1995 Volume 44 Issue 4 Pages 644-651
Oral lichen planus (OLP) was clinically examined in 150 patients treated in our clinic during the last 10 years. The buccal mucosa was most predisposed to OLP, followed by the tongue, lip and palate. Erosive ulcerative type was most common (184 sites) being complicated with candidiasis in 19 patients, and reticular, leukoplakic and erythroplakic lesions were observed at 166, 28 and 14 sites, respectively. Considering the severity of the inflammation, topical prednisolone (PSL), which was ionophoresed in most cases, was primarily applied to 133 cases and oral administration of PSL was tried in 17 cases with widely distributed OLP. In cases complicated with candidiasis, an antifungal agent amphotericin B was prescirbed for gargling. In addition, an antiallergic drug azelastine hydrochrolide (Azeptin) was orally used in 8 patients who exhibited relatively severe contact pains. As the result, disappearance of the discomfort was obtained in 88.7% of locally treated cases within about 3 weeks after the start of treatment. No relationship between the clinical types and the therapeutic effects was observed, however, the response in leukoplakic lesions was weak; nevertheless, all Azeptin-prescribed cases became free from discomfort. Lesions in 12 cases, which were unsatisfactorily improved by topical PSL, were secondarily treated with oral PSL for about 1 month, and all of them were improved. Of 17 cases which received oral PSL originally, 2 cases did not show any improvement. Some lesions of originally severe cases became symptomatic again, but recurring OLP responded sufficiently to secondary treatment with PSL. These results indicate that ionophoresed topical PSL is very useful for OLP and oral PSL should be limited to severe cases and that treatment of OLP complicated with candidiasis and leukoplakic OLP should be revised.
