Efficacy of photodynamic therapy in the treatment of oral lichen planus by use of amino levulinic acid

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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Could photodynamic therapy be utilized as a treatment modality for oral lichen planus?

Photodiagnosis and Photodynamic Therapy ◽

10.1016/j.pdpdt.2020.101677 ◽

2020 ◽

Vol 30 ◽

pp. 101677 ◽

Cited By ~ 2

Author(s):

Wafaa Saleh ◽

Sara Tageldin ◽

Eman Khashaba ◽

Mahmoud Darwish ◽

Sherif Elnagdy ◽

...

Keyword(s):

Photodynamic Therapy ◽

Lichen Planus ◽

Treatment Modality ◽

Oral Lichen Planus ◽

Oral Lichen

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Methodological comments on: Efficacy of photodynamic therapy and low-level laser therapy against steroid therapy in the treatment of erosive-atrophic oral lichen planus

Photodiagnosis and Photodynamic Therapy ◽

10.1016/j.pdpdt.2020.101690 ◽

2020 ◽

Vol 31 ◽

pp. 101690

Author(s):

Sara Pourshahidi ◽

Amir Mohammad Azizzadeh Roodpishi

Keyword(s):

Photodynamic Therapy ◽

Laser Therapy ◽

Lichen Planus ◽

Steroid Therapy ◽

Oral Lichen Planus ◽

Low Level Laser Therapy ◽

Low Level ◽

Low Level Laser ◽

Level Laser ◽

Oral Lichen

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Photodynamic therapy in the treatment of oral lichen planus with moderate‐to‐severe dysplasia: A case report

Dermatologic Therapy ◽

10.1111/dth.14490 ◽

2020 ◽

Vol 33 (6) ◽

Author(s):

Qianhui Shang ◽

Zhen Wang ◽

Yunmei Dong ◽

Luyao Cai ◽

Fei Mao ◽

...

Keyword(s):

Photodynamic Therapy ◽

Case Report ◽

Lichen Planus ◽

Oral Lichen Planus ◽

Severe Dysplasia ◽

Oral Lichen

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A Comparison of Clinical Efficiency of Photodynamic Therapy and Topical Corticosteroid in Treatment of Oral Lichen Planus: A Split-Mouth Randomised Controlled Study

Journal of Clinical Medicine ◽

10.3390/jcm10163673 ◽

2021 ◽

Vol 10 (16) ◽

pp. 3673

Author(s):

Jacek Zborowski ◽

Dorota Kida ◽

Aleksandra Szarwaryn ◽

Karol Nartowski ◽

Patrycja Rak ◽

...

Keyword(s):

Photodynamic Therapy ◽

Lichen Planus ◽

Oral Lichen Planus ◽

Drug Carriers ◽

Controlled Study ◽

Repeated Treatment ◽

First Case ◽

Short Period ◽

Randomised Controlled ◽

Oral Lichen

Background: The aim of the study was to compare the effectiveness of photodynamic therapy (PDT) to steroid therapy in the treatment of oral lichen planus (OLP). Due to the lack of commercially available drug carriers, innovative proprietary solutions were used for both the photosensitiser and the steroid carrier—in the first case to shorten and in the second to extend the contact of the active substance with the mucosa. Methods: A prospective, randomised, single-blind, 12-week full contralateral split-mouth clinical trial of 30 patients with bilateral oral lichen planus was conducted. The prepared matrices were incorporated with active substances methylene blue 5% and 0,05% triamcinolone. The size of lesions, Thongprasom, ABISIS, and VAS scale were evaluated. Results: Relatively high rates of complete remission of lichen were demonstrated: immediately after treatment, 33.3% with PDT and 22.2% with triamcinolone (TA), and after 3 months, 54.2% with PDT and 62.9% with TA. After 3 months of treatment, a reduction in the area of evaluated lesions of 52.7% for PDT and 41.7% for TA was achieved. Conclusion: In situations of topical or general contraindications to oral corticosteroids, resistance to them, or the need for repeated treatment in a short period of time, PDT appears to be a very promising treatment option.

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Efficacy of photodynamic therapy or low level laser therapy against steroid therapy in the treatment of erosive-atrophic oral lichen planus

Photodiagnosis and Photodynamic Therapy ◽

10.1016/j.pdpdt.2018.02.001 ◽

2018 ◽

Vol 21 ◽

pp. 404-408 ◽

Cited By ~ 13

Author(s):

Sana Mirza ◽

Navedur Rehman ◽

Ali Alrahlah ◽

Wa’ad Rafa Alamri ◽

Fahim Vohra

Keyword(s):

Photodynamic Therapy ◽

Laser Therapy ◽

Lichen Planus ◽

Steroid Therapy ◽

Oral Lichen Planus ◽

Low Level Laser Therapy ◽

Low Level ◽

Low Level Laser ◽

Level Laser ◽

Oral Lichen

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Photodynamic Treatment of Oral Lichen Planus: A Literature Review

Integrative Journal of Medical Sciences ◽

10.15342/ijms.2021.485 ◽

2021 ◽

Vol 8 ◽

Author(s):

Asma Azzouzi ◽

Karima El Harti

Keyword(s):

Photodynamic Therapy ◽

Lichen Planus ◽

Oral Lichen Planus ◽

Signs And Symptoms ◽

First Line ◽

Photodynamic Treatment ◽

Randomized Controlled ◽

Oral Lichen ◽

Exact Origin

Lichen planus (LP) is a chronic, relapsing, non-infectious inflammatory disease affecting the skin and mucous membranes. The exact origin of oral lichen planus (OLP) is not well known. Complete spontaneous healing is rare. The treatment of oral lichen planus is palliative, and there is no curative treatment so far, which is a therapeutic challenge for practitioners. The goals of treatment are the control of pain, signs, and symptoms. Local corticosteroids remain the first-line treatment. In case of failure of drug therapy, other treatments can be considered, such as photodynamic therapy. Material and methods: Our work was carried out using the PubMed, ScienceDirect, and EBSCO search engines to explore the literature on the efficacy of photodynamic therapy in the treatment of lichen planus. Conclusion: Photodynamic therapy appears to have some effect in the treatment of OLP in adult patients. However, further randomized controlled trials with a long follow-up period, standardized PDT parameters, and comparison of PDT efficacy with steroid therapy are warranted to obtain firm conclusions in this regard.

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