A randomized controlled trial to compare steroid with cyclosporine for the topical treatment of oral lichen planus.
OBJECTIVE
To compare the effectiveness of cyclosporine solution versus triamcinolone acetonide in orabase in the treatment of oral lichen planus (OLP) in reducing signs and symptoms.


METHODS
One hundred thirty-nine biopsy-proven OLP patients were randomly assigned to cyclosporine (68) or steroid (71) applied onto the target lesion and affected areas. Assessments were at weeks 0, 2, 4, 8 by clinical scoring and grid measurement of the target lesion (reticulation, erythema, ulceration). Patients ranked severity of pain and burning sensation using visual analog scales.


RESULTS
Although clinical response, pain, burning sensation, area of reticulation, erythema, and ulceration at week 4 were all worse in patients receiving cyclosporine than in those receiving steroid, the differences were not statistically significant. Large patient-to-patient variability was evident over the observation period, with little evidence of marked changes in levels over time in both treatment groups.


CONCLUSIONS
Topical cyclosporine appears no more effective than steroid in the treatment of oral lichen planus.
Yoke
Poon Choy
PC
Department of Oral and Maxillofacial Surgery, National Dental Center, Singapore. pcy@ndc.com.sg
Tin
Goh Bee
GB
Kim
Myung-Jin
MJ
Rajaseharan
Annabelle
A
Ahmed
Shaheen
S
Thongprasom
Kobkan
K
Chaimusik
Mantharop
M
Suresh
Shirley
S
Machin
David
D
Bee
Wong Hwee
WH
Seldrup
Jorgen
J
D000287:Administration, Topical; D000293:Adolescent; D000328:Adult; D000368:Aged; D002266:Carboxymethylcellulose Sodium / Q000031:analogs & derivatives; D002648:Child; D016572:Cyclosporine / Q000627:therapeutic use*; D005260:Female; D005938:Glucocorticoids / Q000008:administration & dosage / Q000627:therapeutic use*; D006801:Humans; D007166:Immunosuppressive Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D017676:Lichen Planus, Oral / Q000188:drug therapy*; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D010147:Pain Measurement; D017060:Patient Satisfaction; D012044:Regression Analysis; D016896:Treatment Outcome; D014222:Triamcinolone Acetonide / Q000008:administration & dosage / Q000627:therapeutic use*
D005938:Glucocorticoids; D007166:Immunosuppressive Agents; C056627:Orabase; D016572:Cyclosporine; D014222:Triamcinolone Acetonide; D002266:Carboxymethylcellulose Sodium