Interventions for erosive lichen planus

Topical steroids, pimecrolimus cream and aloe vera gel may be effective for oral erosive lichen planus.

Comment: The quality of evidence is downgraded by imprecise results (few patients for each comparison) and by study limitations (lack of/unclear allocation concealment; heterogeneity in outcome variables and disease severity scoring tools).

Summary

A Cochrane review on erosive lichen planus (ELP) affecting mucosal surfaces included 15 studies with a total of 473 subjects, all with oral ELP. Six of the 15 studies included participants with non-erosive lichen planus. Data were not pooled. Clobetasol propionate 0.025% administered as liquid microspheres significantly reduced pain compared to ointment (MD –18.30, 95% CI –28.57 to –8.03; 1 study, n=50). One study showed significant difference in pain favouring ciclosporin solution over 0.1% triamcinolone acetonide in orabase in the small subgroup of 11 ELP participants (MD –1.40, 95% CI –1.86 to –0.94). Aloe vera gel was 6 times more likely to result in at least a 50% improvement in pain symptoms compared to placebo (RR 6.16, 95% CI 2.35 to 16.13; 1 study, n=45). Pimecrolimus 1% cream was 7 times more likely to result in a strong improvement as rated by the Physician Global Assessment when compared to vehicle cream (RR 7.00, 95% CI 1.04 to 46.95; 1 study, n=20). Several side-effects were reported in the studies, but none were serious. With topical corticosteroids, the main side-effects were oral candidiasis and dyspepsia.

Clinical comments

Date of latest search:

Ədəbiyyat

1. Cheng S, Kirtschig G, Cooper S et al. Interventions for erosive lichen planus affecting mucosal sites. Cochrane Database Syst Rev 2012;(2):CD008092.