[The topical treatment of atrophic-erosive oral lichen planus with fluocinonide in a bioadhesive gel, chlorhexidine and miconazole gel. A totally open trial].

Abstract

To evaluate the efficacy and long-term course of topical steroids treatment in oral lichen planus (OLP), an open trial has been carried out in 30 patients with atrophic-erosive or symptomatic varieties of OLP confirmed histologically with relative contraindications for systemic steroid treatment (namely, liver disease, peptic ulcer, diabetes, blood hypertension or osteoporosis). The treatment was the following: Fluocinonide (Topsyn) 0.025% in 4% idrossiethylcellulose gel applied 3 times/daily for two months, 2 times/daily for the next 2 months and 1 times/daily for other 2 months. Moreover, chlorhexidine (Plakout) 0.12%, 3 mouthwashes/daily and miconazole gel (Micotef) applied 1 times/daily were used for the entire period of the steroid therapy as antimycotics. The clinical evaluation of signs and symptoms was assessed on a scale of 0 to 5 and of 0 to 3, respectively. Twenty patients concluded the entire therapeutical scheme, whereas 5 (17%) interrupted the treatment for the appearance of side-effects (namely, gastroesophageal disturbances, mucosal bleeding and pruritus), 1 interrupted voluntarily the treatment and 4 cases did not present at the controls. No cases of oral candidiasis were seen. Eighteen patients (90%) had improvements of oral lesions with significant statically reductions in the scores of signs (p < 0.002) and of symptoms (p < 0.02) (Wilcoxon test). We emphasize also that in 61% of the responders the oral conditions were stable after 6 months of follow-up. In conclusion our results suggest the following: a) fluocinonide is an effective and safe drug for the treatment of OLP, especially in addition with chlorehixidine and miconazole; b) the stability of our results demonstrates that probably an adequate steroid therapeutical scheme is more useful than continuous steroid administration in the treatment of OLP.

• Authors: M Carbone, M Carrozzo, R Broccoletti, A Mattea, S Gandolfo
• Journal: Minerva stomatologica (Minerva Stomatol) Vol. 45 Issue 3 Pg. 61-8 (Mar 1996) ISSN: 0026-4970 [Print] Italy
• Vernacular Title: Il trattamento topico del lichen planus orale atrofico-erosivo con fluocinonide in gel bioadesivo, clorexidina e miconazolo gel. Un trial tutto aperto.
• PMID: 8926975 (Publication Type: Clinical Trial, English Abstract, Journal Article)

Chemical References

• Anti-Inflammatory Agents
• Antifungal Agents
• Gels
• Mouthwashes
• Fluocinonide
• Miconazole
• Chlorhexidine

Topics

• Administration, Topical
• Adult
• Aged
• Anti-Inflammatory Agents (administration & dosage, adverse effects)
• Antifungal Agents (administration & dosage, adverse effects)
• Chlorhexidine (administration & dosage)
• Drug Therapy, Combination
• Female
• Fluocinonide (administration & dosage, adverse effects)
• Follow-Up Studies
• Gels
• Humans
• Lichen Planus, Oral (drug therapy)
• Male
• Miconazole (administration & dosage)
• Middle Aged
• Mouthwashes (administration & dosage, adverse effects)
• Remission Induction