Department of Dermatology, Venereology and Leprology, Postgraduate Institute of Medical Education and Research, Chandigarh, India.
Department of Histopathology, Postgraduate Institute of Medical Education and Research, Chandigarh, India.
Dermatol Ther. 2018 Jan;31(1). doi: 10.1111/dth.12563. Epub 2017 Nov 10.
Topical corticosteroids are considered to be the most effective treatment for oral lichen planus (OLP). Methotrexate has been found to be effective in extensive cutaneous lichen planus. The objectives of the study were to evaluate the clinical efficacy and safety of topical triamcinolone 0.1% oral paste, oral methotrexate and a combination of these in symptomatic moderate-to- severe OLP. Forty-five patients were recruited and were allocated to three treatment arms with 15 patients in each treatment arm. They were treated for a period of 16 weeks or until complete clinical remission, whichever was earlier. The parameters assessed were clinical severity score, visual analogue score, and quality of life impairment questionnaire score. Forty-three patients completed the study. All three treatment modalities were effective. The patients in the combination group had significantly better reduction in the outcome parameters assessed compared to the other two groups. Nine patients achieved complete clinical remission, 6 in the combination group and 3 in the topical triamcinolone group. Systemic methotrexate, alone or in combination with topical triamcinolone, is effective in management of moderate to severe OLP.
局部皮质类固醇被认为是治疗口腔扁平苔藓（OLP）最有效的方法。甲氨蝶呤已被发现对广泛的皮肤扁平苔藓有效。本研究的目的是评估 0.1%曲安奈德口腔糊剂局部治疗、口服甲氨蝶呤以及这两种方法联合治疗中到重度 OLP 的临床疗效和安全性。招募了 45 名患者，并将他们分配到三个治疗组，每组 15 名患者。他们接受了为期 16 周的治疗，或直到完全临床缓解，以先发生者为准。评估的参数包括临床严重程度评分、视觉模拟评分和生活质量受损问卷评分。43 名患者完成了研究。三种治疗方法均有效。与其他两组相比，联合组患者评估的结局参数明显改善。9 名患者达到完全临床缓解，联合组 6 例，曲安奈德组 3 例。单独使用或与曲安奈德联合使用甲氨蝶呤治疗中到重度 OLP 是有效的。
