scholarly journals Topical Cyclosporine in Oral Lichen Planus—A Series of 21 Open-Label, Biphasic, Single-Patient Observations

2021 ◽  
Vol 10 (22) ◽  
pp. 5454
Author(s):  
Babak Monshi ◽  
Christina Ellersdorfer ◽  
Michael Edelmayer ◽  
Gabriella Dvorak ◽  
Clemens Ganger ◽  
...  

Topical cyclosporine (CSA) has been reported as an alternative treatment in steroid-refractory oral lichen planus (OLP), but evidence is limited and conflicting. An N-of-1 trial setting could be appropriate to evaluate interindividual differences in treatment response. We studied a series of 21 open-label, biphasic single-patient observations. Patients (15 women, 6 men) with OLP recalcitrant to topical steroids received four weeks of CSA mouth rinse (200 mg/twice daily) followed by four weeks of drug withdrawal. Pain (visual analogue scale (VAS) score), disease extent (physicians’ global assessment (PGA) score) and quality of life (Dermatology Life Quality Index (DLQI) score,) were assessed at baseline (T0), after four weeks of treatment (T1) and after another four weeks without treatment (T2). Median age was 58 years (interquartile range/IQR = 52–67) and median disease duration was 18 months (IQR = 12–44). Median baseline VAS score decreased significantly at T1 (p = 0.0003) and increased at T2 (p = 0.032) (T0 = 5 (IQR = 3–6.5); T1 = 2 (IQR = 0.5–3.4); T2 = 3 (IQR = 2–4.8)). Similarly, median baseline PGA score decreased significantly at T1 (p = 0.001) and increased at T2 (p = 0.007) (T0 = 2 (IQR = 1.3–2.5); T1 = 1 (IQR = 1–2); T2 = 2 (IQR = 1–2)). Median baseline DLQI score also decreased significantly at T1 (p =.027) but did not change at T2 (p = 0.5) (T0 = 2.5 (IQR = 1–5.8); T1 = 1 (IQR = 0–3); T2 = 1 (IQR = 1–4)). CSA responders (n = 16) had significantly higher median baseline VAS scores (5.2 (IQR = 5–6.5)) than nonresponders (n =5) (2 (IQR = 2–3.5) (p = 0.02). In our study, pain, disease extent and quality of life of patients with OLP improved significantly during therapy with low-dose CSA mouth rinse and exacerbated after drug withdrawal. Remarkably, patients with high initial VAS scores seemed to profit most.

2019 ◽  
Vol 24 (1) ◽  
pp. 301-308 ◽  
Author(s):  
Ioanina Parlatescu ◽  
Mihaela Tovaru ◽  
Carmen Larisa Nicolae ◽  
Ruxandra Sfeatcu ◽  
Andreea Cristiana Didilescu

2020 ◽  
Vol 8 (4) ◽  
pp. 113
Author(s):  
Sasirin Yiemstan ◽  
Sudaduang Krisdapong ◽  
Pornpan Piboonratanakit

Subjective patient’s symptoms and Oral Health-Related Quality of Life (OHRQoL) are recommended to be involved in oral lichen planus (OLP) studies. This study aims to assess the OHRQoL of OLP patients, and their associations with pain and OLP in Thai patients. Sixty-nine patients were interviewed using the Numeric Rating Scale (NRS) for pain perception and Oral Impacts on Daily Performance (OIDP) index. OLP signs examined included localization, types, number of affected sides and clinical severity using the Thongprasom sign scoring system. There were significant associations (rs = 0.490, p < 0.001) between clinical severity and the intensity of oral impacts as well as pain (rs = 0.298, p = 0.013). The intensity of oral impacts and pain increased according to the increasing OLP clinical severity, except for the white striae lesions (Thongprasom sign score 1). The erosive/ulcerative OLP lesions (Thongprasom sign scores 4 and 5) were the most painful symptom and had the highest degree of oral impacts (p < 0.001). No significant associations were found between the number of affected lesion sides and OHRQoL (p = 0.316) and pain (p = 0.284). OHRQoL was associated with OLP type and clinical severity but not with the number of affected sides.


2016 ◽  
Vol 131 (1) ◽  
pp. 69-76 ◽  
Author(s):  
A R Singh ◽  
A Rai ◽  
M Aftab ◽  
S Jain ◽  
M Singh

AbstractObjective: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.


Author(s):  
Dvorak Gabriella ◽  
Rappersberger Klemens ◽  
Rausch-Fan Xiao-hui ◽  
Bruckmann Corinna ◽  
Hofmann Eva

Abstract Objectives The aim of this study was to evaluate the relationship between personality traits and perceived treatment success in oral lichen planus. Material and methods A total of 53 patients with diagnosed oral lichen planus were evaluated at the time of diagnosis and along the course of their treatment. The visual analogue scale (VAS) was used for evaluating pain and burning sensation, along with an evaluation of the oral health-related quality of life (OHIP) and the clinical severity. In order to determine the personality trait, the NEO-FFI questionnaire was applied. Data were assessed with the statistical software Stata by a multiple linear regression. Results A significant relationship between the two personality traits: “conscientiousness” and “extraversion” and a perceived improvement in oral lichen planus could be observed. The higher the “conscientiousness,” the better the perceived oral health-related quality of life. Furthermore, “extraversion” had a significant influence on the improvement in clinical severity index (P < 0.05). Conclusions Personality traits, especially conscientiousness and extraversion, have a significant impact on the perception of therapeutic intervention in oral lichen planus. Clinical relevance As personalized patient management is gaining importance and psychosocial factors play a significant role in mucosal diseases, the patient’s psychological profile should be considered in the oral lichen planus management.


2018 ◽  
Vol 2018 ◽  
pp. 1-13 ◽  
Author(s):  
Mircea Tampa ◽  
Constantin Caruntu ◽  
Madalina Mitran ◽  
Cristina Mitran ◽  
Isabela Sarbu ◽  
...  

Oral lichen planus (OLP) is a chronic inflammatory disease of unknown etiology with significant impact on patients’ quality of life. Malignant transformation into oral squamous cell carcinoma (OSCC) is considered as one of the most serious complications of the disease; nevertheless, controversy still persists. Various factors seem to be involved in the progression of malignant transformation; however, the mechanism of this process is not fully understood yet. Molecular alterations detected in OLP samples might represent useful biomarkers for predicting and monitoring the malignant progression. In this review, we discuss various studies which highlight different molecules as ominous predictors of OLP malignant transformation.


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