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A randomized controlled trial to compare steroid with cyclosporine for the topical treatment of oral lichen planus.
Authors:Poon Choy Yoke  Goh Bee Tin  Myung-Jin Kim  Annabelle Rajaseharan  Shaheen Ahmed  Kobkan Thongprasom  Mantharop Chaimusik  Shirley Suresh  David Machin  Wong Hwee Bee  Jorgen Seldrup
Affiliation:Department of Oral and Maxillofacial Surgery, National Dental Center, Singapore. pcy@ndc.com.sg
Abstract:OBJECTIVE: To compare the effectiveness of cyclosporine solution versus triamcinolone acetonide in orabase in the treatment of oral lichen planus (OLP) in reducing signs and symptoms. STUDY DESIGN: One hundred thirty-nine biopsy-proven OLP patients were randomly assigned to cyclosporine (68) or steroid (71) applied onto the target lesion and affected areas. Assessments were at weeks 0, 2, 4, 8 by clinical scoring and grid measurement of the target lesion (reticulation, erythema, ulceration). Patients ranked severity of pain and burning sensation using visual analog scales. RESULTS: Although clinical response, pain, burning sensation, area of reticulation, erythema, and ulceration at week 4 were all worse in patients receiving cyclosporine than in those receiving steroid, the differences were not statistically significant. Large patient-to-patient variability was evident over the observation period, with little evidence of marked changes in levels over time in both treatment groups. CONCLUSION: Topical cyclosporine appears no more effective than steroid in the treatment of oral lichen planus.
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