Oral lichen planus: topical and systemic therapy

Area of Science:

• Oral Medicine
• Dermatology

Background:

• Oral lichen planus (OLP) presents a significant clinical challenge, with treatment failures often stemming from diagnostic inaccuracies.
• Accurate diagnosis via biopsy is paramount before initiating OLP therapy.
• While many OLP cases are asymptomatic, symptomatic forms, particularly erosive and atrophic types, can severely impact daily life.

Purpose of the Study:

• To review current challenges and strategies in the diagnosis and treatment of oral lichen planus.
• To highlight the importance of accurate diagnosis in OLP management.
• To discuss various therapeutic options and considerations for chronic and recalcitrant OLP.

Main Methods:

• Review of existing literature on OLP diagnosis and treatment modalities.
• Discussion of systemic and topical therapies, including corticosteroids, cyclosporine, and retinoids.
• Emphasis on the chronic and recalcitrant nature of erosive OLP.

Main Results:

• Accurate diagnosis is critical for successful OLP treatment.
• Systemic steroids and potent topical corticosteroids are effective for acute symptomatic OLP.
• Alternative therapies like topical cyclosporine and retinoids show controversial and unpromising results.

Conclusions:

• Long-term management of OLP requires careful consideration of treatment duration and potential adverse effects.
• Alternate-day protocols, low-dose regimens, and adjunct therapies are important strategies for managing erosive OLP.
• No single standard protocol is universally effective, necessitating individualized treatment plans for OLP.