Prompt healing of erosive oral lichen planus lesion after combined corticosteroid treatment with locally injected triamcinolone acetonide plus oral prednisolone

Abstract

Erosive oral lichen planus (EOLP) is a T-cell-mediated inflammatory disease that is refractory to treat. This study tested whether local injection of triamcinolone acetonide plus oral administration of low- or medium-dose prednisolone could hasten the healing of EOLP lesions. In this study, 50 EOLP patients were treated with local injection of Kenacort A (40 mg triamcinolone acetonide once weekly for 3 and 2 weeks for 30 major and 20 minor EOLP patients, respectively) plus oral administration of prednisolone (25-30 mg and 15-20mg of prednisolone once daily for 2 weeks for 30 major and 20 minor EOLP patients, respectively). The oral administration of prednisolone was tapered to 5mg per day and stopped in 7 days. Then, the patients were treated with topical Dexaltin (0.1% dexamethasone, once or twice per daily) and oral administration of vitamin Bc (one capsule twice daily) thereafter. After 3-week treatments, the 30 major EOLP patients showed complete response (lack of detectable erosive or ulcerative lesion with absence or regression of reticular or papular OLP) in 27 cases (90%) and partial response (reduction of erosive or ulcerative lesion by at least 30% in diameter with regression of reticular or papular OLP) in cases (10%); and 20 minor EOLP patients demonstrated complete response in 18 cases (90%) and partial response in two cases (10%). However, all the 45 complete response major or minor EOLP patients showed recurrence of erosive or ulcerative lesion after 3-24 (mean 12) months of follow-up. Prompt and complete healing of the EOLP lesions could be achieved in a relative short period of time after treatment with our protocol. Although complete response EOLP lesions recurred after a follow-up period of 3-24 months, patients did have an average remission period of 12 months after treatment with our protocol.