A randomized-controlled trial to compare topical cyclosporin with triamcinolone acetonide for the treatment of oral lichen planus

OralPathology Department, Faculty of Dentistry, Chulalongkorn University, Bangkok, ThailandBACKGROUND: Various treatments have been em-ployed to treat symptomatic oral lichen planus (OLP),but a complete cure is very difficult to achieve becauseof its recalcitrant nature. Topical cyclosporin therapy ofOLP has shown conflicting results in many reports. Thepurpose of this study was to compare the effectivenessof cyclosporin solution with triamcinolone acetonide0.1% in orabase in the treatment of Thai patients withOLP.METHODS: Thirteen Thai patients with symptomaticOLP and proven by biopsy were randomly assignedtreatment with cyclosporin (six) or triamcinoloneacetonide 0.1% (seven). The patients were instructed toapply cyclosporin or triamcinolone acetonide 0.1% threetimes daily at the marker lesions and affected areas. Theassessments were at weeks 0, 2, 4, 8 by clinical scoringand grid measurement of the target lesions. Cyclosporinlevels were assessed at weeks 2 and 8 of treatment. Painand burning sensation were evaluated by linear visualanalogue scale (0–10).RESULTS: OLP patients in the triamcinolone acetonidegroup showed equal cases of clinical complete andpartial remission (50%). Whereas, in the cyclosporingroup, there was partial remission in only two cases(33.5%) and no response in four cases (66.7%). However,our study showed that there were no statistical differ-ences in pain, burning sensation and clinical response inOLP patients between the two groups (P > 0.01).Moreover, five of six cases in the cyclosporin groupdeveloped side-effects such as transient burning sensa-tion, itching, swelling lips, petechial haemorrhages andothers.CONCLUSION: Our results indicated that topicalcyclosporin did not provide any beneficial effect and wasnot more effective than triamcinolone acetonide 0.1% inthe treatment of Thai patients with symptomatic OLP.J Oral Pathol Med (2007) 36: 142–6Keywords: cyclosporin; oral lichen planus; triamcinolone aceto-nide