Topical hyaluronic acid in the management of oral lichen planus: A comparative study

Abstract

Lichen planus is a chronic mucocutaneous inflammatory disorder that is estimated to affect 0.5%-2.2% of the general population. 1 The cause is unknown in most cases; however, in a minority of patients, precipitating factors have been suggested, including dental materials, drugs, stress, and infectious agents. 2 It primarily affects middleaged adults, and the prevalence is greater among women. There are four forms of oral lichen planus (OLP) that relate to clinical appearance: reticular, atrophic, bullous, and erosive. 3 Symptoms arising from OLP vary markedly and often relate to the specific category.Patients with an atrophic/erosive form of OLP often present with symptoms ranging from burning sensation to severe pain, interfering with speaking, eating, and swallowing. 4Patients with symptomatic OLP often require therapy and should be treated if symptoms are significant. 5 Various treatments have Abstract Aim: Oral lichen planus (OLP) is a chronic mucocutaneous disorder seen in clinical dental practice. Despite the progress in research and advances in knowledge, the successful management of OLP is still difficult to achieve. The aim of the present study was to compare the therapeutic effects of triamcinolone (TA) preparation (0.1%) with hyaluronic acid (HA) preparation (0.2%) in the management of OLP. Methods:In total, 40 patients of any age or sex who had symptomatic OLP were selected and randomly divided into two groups. Group I received topical 0.1% TA, and group II received topical 0.2% HA preparation three times per day for a period of 4 weeks. Basement data were recorded for each patient. Patients were evaluated on days 14 and 21, and after completing the course of treatment. The visual analog scale (VAS) was used for evaluating pain and burning sensation, along with an evaluation of the degree of erythema and mean area of the lesion. Data were analyzed by SPSS 17.0 software using Mann-Whitney and t test. P ≤ 0.05 was considered statistically significant. Results:Our results showed considerable improvement in all of the parameters evaluated. Baseline characteristics, including pain score, size, and clinical characteristics of the lesions, were not different between the two treatment groups. Both TA and HA were found to reduce the VAS score, the degree of erythema, and size of the lesions after treatment. Conclusion:The application of HA is suggested, and is an effective substitute for TA in the treatment of OLP. K E Y W O R D Scorticosteroid, hyaluronic acid, mucocutaneous, oral lichen planus, triamcinolonePatients were asked to return to the clinic for review at 14, 21, and 28 days' post-baseline. During these visits, any changes in the VAS values and site of lesion, color, size, or appearance of the lesions were duly noted on the proforma. The entire data were then entered into the proforma. | Statistical analysisAll data were tabulated and analyzed using SPSS version 17.0 (Chicago, IL, USA). The results are presented as mean ± standard deviation. Comparison between the groups for VAS and degree of erythe...

Is Topical Application of Hyaluronic Acid in Oral Lichen Planus Effective? A Randomized Controlled Crossover Study

“…In a study evaluating the efficacy of a 0.2% topical hyaluronic acid gel preparation in the management of OLP patients, the test group showed only transient improvements for up to 4 hours post-application. There were no differences between treatment groups at any of the time intervals, and HA, as well as placebo, had no effect on the extent and severity [25]. These data corroborate our findings.…”

“…While some authors related the positive immediate effect on pain in OLP [25] or patients with oral ulcers to a barrier effect of HA [61], Romeo et al found no difference in pain perception in biopsy wounds treated with a gel containing amino acids and 1.33% HA versus no gel, despite faster healing [62]. Interestingly, proteins essential for lubrication and viscoelasticity were missing in saliva from OLP patients [63], possibly rendering them more sensitive to the beneficial effects of HA.…”

“…Due to its anti-edematous, anti-inflammatory, bacteriostatic, fungistatic, and pro-angiogenetic properties, it has been shown to promote wound healing in several tissues, and, therefore, could be topically used in OLP [22][23][24]. Beneficial effects of HA in OLP have already been reported in recent studies [24] focusing mainly on subjective outcome parameters, such as the visual analogue scale (VAS) and clinical appearance [24][25][26][27].…”

Interventions for oral lichen planus: A systematic review and network meta‐analysis of randomized clinical trials

“…Two‐thousand seven‐hundred and fifteen articles were retrieved with the search strategy and two from the cross‐references. Out of 2717, 55 studies 13–67 were included in the systematic review encompassing 2831 patients. Three studies did not report their outcomes amenable for calculating the pooled estimates.…”

Effect of personality traits on the oral health-related quality of life in patients with oral lichen planus undergoing treatment

“…Hyaluronic acid is an effective substitute for topical corticosteroid with similar results. Moreover, in severely painful OLP, 0.2% HA could be used in addition to other topical drugs, such as corticosteroids and calcineurin inhibitors, to reduce the overall amount of immunosuppressant therapy used in a course of treatment [30].…”