Systemic and topical corticosteroid treatment of oral lichen planus: a comparative study with long-term follow-up

Authors

  • M. Carbone,

    1. Department of Biomedical Sciences and Human Oncology, Oral Medicine Section, School of Medicine and Dentistry, University of Turin, Italy
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  • E. Goss,

    1. Department of Biomedical Sciences and Human Oncology, Oral Medicine Section, School of Medicine and Dentistry, University of Turin, Italy
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  • M. Carrozzo,

    1. Department of Biomedical Sciences and Human Oncology, Oral Medicine Section, School of Medicine and Dentistry, University of Turin, Italy
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  • S. Castellano,

    1. Department of Biomedical Sciences and Human Oncology, Oral Medicine Section, School of Medicine and Dentistry, University of Turin, Italy
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  • D. Conrotto,

    1. Department of Biomedical Sciences and Human Oncology, Oral Medicine Section, School of Medicine and Dentistry, University of Turin, Italy
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  • R. Broccoletti,

    1. Department of Biomedical Sciences and Human Oncology, Oral Medicine Section, School of Medicine and Dentistry, University of Turin, Italy
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  • S. Gandolfo

    1. Department of Biomedical Sciences and Human Oncology, Oral Medicine Section, School of Medicine and Dentistry, University of Turin, Italy
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Dr Mario Carbone
Clinica Odontostomatologica,
C.so Dogliotti 14, 10126 Torino, Italy
e-mail: mario_carbone@libero.it

Abstract

Background:  Topical corticosteroids are the mainstay treatment for oral lichen planus (OLP), but some authors suggest that systemic corticosteroid therapy is the only way to control acute presentation of OLP.

Methods:  Forty-nine patients with histologically proven atrophic–erosive OLP were divided into two groups matched for age and sex. The test group (26 patients) was treated systemically with prednisone (50 mg/day), and afterwards with clobetasol ointment in an adhesive medium plus antimicotics, whereas the control group (23 patients) was only treated topically with clobetasol plus antimycotics.

Results:  Complete remission of signs was obtained in 68.2% of the test group and 69.6% of the control group, respectively (P = 0.94). Similar results were obtained for symptoms. Follow-up showed no significant differences between the two groups. One-third of the patients of the test group versus none in the control group experienced systemic side-effects (P = 0.003).

Conclusions:  The most suitable corticosteroid therapy in the management of OLP is the topical therapy, which is easier and more cost-effective than the systemic therapy followed by topical therapy.

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