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Inicio Medicina Clínica (English Edition) Treatment of oral lichen planus. Systematic review and therapeutic guide
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Vol. 149. Issue 8.
Pages 351-362 (October 2017)
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Vol. 149. Issue 8.
Pages 351-362 (October 2017)
Review
Treatment of oral lichen planus. Systematic review and therapeutic guide
Tratamiento del liquen plano oral. Revisión sistemática y protocolo de actuación
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María José García-Pola
Corresponding author
mjgarcia@uniovi.es

Corresponding author.
, Laura González-Álvarez, José M. Garcia-Martin
Departamento de Cirugía y Especialidades Médico-Quirúrgicas, Facultad de Medicina, Universidad de Oviedo, Oviedo, Spain
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Tables (4)
Table 1. Randomized trials with triamcinolone acetonide with statistically significant results.
Table 2. Randomized clinical trials with clobetasol propionate with statistically significant findings in their results.
Table 3. Randomized clinical trials with statistically significant findings with dexamethasone, fluocinolone, betamethasone and prednisone.
Table 4. Randomized clinical trials with statistically significant findings using immunosuppressants: tacrolimus versus pimecrolimus, diode laser and CO2 laser.
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Abstract

In this systematic review, 55 structured articles on the therapeutic efficacy against pain and clinical signs of oral lichen planus (OLP) were analyzed. The literature search was developed according to the criteria of the PRISMA system, selecting the tests performed using one of the following methodological designs: drug (active ingredient) vs. drug in different excipient or concentration, drug vs. different active principle, drug vs. phytotherapy and drug vs. treatment with phototherapy.

Based on the results, an algorithm is proposed to guide the treatment of OLP in its atrophic and erosive clinical forms. The use of clobetasol propionate at 0.025–0.05% of topical application as the first therapeutic alternative is highlighted. Secondly, 0.1% tacrolimus and 1% pimecrolimus also formulated for its topical regimen. And finally, we address the use of systemic corticosteroids and the application of diode lasers.

Keywords:
Oral lichen planus
Treatment
Clobetasol propionate
Triamcinolone acetonide
Laser
Retinoids
Calcineurin inhibitors
Resumen

En la presente revisión sistemática se analizaron 55 artículos estructurados sobre la eficacia terapéutica frente al dolor y a los signos clínicos del liquen plano oral (LPO). La búsqueda bibliográfica se elaboró siguiendo los criterios del sistema PRISMA, seleccionando los ensayos realizados mediante alguno de los siguientes diseños metodológicos: entre fármaco (principio activo) vs. mismo fármaco en diferente excipiente o concentración, fármaco vs. diferente principio activo, fármaco vs. fitoterapia y fármaco vs. tratamiento con fototerapia.

Basándonos en los resultados se propone un algoritmo que sirva de guía para establecer el tratamiento del LPO en sus formas clínicas atrófica y erosiva. Se destaca el empleo del propionato de clobetasol al 0,025-0,05% de aplicación tópica como primera alternativa terapéutica. En segundo lugar, el tacrolimús al 0,1% y pimecrolimús al 1% también formulado para su pauta tópica. Y, finalmente, se aborda el empleo de corticosteroide sistémico y la aplicación de láser de diodo.

Palabras clave:
Liquen plano oral
Tratamiento
Propionato de clobetasol
Acetónido de triamcinolona
Láser
Retinoides
Inhibidores de calcineurina

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