Mucosal lichen planus: an evidence-based treatment update

Am J Clin Dermatol. 2014 Jul;15(3):181-95. doi: 10.1007/s40257-014-0068-6.

Abstract

Background: Mucosal lichen planus (MLP) is a chronic mucosal disorder that often poses a therapeutic challenge to dermatologists, dentists, and gynecologists. To relieve patients' pain and discomfort, improve their quality of life, and achieve clinical improvement, various therapeutic approaches can be considered for this disease. Based on the current literature it is difficult to define any particular treatment as the main therapeutic modality.

Objective: We aimed to systematically review the current literature for the effectiveness of available treatment modalities for MLP.

Methods: All of the randomized controlled trials and systematic reviews of MLP were collected by searching Pubmed, EMBASE, the Cochrane Database of Systematic Reviews, Database of Abstracts of Reviews of Effects, Cochrane Central Register of Controlled Trials, Health Technology Assessment Database, and China National Knowledge Infrastructure. Meta-analysis was performed, if possible.

Results: Topical betamethasone valerate, clobetasol-17-propionate, and fluocinonide are effective in the treatment of oral lichen planus (OLP) when compared with placebo. Calcineurin inhibitors and topical retinoids are also beneficial treatment options.

Limitations: The review does not include therapies with a lower level of evidence.

Conclusion: Topical corticosteroids are the mainstay of therapy for OLP. High-quality evidence is lacking for the treatment of lichen planus.

Publication types

  • Review

MeSH terms

  • Administration, Cutaneous
  • Dermatologic Agents / administration & dosage
  • Dermatologic Agents / therapeutic use*
  • Evidence-Based Medicine
  • Glucocorticoids / administration & dosage
  • Glucocorticoids / therapeutic use
  • Humans
  • Lichen Planus / drug therapy*
  • Lichen Planus / pathology
  • Lichen Planus, Oral / drug therapy*
  • Lichen Planus, Oral / pathology
  • Mucous Membrane / pathology
  • Quality of Life

Substances

  • Dermatologic Agents
  • Glucocorticoids