"efficacy of topical retinoic acid compared with topical triamcinolone acetonide in the treatment of oral lichen planus"

the purpose of this study was to compare the efficacy of retinoic acid 0.05% with triamcinolone acetonide 0.1%, both in an oral base, in the treatment of atrophic and erosive oral lichen planus. thirty patients with clinically proven oral lichen planus were asked to participate in the study. the severity of lesions was scored from 0 (no lesion) to 5 (large erosion), and symptoms were scored ranging from 100 (asymptomatic) to 0 (impossible to live with symptoms). patients were randomly assigned to receive either triamcinolone acetonide or retinoic acid. they were instructed to apply the medication on dried lesions four times a day. the signs and symptoms were evaluated after 1, 2, 3 and 4 weeks of treatment. the scores were analyzed by the wilcoxon rank sum test. the stage of lesions in patients receiving topical triamcinolone acetonide (n=18) improved from an average score of 3.22 to 1.05 after 4 weeks of treatment, whereas patients receiving topical retinoic acid (n=12) showed nonsignificant improvement (average score 3.41 improved to 3.25). the keratotic areas in 4 patients (22.2%) receiving triamcinolone acetonide and one patient (8.3%) in the retinoic acid group were completely resolved. after 4 weeks of treatment all patients in triamcinolone acetonide group, and 50% of retinoic acid group were asymptomatic. improvement in symptoms and signs was significantly different in the two groups (p≤ 0.003, p≤ 0.0001 respectively). the results suggest that in non-keratotic and even keratotic oral lichen planus, topical triamcinolone acetonide 0.1% in oral base reduces the severity of atrophic and erosive oral lesions more effectively than topical retionoic acid 0.05% in oral base.