Oral Health and Dental Management

Abstract

Topical HCQS vs. Enteral HCQS in Oral Lichen Planus Comparitive Study

Ambati Silpa Naidu, Triekan Sownetha, Susheel Ramdaspally, K Charan Raj, Raj Kumar Badam

Oral lichen planus is a chronic muco cutaneous inflammatory disorder of varied etiology. It manifests in many clinical forms like reticular, erosive, bullous, atrophic and ulcerative. It usually occurs in middle aged women and malignant potential of these lesions are reported in the literature. These lesions are usually associated with severe burning sensation. There are many options available for the management of oral lichen planus. Studies have shown that hydroxychloroquine is a promising drug in the treatment of lichen planus. Objective: 1.To evaluate the efficacy of Hydroxychloroquine in the management of Oral lichen Planus. 2. To compare the efficacy of topical Hydroxychloroquine to that of systemic Hydroxychloroquine. Methods: 1.Randomly 30 consecutive symptomatic oral lichen Planus cases that were reported to the department of Oral Medicine and Radiology; PMVIDS & RC, were included in the study. All clinical variants of Oral Lichen Planus were considered for the study. 2. Subjects were screened for Oral & dermatologic lesions, routine blood tests, and an ophthalmic screening as a prerequisite. A detailed clinical examination was performed and the suspected cases of Lichen Planus based on clinical examination were subjected to incisional biopsy to confirm the diagnosis. Patients were divided into two groups, group A was treated with Topical Hydroxychloroquine gel till symptoms subsided and Group B with systemic Hydroxychloroquine tablets therapy till symptoms subsided. The obtained results were subjected to statistical analysis. Results: At the end of study Group A (Topical HCQs) showed decrease of clinical scores in 2 patients. In Group B (Systemic Group) showed decrease in the clinical scores in 8 patients. When the mean was compared (Group A) Topical Group showed a change of only 0.133, whereas Group B (Systemic Group) showed a mean change of 0.933. This showed that systemic group showed better remission of scores as compared to topical group that was statistically significant with a p value of <0.05. Conclusion: From this study it can thus be concluded that systemic Hydroxychloroquine can be used effectively to treat patients with Oral Lichen Planus when compared with Topical Hydroxychloroquine, though it is not recommended as a first line therapy, it can be used effectively as adjunctive drug.