Treatment of Erosive Oral Lichen Planus With Methotrexate Publisher



Lajevardi V¹ ; Ghodsi SZ¹ ; Hallaji Z¹ ; Shafiei Z¹ ; Aghazadeh N¹ ; Akbari Z¹
Source: JDDG - Journal of the German Society of Dermatology Published:2016

Abstract

Background and objectives: Erosive oral lichen planus (EOLP) is a chronic inflammat­ory disease of the oral mucosa causing significant pain and impairment of the quality of life. No immediate and definitive cure is available, especially in its chronic and most recalcitrant forms. The objective of this study was to evaluate the efficacy of methotrexate treatment in EOLP. Patients and methods: A prospective open trial of oral methotrexate 15 mg QWK in 18 patients with EOLP (clinically and histopathologically confirmed) unresponsive to at least one previous topical or systemic medication. Duration: Twelve weeks followed by twelve weeks of follow-up. Results: Partial response or better was achieved in 15 (83.3 %) patients. A statistical­ly significant reduction in Thongprasom scale score was observed (mean value 5 at baseline, 3.08 ± 1.11 at week 12, 2.94 ± 0.97 at week 24, P value < 0.001). A statistically significant reduction was noted in the pain visual analogue scale (mean value 6.55 ± 2.33 at baseline, 2.46 ± 2.18 at week 12, 2.29 ± 1.93 at week 24, P value < 0.001). Adverse events occurred in four (22.2 %) patients, requiring discontinuation of treatment in one patient. Conclusion: Methotrexate is a valuable therapeutic option in longstanding recalcitrant EOLP, particularly with respect to the improvement of subjective symptoms. Randomized controlled trials are required. © 2016 Deutsche Dermatologische Gesellschaft (DDG).