Successful treatment using occlusive steroid therapy in patients with erosive lichen planus: a report on 2 cases

Gingival involvement in erosive lichen planus (ELP) is classified as nonplaque-induced gingival lesions. Occlusive steroid therapy (OST) using a plastic stent is administered to enhance the effect of corticosteroids by maximizing the contact between the corticosteroids applied on the gingiva and the gingival lesions. Clinical efficacy may be enhanced with OST even when low-potency topical corticosteroids are used. The treatment of 2 cases of gingival ELP with symptoms of intraoral pain and a long-term burning sensation is presented. In both cases, severe erythema was found in the attached gingiva. Plastic stents were constructed to provide OST. The patient was instructed to apply topical corticosteroid (0.1% triamcinolone acetonide) to the inner surface of the stent and wear the stent continuously between meals and at night. The condition of the gingiva dramatically improved by providing OST for 10 weeks (case 1) and 3 weeks (case 2). The improvement in the gingival condition has been controlled for a long period (7 to 10 months) even after OST was completed. The treatment methods shown in this report are encouraging and worthy of further study.