Arunkumar Shantala, Kalappanavar Anupama N, Annigeri Rajeshwari G, Kalappa Shakuntala G
Department of Oral Medicine and Radiology, Sri Dharmasthala Manjunatheshwara College of Dental Sciences and Hospital, Dharwad, India.
Department of Oral Medicine and Radiology, College of Dental Sciences and Hospital, Davangere, Karnataka, India.
Indian J Dent. 2015 Jan-Mar;6(1):14-9. doi: 10.4103/0975-962X.151692.
Oral lichen planus (OLP) is a relatively common, chronic inflammatory condition that frequently presents with symptoms of pain and burning sensation. It is generally a very unrelenting disorder despite several kinds of treatment. Only symptomatic OLP requires treatment, and it remains a challenging predicament. Efforts are made in a sustained manner for searching for novel therapies for symptomatic OLP. Therefore, this study was aimed to compare the efficacy of treatment with topical pimecrolimus cream 1% with that of triamcinolone acetonide oral paste 0.1% in subjects with symptomatic OLP.
A prospective, parallel-group, randomized, active control clinical study was conducted among 30 symptomatic OLP subjects (20 females and 10 males, with 15 patients in each treatment group) treated with topical pimecrolimus 1% cream and triamcinolone acetonide 0.1% oral paste four times daily for two consecutive months and treatment-free follow-up was performed for 2 months. Pain or burning sensation, mean clinical score and presence of erythematous areas were assessed. The data obtained were statistically analyzed using Wilcoxon's Rank test and the Mann Whitney test.
Subjects in both the groups showed significant improvement in symptom scores; however, the overall treatment response was higher in the pimecrolimus group compared with the triamcinolone acetonide group. On intergroup comparison, there was no statistically significant difference between the groups in the reduction in burning sensation (P = 0.18) and erythematous area (P = 0.07), but there was a statistically highly significant improvement in reduction of clinical scoring (P < 0.01%). Following the termination of the treatment, sustained remission of symptoms and long-lasting therapeutic effects was detected in 93.3% of the patients treated with pimecrolimus.
Topical pimecrolimus 1% cream showed better therapeutic response compared with triamcinolone acetonide 0.1% oral paste in subjects with symptomatic OLP.
口腔扁平苔藓（OLP）是一种相对常见的慢性炎症性疾病，常伴有疼痛和烧灼感等症状。尽管有多种治疗方法，但它通常是一种非常顽固的疾病。只有有症状的OLP才需要治疗，而这仍然是一个具有挑战性的难题。人们一直在持续努力寻找有症状OLP的新疗法。因此，本研究旨在比较1%吡美莫司乳膏与0.1%曲安奈德口腔糊剂治疗有症状OLP患者的疗效。
对30例有症状的OLP患者（20例女性和10例男性，每个治疗组15例患者）进行了一项前瞻性、平行组、随机、活性对照临床研究，患者连续两个月每天4次外用1%吡美莫司乳膏和0.1%曲安奈德口腔糊剂，并进行2个月的无治疗随访。评估疼痛或烧灼感、平均临床评分和红斑区域的存在情况。使用Wilcoxon秩和检验和Mann Whitney检验对获得的数据进行统计分析。
两组患者的症状评分均有显著改善；然而，吡美莫司组的总体治疗反应高于曲安奈德组。组间比较，两组在烧灼感减轻（P = 0.18）和红斑面积减少（P = 0.07）方面无统计学显著差异，但在临床评分降低方面有统计学高度显著改善（P < 0.01%）。治疗结束后，93.3%接受吡美莫司治疗的患者症状持续缓解且疗效持久。
在有症状的OLP患者中，1%吡美莫司乳膏比0.1%曲安奈德口腔糊剂显示出更好的治疗反应。
