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Instructor: Dr. Heddie Sedano
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LICHEN PLANUS: TREATMENT OF LICHEN PLANUS

Pages: 1 2 3 4 5 | Treatment | References

The intraoral lesions of the reticular and plaque varieties of LP, as a rule are not treated. Treatment, as presented below, is generally indicated for the erosive variety of LP.

Rx: Triamcinolone acetonide (Kenalog) in Orabase 0.1%
Disp: 5 gm tube
Sig: Aply over the lesion after each meal and at bed time.
Note: Mixing ointments with equal part of Orabase facilitates adhesion.
 
Rx: Dexametasone (Decadron) elixir 0.5 mg/5 ml
Disp: 100 ml
Sig: Rinse with 1 teaspoon for 2 to 3 minutes and spit.
Note: Check patient at 10 days intervals, discontinue medication when lesions heal or become asymptomatic.
 
The following topical steroids also can be prescribed:
Rx: Fluocinonide (Lidex) gel 0.05%
Rx: Fluocinonide (Lidex) ointment 0.05%
Rx: Clobetasol propionate (Temovate) ointment 0.05%
Disp & Sig: As per Triamcinolone above.

Cyclosporine (topical) and retinoids, both systemic (etretinate) and topical (tretinoin) have been used but there is no definite protocol which has been effective with either medication. Results have been controversial and not very promising.

Some authors have had positive results in treating LP of the lip with chloroquine phosphate applied to the lesion. Gingival lesions have been treated with corticosteroid ointment applied topically to mucosal lesions using cloth strips a novel method of delivery of the medication (see reference # 1)

Several recent publications (see references # 3, 9, 15) advocate the treatment of LP with ultraviolet (UV) light radiation at wave lengths of 320-400 nm for 5-10 minutes per single exposure once a week. Patients are protected with eye goggles some methods use photosensitizer other methods do not. Critics of these techniques warn of the possible carcinogenic effects of UV light radiation. More data is needed in order to properly evaluate these novel approaches to LP treatment.

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Pages: 1 2 3 4 5 | Treatment | References