Aleinikov A, Jordan R C, Main J H
Department of dentistry, University of Toronto, Ont.
J Can Dent Assoc. 1996 Apr;62(4):324-7.
Lichen planus is a chronic mucocutaneous disorder of unknown etiology. The natural progression of oral lichen planus (OLP) is long and can extend over a number of years. Although many patients with OLP remain asymptomatic, some experience periods of marked inflammation with breakdown of the lesions, and require treatment. Corticosteroids are the mainstay of treatment for oral lesions, but delivery to affected mucosal sites can be problematic. The purpose of this study was to retrospectively review the results of topical steroid therapy in a group of patients with OLP, using a novel delivery method. The records of 33 patients with biopsy-proven OLP were reviewed and the relevant clinical features were noted at minimum review intervals of one, six and 12 months. Of this group, 24 patients had been treated using a standardized treatment protocol consisting of a corticosteroid ointment applied topically to mucosal lesions using cloth strips. Gingival lesions were treated using a steroid preparation in an adhesive paste. Nine patients remained asymptomatic and were not treated. In the treated group, 14/24 (58 per cent) of patients showed an improvement in symptoms by one month. The remainder showed no change or a worsening of their symptoms. Repetition of the treatment protocol resulted in improvement in all the non-responders, and by one year 23 of 24 (96 per cent) of the patients had experienced improvement or control of their symptoms. Long-term failure to control the symptoms in the single non-responding case was related to poor patient compliance. Results from this study show that a novel delivery method and treatment protocol for the application of topical steroids onto lesional mucosa is useful for the symptomatic control of oral lichen planus.
扁平苔藓是一种病因不明的慢性黏膜皮肤疾病。口腔扁平苔藓（OLP）的自然病程较长，可持续数年。尽管许多OLP患者没有症状，但有些患者会经历病变破溃的明显炎症期，需要治疗。皮质类固醇是口腔病变治疗的主要药物，但将其送达受影响的黏膜部位可能存在问题。本研究的目的是回顾一组OLP患者采用新型给药方法进行局部类固醇治疗的结果。回顾了33例经活检证实为OLP患者的记录，并在至少1个月、6个月和12个月的复查间隔时记录相关临床特征。在这组患者中，24例患者采用标准化治疗方案进行治疗，该方案包括使用布条将皮质类固醇软膏局部涂抹于黏膜病变处。牙龈病变使用粘贴剂型的类固醇制剂进行治疗。9例患者无症状，未接受治疗。在治疗组中，14/24（58%）的患者在1个月时症状有所改善。其余患者症状无变化或加重。重复治疗方案使所有无反应者症状改善，到1年时，24例患者中有23例（96%）症状得到改善或得到控制。唯一1例无反应患者长期未能控制症状与患者依从性差有关。本研究结果表明，一种将局部类固醇应用于病变黏膜的新型给药方法和治疗方案对口腔扁平苔藓的症状控制有效。
