[Topical treatment of atrophic-erosive oral lichen planus with clobetasol in bioadhesive gel as well as chlorhexidine and miconazole in oral gel]

The study was performed to evaluate the efficacy of the combination of a topical corticosteroid with topical antimicrobic drugs in the therapy of the atrophic-erosive forms of oral lichen planus. Clobetasol propionate, a very potent corticosteroid in the Miller and Munro classification, was used in a 4% hydroxy ethylcellulose bioadhesive gel and applied twice daily for the first four months and once daily for the last two months. Because of the high frequency of candidal infections during corticosteroid therapy, chlorhexidine 0.12%, 3 mouthwashes daily, and miconazole gel, once daily, were added for the whole period of the treatment. Twenty-five patients (17 female, 8 male) participated in the study; 20 concluded the six months of therapy and the six months of follow-up. All 20 patients (100%) had an improvement, while 75% had a complete remission of oral signs. No cases of oral candidiasis were seen. After six months from therapy suspension, 65% of patients were stable in their oral conditions. Our study confirms the efficacy of the combination of a topical corticosteroid with topical antimicrobic drugs in the therapy of the atrophic-erosive forms of oral lichen planus. The stability of our results suggests that, extending the therapy, control of the disease is better.