Methylene blue‐mediated photodynamic therapy: A possible alternative treatment for oral lichen planus

Abstract

Background and Objectives: In this study, methylene blue-mediated photodynamic therapy (MB-PDT) was used as a possible alternative method for the treatment of oral lichen planus (OLP). Study Design/Materials and Methods: Thirteen patients with 26 OLP lesions were enrolled in this study. Patients were instructed to gargle a 5% methylene blue solution in water for 5 minutes. Ten minutes later, irradiation was performed by laser light (l ¼ 632 nm, light exposure dose ¼ 120 J/cm 2 ). Lesions were evaluated pre and post-operatively and at follow-up sessions by changes in sign and symptom (pain) scores, and size of lesions. Results: Improvement in sign scores was achieved in 16 lesions. Four keratotic lesions disappeared completely. There was a statistically significant decrease in sign and symptom scores 1 week after treatment and at follow-up sessions up to 12 weeks. Average reduction in size of lesions was 44.3%. Conclusion: MB-PDT seems to be an effective alternative treatment for control of OLP. In our opinion, this preliminary result warrant further studies in order to show the efficacy of MB-PDT in control of OLP for a longer period of time.

Photodynamic Therapy – A Non-invasive Treatment Modality for Precancerous Lesions

“…There were previous studies done on OLP, but in all of them methylene blue was used as a photosensitizer. Aghahosseini et al, 31 treated 13 patients with 26 OLP lesions with MB-mediated PDT and results were evaluated a week after single session of PDT and at follow up sessions up to 12 weeks. The average reduction in size of lesions was 44.3% which was statistically significant.…”

“…The average reduction in size of lesions was 44.3% which was statistically significant. In another study conducted by Aghahosseini et al, 11 2 patients with 5 OLP lesions were subjected to MB-mediated PDT and results were evaluated 2 weeks after a single session of PDT, resulting complete response in 2 lesions, and 2 other lesions showed partial response at 3-9 months follow up, and no response could be detected in one lesion. In a study conducted by Sadaksharam et al, 32 20 patients with symptomatic OLP were treated by using PDT with 5% methylene blue and irradiated with xenon arc lamp, at a wavelength 630 ± 5 nm, at a dose of 120 J/cm 2 per sitting in four sessions (1st, 4th, 7th and 15th day).…”

Photodynamic therapy of oral leukoplakia and oral lichen planus using methylene blue: A pilot study

“…It is worth to note that many of the precancerous lesions such as oral leukoplakia (OL) and oral lichen planus (OLP) are not having de¯nitive treatment protocols. 7,8 OL is one of the most common precancerous lesions, which appears like an adherent white patch of keratosis. OL will primarily a®ect oral mucous membrane or tongue.…”

“…The female population is a®ected two folds higher than that of the male population with a peak age range of 30-60 years. 8,12 The occurrence of OLP is clinically classi¯ed into four based on their presentation: reticular, papular, erythematous (atrophic) and erosive (ulcerated, bullous), 13,14 of which recticular lesions on the posterior buccal mucosa have the most common occurrence. 15 The potential of malignant transformation of OLP is reported to vary greatly from 0.4% to more than 5% over a period of 0.5-20 years.…”

“…15 The potential of malignant transformation of OLP is reported to vary greatly from 0.4% to more than 5% over a period of 0.5-20 years. 8 As OLP is related to T-cell mediated immunological disease, corticosteroids, cyclosporine, tacrolimus and retinoids are generally recommended, but the therapeutic outcome is not satisfactory. 12,16 In this context, there is a need for alternative and/or complementary therapeutic modalitiy to improve the therapeutic e±cacy.…”