Fractal Dimension and Texture Analysis of Lesion Autofluorescence in the Evaluation of Oral Lichen Planus Treatment Effectiveness.

Kamil Jurczyszyn,Witold Trzeciakowski,Bożena Karolewicz,Dorota Kida,Jacek Zborowski,Katarzyna Malec,Tomasz Konopka,Marcin Kozakiewicz

doi:10.3390/ma14185448

Abstract

Background: Oral Lichen planus (OLP) is a chronic inflammatory disease. Topical steroids are used as the treatment of choice. The alternative is photodynamic therapy (PDT). The study aimed to fabricate optimal biodegradable matrices for methylene blue or triamcinolone acetonide because of a lack of currently commercially available carriers that could adhere to the mucous. Methods: The study was designed as a 12-week single-blind prospective randomized clinical trial with 30 patients, full contralateral split-mouth design. Matrices for steroid and photosensitizer and laser device were fabricated. Fractal and texture analysis of photographs, taken in 405, 450, 405 + 450 nm wavelength, of lesions was performed to increase the objectivity of the assessment of treatment. Results: We achieved two total responses for treatment in case of steroid therapy and one in the case of PDT. Partial response was noted in 17 lesions treated using local steroid therapy and 21 in the case of PDT. No statistically significant differences were found between the effectiveness of both used methods. Statistically significant differences in fractal dimension before and after treatment were observed only in the analysis of photographs taken in 405 + 450 nm wavelength. Conclusions: Photodynamic therapy and topical steroid therapy are effective methods for treating OLP. Using a carrier offers the possibility of a more predictable and effective method of drug delivery into the mucous membrane. Autofluorescence enables the detection of lesions especially at the early stage of their development.

Highlights

Partial response was noted in 17 lesions treated using local steroid therapy and 21 in case of photodynamic therapy (PDT)
Enlarge in lesion size was observed in five lesions treated using steroid and in two lesions in the case of PDT
In lesions treated with steroids, the surface area was reduced by 4.3 mm2 as compared to those treated with PDT whose surface area was reduced by 7.3 mm2

Summary

Introduction

Lichen planus is a chronic inflammatory disease with an unclear aetiology that involves stratified squamous epithelium of the skin, mucous membranes and reproductive organs [1]. The prevalence of lichen planus in the general population is estimated at up to 5% and that of its oral form at 0.5–2.2% with a female to male incidence ratio of 2:1 [2]. The disease most frequently affects individuals over 30 years old. Symptoms within the oral cavity develop in as many as 60% of patients with their skin affected by the disease

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Discussion

Conclusion