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Campana F, Lan R, Girard C, Rochefort J, Le Pelletier F, Leroux-Villet C, Mares S, Millot S, Zlowodzki AS, Sibaud V, Tessier MH, Vaillant L, Fricain JC, Samimi M. French guidelines for the management of oral lichen planus (excluding pharmacological therapy). Ann Dermatol Venereol 2022; 149:14-27. [PMID: 34238586 DOI: 10.1016/j.annder.2021.04.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2020] [Revised: 01/16/2021] [Accepted: 04/01/2021] [Indexed: 02/06/2023]
Abstract
INTRODUCTION Oral lichen is a chronic inflammatory disease for which diagnostic management and follow-up are heterogeneous given the absence of specific guidelines in France. Our objective was to develop French multidisciplinary guidelines for the management of oral lichen. MATERIALS AND METHODS Working groups from the Groupe d'Etude de la Muqueuse Buccale (GEMUB) formulated a list of research questions and the corresponding recommendations according to the "formal consensus" method for developing practice guidelines. These recommendations were submitted to a group of experts and the degree of agreement for each recommendation was assessed by a scoring group. RESULTS Twenty-two research questions, divided into 3 themes (nosological classification and initial assessment, induced oral lichenoid lesions, and follow-up) resulted in 22 recommendations. Initial biopsy for histology is recommended in the absence of reticulated lesions. Biopsy for direct immunofluorescence is recommended for ulcerated, erosive, bullous types and for diffuse erythematous gingivitis. Management should include a periodontal and dental check-up, and investigation for extra-oral lesions. Hepatitis C testing is recommended only if risk factors are present. Definitions, triggering factors and the management of "induced oral lichenoid lesions" were clarified. Oral lichen must be monitored by a practitioner familiar with the disease at least once a year, using objective tools. CONCLUSION This formalised consensus of multidisciplinary experts provides clinical practice guidelines on the management and monitoring of oral lichen.
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Affiliation(s)
- F Campana
- Aix Marseille Univ, APHM, INSERM, MMG, Hôpital de la Timone, Unité de chirurgie orale, 264 Rue Saint-Pierre, 13005 Marseille, France
| | - R Lan
- Aix Marseille Univ, APHM, CNRS, EFS, ADES, Hôpital de la Timone, Unité de chirurgie orale, 264 Rue Saint-Pierre, 13005 Marseille, France
| | - C Girard
- Dermatologie, CHU de Montpellier, 34295 Montpellier cedex, France
| | - J Rochefort
- Odontologie, Hôpital La Pitié Salpetrière - Université Paris Diderot, 47-83 Boulevard de l'Hôpital, 75013 Paris, France
| | - F Le Pelletier
- Anatomie Pathologique, Hôpital La Pitié-Salpêtrière, 47-83 Boulevard de l'Hôpital, 75013 Paris, France
| | - C Leroux-Villet
- Dermatologie, Hôpital Avicenne, 125 Rue de Stalingrad, 93000 Bobigny, France
| | - S Mares
- Chirurgie Maxillo-faciale, Hôpital La Pitié-Salpêtrière, 47-83 Boulevard de l'Hôpital, 75013 Paris, France
| | - S Millot
- Chirurgie Orale, CHU de Montpellier, 34295 Montpellier cedex, France
| | | | - V Sibaud
- Dermatologie, IUCT Oncopôle, 31000 Toulouse, France
| | - M-H Tessier
- Dermatologie, CHU de Nantes, 44000 Nantes, France
| | - L Vaillant
- Dermatologie, CHU de Tours, Université de Tours, 37000 Tours, France
| | - J-C Fricain
- Université de Bordeaux, INSERM U1026, service de chirurgie orale, CHU Bordeaux, 33000 Bordeaux, France
| | - M Samimi
- Dermatologie, CHU de Tours, Université de Tours, 37000 Tours, France.
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Hashem AS, Issrani R, Elsayed TEE, Prabhu N. Topical hyaluronic acid in the management of oral lichen planus: A comparative study. ACTA ACUST UNITED AC 2018; 10:e12385. [PMID: 30556961 DOI: 10.1111/jicd.12385] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2018] [Accepted: 09/28/2018] [Indexed: 12/21/2022]
Abstract
AIM Oral lichen planus (OLP) is a chronic mucocutaneous disorder seen in clinical dental practice. Despite the progress in research and advances in knowledge, the successful management of OLP is still difficult to achieve. The aim of the present study was to compare the therapeutic effects of triamcinolone (TA) preparation (0.1%) with hyaluronic acid (HA) preparation (0.2%) in the management of OLP. METHODS In total, 40 patients of any age or sex who had symptomatic OLP were selected and randomly divided into two groups. Group I received topical 0.1% TA, and group II received topical 0.2% HA preparation three times per day for a period of 4 weeks. Basement data were recorded for each patient. Patients were evaluated on days 14 and 21, and after completing the course of treatment. The visual analog scale (VAS) was used for evaluating pain and burning sensation, along with an evaluation of the degree of erythema and mean area of the lesion. Data were analyzed by SPSS 17.0 software using Mann-Whitney and t test. P ≤ 0.05 was considered statistically significant. RESULTS Our results showed considerable improvement in all of the parameters evaluated. Baseline characteristics, including pain score, size, and clinical characteristics of the lesions, were not different between the two treatment groups. Both TA and HA were found to reduce the VAS score, the degree of erythema, and size of the lesions after treatment. CONCLUSION The application of HA is suggested, and is an effective substitute for TA in the treatment of OLP.
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Affiliation(s)
- Ahmed S Hashem
- Department of Preventive Dentistry, Jouf University, Sakaka, Saudi Arabia
| | - Rakhi Issrani
- Department of Preventive Dentistry, Jouf University, Sakaka, Saudi Arabia
| | | | - Namdeo Prabhu
- Department of Oral and Maxillofacial Surgery and Diagnostic Sciences, Jouf University, Sakaka, Saudi Arabia
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