Vitamin D in the Treatment of Recalcitrant Oral Lichen Planus: A Case Series

Oral lichen planus (OLP) is a chronic mucocutaneous inflammation. Although the aetiology of OLP was unknown, dysregulation of T lymphocyte function (CD8 T lymphocytes) in autoimmune disease was considered a contributing factor. Vitamin D deficiency was found to exacerbate the condition by increasing oral keratinocyte apoptosis, which led to worsened clinical manifestations and delayed healing in OLP patients. Moreover, OLP management was challenging due to its frequent recurrences. Vitamin D receptor (VDR) has anti-inflammatory and immunomodulatory properties, along with a regulatory effect on keratinocyte proliferation and differentiation; thus, suggesting its possible role in the treatment of OLP.

This case report analyzed recalcitrant OLP lasting over one year and highlighted the significant role of vitamin D in enhancing wound healing.

Two female patients, aged 50 and 58 years, complained of pain in the left and right cheeks for one and three years ago. Both patients had received previous therapies but had shown no improvement. Intraoral examination revealed erosive lesions with Wickham striae on the left and right buccal mucosa. We diagnosed both patients with erosive and reticular OLP.

The first-line treatment for both patients was corticosteroid mouthwash and anti-inflammatory therapy. An examination of vitamin D 25 (OH) levels was carried out as a risk factor screening due to the clinical manifestations being quite severe and persistent. The examination results indicated a vitamin D deficiency; both patients received vitamin D replacement therapy. The last control showed that patients' subjective and objective complaints experienced significant changes.

Vitamin D deficiency could increase the risk of OLP. Vitamin D examination and administration were important considerations in therapeutic decisions for OLP patients because they could accelerate the healing process.