Lichen Planus

Ann Dermatol. 2015 Oct;27(5):485-91. doi: 10.5021/ad.2015.27.5.485. Epub 2015 Oct 2.

Comparison of Low-Level Laser Therapy versus Ozone Therapy in the Treatment of Oral Lichen Planus.

Kazancioglu HO1, Erisen M2.
Author information
1Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Bezmialem Vakif University, Istanbul, Turkey.  2Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Istanbul University, Istanbul, Turkey.
Abstract
BACKGROUND:
The treatment options for oral lichen planus (OLP) are numerous and include topical and systemic agents. Intralesional and systemic corticosteroids are used; however, the therapeutic results are often disappointing.
OBJECTIVE:
To compare the influence of ozone, laser, and topical corticosteroid therapies in the treatment of OLP.
METHODS:
One hundred twenty adult patients with <3 cm atrophic-erosive biopsy-proven OLPs in the tongue or buccal mucosa were recruited into the study. They were randomly assigned, by preoperative envelope drawing, to be treated with low-level laser therapy (LLLT group), ozone therapy (ozonated group), and topical corticosteroid therapy (positive control group). A placebo treatment containing base ointment without the active corticosteroid component was administered to patients in the negative control group. Response rate scores were determined on the basis of changes in the appearance score and pain score of the lesions between baseline and after each treatment.
RESULTS:
The study subjects consisted of 56 male and 64 female OLP patients with a combined mean age of 42.6±8.3 years (range, 28~55 years). No statistically significant difference was detected in clinical severity among the groups. The sign scores decreased in almost all scoring groups; however, statistically significant improvement was found in the ozonated and corticosteroid-treated groups. Symptom improvement was achieved after treatment with LLLT, ozone, and corticosteroid (p<0.05). The efficacy indices were significantly higher in the ozonated and corticosteroid-treated groups.
CONCLUSION:
Ozone and corticosteroid therapies were more effective than 808-nm LLLT in the treatment of OLP.
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J Dent (Shiraz) 2013 Dec;14(4):201-4.

Use of low level laser therapy for oral lichen planus: report of two cases.

Mahdavi O1, Boostani N2, Jajarm H3, Falaki F3, Tabesh A4.
  • 1Dept. of Oral and Maxillo Facial Medicine, School of Dentistry, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.
  • 2Resident, Dept. of Anesthesiology, School of Medicine, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.
  • 3Dept. of Oral Medicine, School of dentistry, Mashhad University of Medical Sciences, Mashhad, Iran.
  • 4Resident, Dept. of Oral and Maxillo Facial Medicine, School of dentistry, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.

Abstract

Oral Lichen Planus is a chronic inflammatory disease of unknown etiology. Erosive/ ulcerative oral lichen planus is often a painful condition that tends to become malignant, urging appropriate therapy. Laser therapy has recently been suggested as a new treatment option without significant side effects. This article presents two cases of erosive/ ulcerative oral lichen planus, who had not received any treatment before, treated with 630 nm low level laser. Lesion type and pain was recorded before and after treatment. Severity of lesions and pain were reduced after treatment. Low Level Laser Therapy was an effective treatment with no side effects and it may be considered as an alternative therapy for erosive/ulcerative oral lichen planus.

Photomed Laser Surg.  2011 Jun;29(6):421-5. Epub 2011 Jan 8.

A comparative pilot study of low intensity laser versus topical corticosteroids in the treatment of erosive-atrophic oral lichen planus.

Jajarm HH, Falaki F, Mahdavi O.

Source

Department of Oral Medicine and Dental Research Center, Faculty of Dentistry, Mashhad, Iran.

Abstract

BACKGROUND AND OBJECTIVE:

Treatment of oral lichen planus (OLP) remains a great challenge for clinicians. The aim of our study was to compare the effect of low intensity laser therapy (LILT) with topical corticosteroids in the treatment of oral erosive and atrophic lichen planus.

MATERIALS AND METHODS:

Thirty patients with erosive-atrophic OLP were randomly allocated into two groups. The experimental group consisted of patients treated with the 630? nm diode laser. The control group consisted of patients who used Dexamethason mouth wash. Response rate was defined based on changes in the appearance score and pain score (Visual Analogue Scale) of the lesions before and after each treatment.

RESULTS:

Appearance score, pain score, and lesion severity was reduced in both groups. No significant differences were found between the treatment groups regarding the response rate and relapse.

CONCLUSION:

Our study demonstrated that LILT was as effective as topical corticosteroid therapy without any adverse effects and it may be considered as an alternative treatment for erosive-atrophic OLP in the future.

Photomed Laser Surg. 2010 Aug 25. [Epub ahead of print]

Effect of Low-Level Laser Irradiation on Unresponsive Oral Lichen Planus: Early Preliminary Results in 13 Patients.

 

Cafaro A, Albanese G, Arduino PG, Mario C, Massolini G, Mozzati M, Broccoletti R.

