title: The Efficacy of Topical Hyaluronic Acid 0.2% in the Management of Symptomatic Oral Lichen Planus.
abstract: BACKGROUND
  Oral lichen planus (OLP) is a condition frequently referred to the specialist dental clinic for diagnosis and management. It is a disease of the skin and mucous membranes with oral manifestations too. It varies in appearance from keratotic to erythematous and ulcerative form. Immunosuppressants are frequently used for patients but some of these drugs could be implicated in malignant transformation, thus there is a clear need to find an alternative therapy for OLP.
  
  
  OBJECTIVE
  To evaluate the relief of symptoms and reduction in the size of the lesions of lichen planus with 0.2% hyaluronic acid topical application and to compare the efficacy of topical hyaluronic acid (0.2%) with that of patients on placebo.
  
  
  METHODS
  A randomized controlled study was conducted on 50 symptomatic and biopsy proven patients with lichen planus. The subjective symptoms like Visual Analogue Scale (VAS) and the objective symptoms like degree of erythema and mean area of the lesion were recorded preoperatively and on day 7, day 14, day 21 and day 28. The selected patients were divided randomly into group-I comprising of 25 patients who received topical 0.2% hyaluronic acid therapy for 14 days and group-II comprising of 25 patients who received topical application of placebo for 14 days. The statistical tests used were Mann-Whitney U test, t-test, Wilcoxon matched pairs test by ranks and paired t-test.
  
  
  RESULTS
  Symptomatic effect of soreness evaluation- there was a significant reduction in VAS scores in the test group as compared to placebo, similarly there was also significant reduction in the degree of erythema, change in the size of the lesion and area of the lesion in the test group. There was significant improvement in relief of symptoms, in the degree of erythema and mean area of the lesion in Group-I when compared with group-II.
  
  
  CONCLUSIONS
  Topical application of 0.2% Hyaluronic acid showed a significant clinical response when compared to topical placebo. It is easy to use; hence a frequent application scheme should be advised to improve the efficacy of hyaluronic acid.
authors.affiliation: Assistant Professor, Department of Oral Medicine & Radiology, Bharati Vidyapeeth Dental College & Hospital , Navi-Mumbai, India .
authors.forename: Rahul Raviraj
authors.initials: RR
authors.lastname: Shetty
authors.affiliation: Professor and Head of Department, Department of Oral Medicine and Maxillofacial Radiology, SDM Dental College and Hospital , Dharwad, Karnataka, India .
authors.forename: Krishna Nagappa
authors.initials: KN
authors.lastname: Burde
authors.affiliation: Associate Professor, Department of Oral Medicine and Maxillofacial Radiology, SDM Dental College and Hospital , Dharwad, India .
authors.forename: Kruthika Satyabodh
authors.initials: KS
authors.lastname: Guttal
keywords: Circuminoids; Corticosteroids; Inflammatory mucocutaneous disorder; Placebo; Ulcerative lesions