Hydroxychloroquine Is Safe and Effective for the Management of Oral Lichen Planus
Oral Diseases Journal: September. 2023
This study was aimed to evaluate
the safety and benefit of short-term application of hydroxychloroquine in the
management of atrophic/erosive/ulcerative oral lichen planus (OLP).
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In this
study, after 4 weeks of treatment, the systemic use of hydroxychloroquine and
the topical use of dexamethasone were effective in improving the subjective and
objective clinical manifestations of atrophic/erosive/ulcerative oral lichen
planus (OLP).
However, no
significant differences were observed between the groups. No factors impacted
the efficacy of hydroxychloroquine in the multifactorial logistic regression
analysis.
To date,
topical corticosteroids are routinely prescribed as the first-line choice in
the treatment of atrophic/erosive/ulcerative OLP, yet these forms of OLP are
most likely to progress to squamous cell carcinoma, and repeated use of the
medication is required owing to the chronicity of OLP.
Hydroxychloroquine is a safe alternative to topical glucocorticoids for the management of atrophic/erosive/ulcerative oral lichen planus (OLP).
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Objectives: This study
was aimed to evaluate the safety and benefit of short-term application of
hydroxychloroquine in the management of atrophic/erosive/ulcerative oral lichen
planus (OLP).
Methods: This
multicenter, randomized, controlled, evaluator-blinded, prospective clinical
trial was performed from October 1, 2019, to September 1, 2022. A total of 99
patients were randomized to receive systemic use of hydroxychloroquine (n =
50), or topical use of 0.05% dexamethasone (n = 49) for 4 weeks. The response
to both treatment modalities was evaluated according to reticulation,
hyperemic, and ulceration (RHU) score and visual analog scale (VAS) score.
Results: After 4
weeks of medication, both groups showed substantial reduction in RHU and VAS
score. In hydroxychloroquine group, the average of RHU score was reduced from
10.60 to 7.68 (dropped 27.49%), and the average of VAS score was reduced from
3.74 to 2.47 (dropped 34.09%). There were no differences between the two groups
in reduction of RHU score and VAS score. Single factor analysis found hyperemic
area and erosive/ulcerative area had impacts on drug efficacy of
hydroxychloroquine, and logistic regression revealed that no factors influenced
its efficacy.
Conclusion: These
findings indicate hydroxychloroquine is a safe and effective agent in treating
atrophic/erosive/ulcerative OLP.
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