1 Oral Medicine Unit, Dentistry Section, Department of Biological Sciences and Human Oncology, University of Turin , Turin, Italy .

Abstract

Abstract Objective: To detail the efficacy of low-level laser therapy (LLLT) for the management of oral lichen planus (OLP) unresponsive to standard therapy. Background: OLP is an inflammatory disease that can be painful, mainly in the atrophic and erosive forms. Numerous drugs have been used with dissimilar results, but most treatments are empiric. However, to date, the most commonly used and useful agents for the treatment of OLP are topical corticosteroids. Materials and Methods: The investigators studied a prospective cohort of 13 patients affected by OLP, who received biostimulation with a pulsed diode laser (GaAs). Patients were exposed to a 904-nm pulsed infrared laser (4 J/cm(2) energy density per minute; spot size, 0.8 cm). Outcome variables, statistically evaluated, were as follows: the size of lesions, visual analogue score of pain, and stability of the obtained result in the follow-up period. Results: We detailed significant reduction in lesion size and in reported pain. No reported complications or therapy side effects were observed in any of the patients treated. Conclusion: This study suggests that LLLT could be a possible treatment for patients with unresponsive OLP. These results, although not conclusive, are a step forward for enhanced management of this quite common condition; however, it would be interesting to the results would be the same with a greater number of patients or in a different clinical setting.

Arch Dermatol. 2004 Apr;140(4):415-20.

Low-dose excimer 308 nm laser for the treatment of oral lichen planus.

Trehan M, Taylor CR.

Department of Dermatology, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02114, USA.

BACKGROUND: Lichen planus is a difficult-to-treat chronic inflammatory disorder that affects mucous membranes, causing inanition, halitosis, and dyspareunia.

OBJECTIVE: To evaluate the novel use of low-dose 308-nm excimer laser radiation for the treatment of symptomatic oral lichen planus (OLP). DESIGN: A single-center, before-after trial.

SETTING: Academic clinical research center.

PATIENTS: Nine patients with symptomatic, biopsy-proven OLP, unresponsive to conventional therapies, were recruited from the dermatology clinics of the Massachusetts General Hospital in Boston. Eight participants completed the entire study, and 1, despite early improvement, did not complete the study because of hospitalization for an unrelated reason.Intervention With a narrow, fiberoptic handpiece to target precisely only diseased sites, 308-nm excimer laser radiation was delivered at an initial dose of 100 mJ/cm(2) once a week.

MAIN OUTCOME MEASURE: A visual analog scale was used to grade subjective disease severity. Clinical improvement was graded in quartiles as follows: poor (<25%), fair (25%-50%), good (51%-75%), and excellent (>75%). Follow-up visits occurred for up to 18 months. A paired t test was performed to evaluate efficacy of treatment.

RESULTS: Treatments were painless and well tolerated. Five patients demonstrated overall excellent clinical and subjective improvement after 7 treatments. Two participants with nonerosive OLP were deemed fair responders. The only poor responder in the study also had chronic active hepatitis C infection. Overall improvement was statistically significant (P<.05), and for the responders, remission times ranged from 2 to 17 months.

Conclusion Low-dose treatment with the excimer 308-nm laser can be very effective in treating symptomatic and especially erosive OLP, an otherwise notoriously difficult-to-control disease.

LOW LEVEL LASER THERAPY: AN OVERVIEW OF THERAPEUTIC POSSIBILITIES

1Zlatko Simunovic, M.D., F.M.H., 2Tatjana Trobonjaca, M.D. 1Pain Clinic-Laser Center, Locarno, Switzerland 2Laser Center, Opatija, Croatia

The first application of Low Level Laser Therapy (LLLT) was completed on dermatological disorders like skin ulcers, in early sixties. In the meantime, dermatological indications for LLLT have increased. Particular effects of LLLT are observed when laser beam is applied on the open wound, which healing can be significantly accelerated especially in patients with delayed or impeded wound healing like patients with circulatory disorders, diabetic patients, etc. LLLT triggers biostimulative-regenerative processes inside the cell and subsequently causes revitalisation of the issue as well. Second effect of LLLT refers to the vasodilatation and neovascularisation of local blood and lymph vessels, thus causing a better removal of waste products and, on the other hand, improved oxygenation and nutrition of damaged tissue. Analgesic and anti-inflammatory effects of LLLT are also significant when irradiating certain dermatological changes. All effects mentioned before will be discussed in details during the lecture. Therefore, LLLT is used today in dermatology in the treatment of the following conditions: – Ulcus cruris – Burns – Herpers infections – Scar tissue – Keliod – Sclerodermia – Rosacea – Neurodermitis – Eczema – Lichen ruber planus and scrofulosus – Psoriasis – Haemathoma – Etc. Each pathological condition will be explained, and optimal and individual energy densities will be presented in this lecture