[The topical treatment of atrophic-erosive oral lichen planus with fluocinonide in a bioadhesive gel, chlorhexidine and miconazole gel. A totally open trial].
To evaluate the efficacy and long-term course of topical steroids treatment in oral lichen planus (OLP), an open trial has been carried out in 30 patients with atrophic-erosive or symptomatic varieties of OLP confirmed histologically with relative contraindications for systemic steroid treatment (namely, liver disease, peptic ulcer, diabetes, blood hypertension or osteoporosis). The treatment was the following: Fluocinonide (Topsyn) 0.025% in 4% idrossiethylcellulose gel applied 3 times/daily for two months, 2 times/daily for the next 2 months and 1 times/daily for other 2 months. Moreover, chlorhexidine (Plakout) 0.12%, 3 mouthwashes/daily and miconazole gel (Micotef) applied 1 times/daily were used for the entire period of the steroid therapy as antimycotics. The clinical evaluation of signs and symptoms was assessed on a scale of 0 to 5 and of 0 to 3, respectively. Twenty patients concluded the entire therapeutical scheme, whereas 5 (17%) interrupted the treatment for the appearance of side-effects (namely, gastroesophageal disturbances, mucosal bleeding and pruritus), 1 interrupted voluntarily the treatment and 4 cases did not present at the controls. No cases of oral candidiasis were seen. Eighteen patients (90%) had improvements of oral lesions with significant statically reductions in the scores of signs (p < 0.002) and of symptoms (p < 0.02) (Wilcoxon test). We emphasize also that in 61% of the responders the oral conditions were stable after 6 months of follow-up. In conclusion our results suggest the following: a) fluocinonide is an effective and safe drug for the treatment of OLP, especially in addition with chlorehixidine and miconazole; b) the stability of our results demonstrates that probably an adequate steroid therapeutical scheme is more useful than continuous steroid administration in the treatment of OLP.
Carbone
M
M
Istituto policattedra di Clinica, Università degli Studi, Torino.
Carrozzo
M
M
Broccoletti
R
R
Mattea
A
A
Gandolfo
S
S
D000287:Administration, Topical; D000328:Adult; D000368:Aged; D000893:Anti-Inflammatory Agents / Q000008:administration & dosage* / Q000009:adverse effects; D000935:Antifungal Agents / Q000008:administration & dosage* / Q000009:adverse effects; D002710:Chlorhexidine / Q000008:administration & dosage*; D004359:Drug Therapy, Combination; D005260:Female; D005447:Fluocinonide / Q000008:administration & dosage* / Q000009:adverse effects; D005500:Follow-Up Studies; D005782:Gels; D006801:Humans; D017676:Lichen Planus, Oral / Q000188:drug therapy*; D008297:Male; D008825:Miconazole / Q000008:administration & dosage*; D008875:Middle Aged; D009067:Mouthwashes / Q000008:administration & dosage* / Q000009:adverse effects; D012074:Remission Induction
D000893:Anti-Inflammatory Agents; D000935:Antifungal Agents; D005782:Gels; D009067:Mouthwashes; D005447:Fluocinonide; D008825:Miconazole; D002710:Chlorhexidine