Oral Lichen Planus (OLP) is a
chronic autoimmune disease with several clinical manifestations. It can affect
the oral mucosa and the skin too. Oral lesions can affect any part of the mucosa
and in general they are bilateral. The aim of the present study is to document a
case of clinically diagnosed OLP treated with topical corticosteroids.

MATERIALS AND METHODS
A healthy 48-year-old female patient presented with reticular hyperkeratotic
striations and atrophic erythematous areas affecting the vestibular and gingival
surfaces of both jaws, the upper and lower fornix and the left surface of the
tongue; the skin was not affected.
The patient did not feel pain, but a mild-moderate oral pyrosis.
As the mucous lesions could not be removed and when OLP was confirmed, toluidine
blue test was performed in order to exclude dysplastic transformations of the
atrophic areas. Given the clinical form and the mild degree, a topical therapy
with fluocinonide gel 4-5 times/day for 1 month was chosen.

RESULTS
One month after corticosteroid therapy, lesions and symptoms were considerably
reduced until complete disappearance. The patient was included in a maintenance
therapy and follow-up program (a daily application and then an application every
other day)

CONCLUSIONS AND DISCUSSION
Negativity to blue dye test allowed to exclude a potential malignant evolution
of the lesion, as OLP is considered as a pre-cancer condition in atrophic and
erosive forms. The topical therapy allowed to obtain good results in terms of
healing of the oral mucosa, without the potential side effects of a chronic
systemic therapy.

FINAL COMMENT
Universal or etiologic therapies for OLP do not exist. The treatment has to
be individualized for each patient in relation to the clinical form (reticular,
papular, plaque, atrophic, erosive, atrophic-erosive), the extent of lesions,
symptoms and local and systemic conditions.

Gingival vestibular areas of both jaws	Upper and lower right fornix		Toluidine blue test
Negative Test	Adherent gingiva in the right lateroposterior region	Keratinized mucosa distal edentulous saddle	Keratinized mucosa distal edentulous saddle and left tongue margin
	Negative Test	Negative Test
Before therapy
1 month after therapy