysis ◽

Lesion Size ◽

Oral Lichen

Abstract Background Photodynamic therapy (PDT) is a new option for oral lichen planus (OLP) management, while there are different opinions on the efficacy of PDT for OLP. To comprehensively assess the efficacy of PDT in the treatment of OLP, and compare it with steroid therapy . Methods A systematic review and meta-analysis was conducted to assess the curative effect of PDT, five electronic databases were searched, including PubMed, Web of Science (SCI), the Cochrane Library, Embase, and EBSCO, up to December 1, 2019. Random or fixed effects models for pooled estimates calculation were used and the Meta package of R software was applied. Results Pooled estimates revealed that lesion size decreased by 1.53 cm 2 (95%: 0.71-2.35) after PDT, while partial response (PR) reached 0.77 (95% CI: 0.65–0.85). The visual analog scale score was decreased 3.82 (95%CI:2.80-4.85), and the Thongprasom sign score was decreased 1.33 (95%CI:0.56-2.10) after PDT. Subgroup analyses revealed that the 5-Aminolevulinic acid (5-ALA) was more effective than methylene blue (MB), with the PR was 0.87 (95%:0.80-0.91). Topical use of 5-ALA can yield better response than gargling methylene blue. In terms of VAS, the diode laser showed better clinic partial response in treatment of OLP. But on changes of lesion size, the efficacy of semiconductor laser is higher than diode laser. And the similar efficacy of PDT with topical corticosteroids was confirmed by pooled estimates of five RCT trials with 139 lesions. Conclusion This systematic review indicates that PDT is an effective treatment modality in the management of OLP. Besides, PDT is as effective as topical corticosteroid in treating OLP and could be used for cases resistant to steroids or when steroids are contraindicated.

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The Clinical Profile of Oral Lichen Planus

Journal of Gandhara Medical and Dental Science ◽

10.37762/jgmds.3-01.45 ◽

2016 ◽

Vol 3 (01) ◽

pp. 27-31

Author(s):

Syed Murad Ali Shah ◽

Muhammad Ilyas ◽

Jawad Ahmad Kundi

Keyword(s):

Lichen Planus ◽

Oral Mucosa ◽

Buccal Mucosa ◽

Oral Lichen Planus ◽

Maxillofacial Surgery ◽

Clinical Profile ◽

Oral And Maxillofacial Surgery ◽

Common Site ◽

Chi Square ◽

Oral Lichen

OBJECTIVESThe objective of the study was to determine the clinical profile of oral lichen planus.METHODOLOGYThis retrospective cohort study was carried from January 2011 to December 2015 at the Department of Oral and Maxillofacial Surgery, Sardar Begum Dental College, Peshawar.A total of 36 with 14 male and 22 female patients having oral lichen planus from were selected. On defined and population-based sample the age selected was ≥ 20 years and divided into four categories i.e..,20-29 years,30-39 years,40-49 years and 50-59 years. The diagnostic criteria proposed by van der Meij et al 23 in 2003 based on the WHO definition of oral lichen planus were used to identify the cases of oral lichen planus.That entire patient’s with incomplete records and aged > 60 years were excluded. The data was analyzed through SPSS 22 at the significance level of p < 0.05 and Chi-square statistics was applied for site and gender association.RESULTSThe mean age presentation was 39.2 (SD± 15.49) years. The female to male ratio was 1:57:1. The dominant aged group was 30-39 years with n=16 (44.44%).The buccal mucosa was the most common site involved n=28(77.8%).Reticular type of oral lichen planus was the most common form and was present in n=22(61.1%) patients however, bilaterally involved mucosa was commonly seen. Chi-square statistics showed a significant association between bilateral involvement of oral mucosa in oral lichen planus with both male and female (x2= 5.833, p= 0.016).CONCLUSIONThe most common site involved in oral lichen planus was buccal mucosa, most common form was atrophic with female predominance and bilaterally involved oral mucosa was significantly associated with gender.

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