The investigators want to study the effect of clobetasol in symptomatic oral lichen planus. The investigators will include 90 patients and randomly allocate them in three groups. The first group will receive active treatment both in the morning an evening. Group two receives placebo in the morning and active treatment in the evening. Group three will get placebo both in the morning and in the evening. All Groups will follow the same protocol with rinsing twice daily with test substance in conjunction with antifungal treatment. The patients will be controlled after two weeks and and again after another two weeks. A biopsy will be performed at inclusion and another biopsy will be taken at the end of the test period. Smears for candida will also be evaluated. The patients will be examined for changes in clinical appearance and will answer questions to note changes in symptoms. Our hypotheses: #Patients receiving clobetasol will have a better resolution af symptoms than those who got placebo. #Patients treated with clobetasol twice daily will have a faster relief of symptoms than patients just treated once daily. #The clinical signs of oral lichen planus will diminish more pronounced in the two groups given active treatment. #A majority of the OLP lesions were infected by candida. #Specific histological changes can be seen in the biopsies taken after clobetasol treatment compared to those taken before treatment.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
QUADRUPLE
Enrollment
90
Klobetasol APL oral gel 0.025% is a topical steroid for rinsing the oral cavity. Manufactured by APL, Sweden.
Placebo/active
Placebo/placebo
Oral surgery, Universityhospital of Scania
Lund, Sweden
Oral Surgery and oral medicine, Malmö University
Malmö, Sweden
Clinical appearance of the lichen lesion
Site-, severity- and activity-score according to Escudier et al
Time frame: Four weeks
Oral health impact profile
Oral health impact profile (OHIP-14)
Time frame: Four weeks
Pain score
VAS scale. A 10 cm scale ranging from no pain what so ever to worst pain imaginable.
Time frame: Four weeks
Burning sensation score
VAS scale. A 10 cm scale ranging from no burning sensation what so ever to worst burning sensation imaginable.
Time frame: Four weeks
Histological appearance
Amount and degree of lichenoid reaction in biopsy
Time frame: Four weeks
Candida
Candida hyphae in smear from lichen lesions
Time frame: baseline (At treatment start)
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