Oral medicine
Efficacy of intralesional betamethasone for erosive oral lichen planus and evaluation of recurrence: a randomized, controlled trial

https://doi.org/10.1016/j.oooo.2013.07.023Get rights and content

Objective

This study aimed to determine the efficacy and safety of intralesional betamethasone in erosive oral lichen planus and to evaluate relapse of erosion.

Study Design

Patients were randomly assigned to the experimental group (1.4 mg intralesional betamethasone) or to the control group (8 mg intralesional triamcinolone acetonide), and they received injections once a week for 2 weeks. Erosive area and pain level were assessed on days 1, 7 ± 2, and 14 ± 2. If the lesion disappeared, any recurrence within the following 3 months was recorded.

Results

Twenty-nine participants in the experimental group and 30 in the control group completed the protocol. Healed percentage was higher with betamethasone (93.1%) than with triamcinolone (66.7%; P = .02), and final reduction in erosion area was greater in the experimental group (21.276 ± 21.064 mm2) than in the control group (11.5 ± 12.95 mm2; P = .02). Reduction in pain level did not differ between groups. The proportion of participants with recurrent erosions was significantly lower in the experimental group (14.8%) than in the control group (45%; P = .04).

Conclusions

Intralesional betamethasone may be used in the topical treatment of erosive oral lichen planus.

Section snippets

Participants

Sixty-one patients with erosive OLP determined clinically and pathologically were enrolled at the Department of Oral Medicine, West China Hospital of Stomatology, Sichuan University, from April 1, 2011, to May 31, 2012. Of these 61 patients, 21 were men and 40 were women, aged 18 to 60 years. Participants were randomly divided into 2 groups: 30 in the experimental group and 31 in the control group.

The inclusion criteria were as follows: age, 18 to 60 years; having a single erosive lesion;

Results

A total of 100 patients with erosive OLP were assessed for eligibility to participate in the study at the Department of Oral Medicine, West China Hospital of Stomatology, Sichuan University, from April 1, 2011, to May 31, 2012. Of these, 34 did not meet the inclusion criteria; 25 had bilateral or multiple erosions, and 5 others refused to participate in the study. A total of 61 participants, 30 in the experimental group and 31 in the control group, were enrolled in the study. Two patients were

Efficacy of intralesional betamethasone in the treatment of erosive OLP

This study was a randomized, positive-controlled clinical trial that compared the efficacy of intralesional betamethasone and triamcinolone acetonide in the treatment of erosive OLP. In our research, we designed a blind evaluation, which in this study involved the injection by one researcher and the recording of the observed indicators, such as erosive area and pain level, by different researchers who were blinded to the medications for the whole treatment duration. In this way, we tried to

References (41)

  • K. Erickson et al.

    Glucocorticoid regulation of diverse cognitive functions in normal and pathological emotional states

    Neurosci Biobehav Rev

    (2003)
  • L.K. Smith et al.

    Glucocorticoid-induced apoptosis of healthy and malignant lymphocytes

    Prog Brain Res

    (2010)
  • V. Crincoli et al.

    Oral lichen planus: update on etiopathogenesis, diagnosis and treatment

    Immunopharmacol Immunotoxicol

    (2011)
  • A. Bermejo-Fenoll et al.

    A retrospective clinicopathological study of 550 patients with oral lichen planus in south-eastern Spain

    J Oral Pathol Med

    (2010)
  • M. Carbone et al.

    Course of oral lichen planus: a retrospective study of 808 northern Italian patients

    Oral Dis

    (2009)
  • Z.Y. Shen et al.

    A retrospective clinicopathological study on oral lichen planus and malignant transformation: analysis of 518 cases

    Med Oral Patol Oral Cir Bucal

    (2012)
  • N. Lavanya et al.

    Oral lichen planus: an update on pathogenesis and treatment

    J Oral Maxillofac Pathol

    (2011)
  • J.K. Ho et al.

    Systematic review of current systemic treatment options for erosive lichen planus

    Expert Rev Dermatol

    (2012)
  • K. Thongprasom et al.

    Steroids in the treatment of lichen planus: a review

    Oral Sci

    (2008)
  • H. Petropoulou et al.

    Effective treatment of erosive lichen planus with thalidomide and topical tacrolimus

    Int J Dermatol

    (2006)
  • Cited by (35)

    • Composite dissolvable microneedle patch for therapy of oral mucosal diseases

      2022, Biomaterials Advances
      Citation Excerpt :

      The MNs are prepared by a two-step casting process and the drug is concentrated in the tip parts of the needles to achieve efficient and precise drug release. Betamethasone sodium phosphate (BSP) is a long-acting GCs, which has been applied in the clinical treatment of many oral mucosal inflammatory diseases with significant efficacy. [36–38] Thus, BSP is selected as the model drug in this study.

    • Hydroxychloroquine and the treatment of Sjogren syndrome, chronic ulcerative stomatitis, and oral lichen planus in the age of COVID-19

      2021, Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology
      Citation Excerpt :

      Injectable steroid therapeutic drugs include triamcinolone and betamethasone. Other alternative therapeutics include topical retinoid therapy and low-level laser therapy.19-27 The major issue with respect to dental patients taking HCQ is drug-to-drug interactions with concerns regarding arrhythmogenic potential, specifically the TdP arrhythmia, which is potentially lethal.

    • Comparative evaluation of effectiveness of autologous platelet rich plasma and intralesional corticosteroids in the management of erosive oral Lichen planus- a clinical study

      2020, Journal of Oral Biology and Craniofacial Research
      Citation Excerpt :

      Extensive past research has proven effectiveness of intralesional steroids in treatment of Oral Lichen planus such as studies conducted by Liu, Chuanxia et al. and Lee, Young Chan et al. Xia, and Juan et al. which observed similar positive results as the present study.5,14,15 However, on comparing both the groups, no statistically significant differences were observed between the two groups.

    • Intralesional triamcinolone acetonide therapy for inflammatory oral ulcers

      2019, Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology
    • Premalignant and malignant oral mucosal lesions: Clinical and pathological findings

      2019, Journal of the American Academy of Dermatology
      Citation Excerpt :

      Initial treatment of symptomatic OLP is usually done with topical steroids. Intralesional corticosteroids have been used in the treatment of erosive OLP.41 Systematic steroids are used in more severe or refractory cases.33

    View all citing articles on Scopus

    This study was supported by grants from the National Natural Science Foundation of China (No. 81172581 and No. 81272962).

    View full text