| |
|
|
| Year : 2011 | Volume
: 22
| Issue : 5 | Page : 639-643 |
|
| Lycopene in the management of oral lichen planus: A placebo-controlled study |
|
|
Nisheeth Saawarn1, MC Shashikanth2, Swati Saawarn3, Vasanti Jirge4, Nallan CSK Chaitanya5, R Pinakapani6
1 Department of Oral Medicine and Radiology, People's College of Dental Sciences and Research Centre, Bhopal, India
2 UP Dental College and Research Centre, Lucknow, India
3 Department of Oral Pathology and Microbiology, People's Dental Academy, Bhopal, India
4 Department of Oral Medicine and Radiology, KLE Institute of Dental Sciences, Belguam, India
5 Mamata Dental College and Hospital, Khammam, India
6 Genesis Institute of Dental Sciences and Research, Ferozpur, India
Click here for correspondence address and email
| Date of Submission | 16-Aug-2010 |
| Date of Decision | 28-Nov-2010 |
| Date of Acceptance | 29-Jul-2010 |
| Date of Web Publication | 7-Mar-2012 |
|
|
 |
|
 Abstract | | |
Context: Oxidative stress has been implicated in the pathogenesis of lichen planus, and a lower level of lycopene has been reported in erosive and atrophic oral lichen planus (OLP) patients. However, its efficacy in the management of OLP has not been reported.
Aim: This study was designed to assess the efficacy of systemic lycopene in the management of OLP.
Settings and Design: This prospective, randomized, double-blind, placebo-controlled study was done in the Oral Medicine Department of a postgraduate teaching dental hospital in India.
Materials and Methods: Thirty symptomatic OLP patients, randomly divided into two groups of 15 each, were administered lycopene 8 mg/day and an identical placebo, respectively, for 8 consecutive weeks. Burning sensation using visual analogue scale and overall treatment response using Tel Aviv-San Francisco scale were recorded at every visit. The data obtained were analyzed statistically using Wilcoxon Rank test, Mann-Whitney and Fischer's Exact test.
Results: A higher (84%) reduction in burning sensation was seen in lycopene than in the placebo group (67%). All 15 (100%) patients in the lycopene group showed 50% or more benefit and 11 (73.3%) patients showed 70-100% benefit, while this number was only 10 and 4 (26.7%), respectively, in the placebo group.
Conclusion: Lycopene was very effective in the management of OLP, and oxidative stress may have a role in disease pathogenesis. Keywords: Antioxidant, free radicals, lycopene, oral lichen planus, oxidative stress
How to cite this article:
Saawarn N, Shashikanth M C, Saawarn S, Jirge V, Chaitanya NC, Pinakapani R. Lycopene in the management of oral lichen planus: A placebo-controlled study. Indian J Dent Res 2011;22:639-43 |
How to cite this URL:
Saawarn N, Shashikanth M C, Saawarn S, Jirge V, Chaitanya NC, Pinakapani R. Lycopene in the management of oral lichen planus: A placebo-controlled study. Indian J Dent Res [serial online] 2011 [cited 2023 Mar 30];22:639-43. Available from: https://www.ijdr.in/text.asp?2011/22/5/639/93448 |
Lichen planus (LP) is a chronic inflammatory mucocutaneous disease of unknown etiology that occurs in about 0.2-4% of the adult population, affecting the skin and/or oral mucosa. [1] Clinically, oral lichen planus (OLP) presents in various forms such as reticular, papular, plaque like, atrophic, erosive and bullous, [2] of which erosive and atrophic forms are usually symptomatic and need therapeutic interventions. [1] The etiology is not known, but there are several hypotheses involving genetic, infectious, psychogenic and autoimmune factors. The pathogenesis has been extensively studied and the disease appears to be a result of a cell-mediated immune reaction in which Langerhans cells, keratinocytes and activated T lymphocytes are involved. [3]
Currently, there is no definite cure for this disease entity, and the large number of therapeutic agents studied reflects the inadequacy of any one agent to control the symptoms in all the patients. Further, most of the therapeutic agents studied have their own associated adverse effects, which need to be monitored, thus making the choice of treatment modality in majority of cases a difficult decision. [2],[4]
The role and importance of oxidative stress has been suggested in the pathogenesis of LP. A study done on erosive vulval LP tissues showed increased oxidative stress and decreased antioxidant enzyme expression. [5] Bernanan et al., found increased expression of inducible nitric oxide synthase in 9 out of 30 OLP cases studied. [6] Vahlaquist et al., reported lower levels of serum carotenoids in LP patients, [7] and Nagao et al., reported a significantly lower level of serum lycopene in the erosive and atrophic OLP cases. [8] Despite these evidences, there are no published reports on the use of antioxidants in the management of OLP, except for the use of vitamin A and its analogues. [1],[2],[3],[4]
Lycopene is a red-colored, fat-soluble carotenoid, which gives tomatoes and several other fruits their deep red color. [9],[10] Lycopene does not have the pro-vitamin A activity [11] and its various benefits on human health can be explained based on its properties of antioxidant activity, inhibition of cancer cell proliferation, interference with growth factor stimulation, inducing phase II enzymes, regulation of transcription and restoration of gap junctions. [9] Lycopene exerts its antioxidant activity by physical and chemical quenching of free radicals and is the most efficient singlet oxygen quenching carotenoid. [9],[10]
Though there are several studies assessing the role of lycopene in general health, very few studies have assessed its role in prevention and treatment of oral diseases. [9],[10],[11],[12] It has shown to be effective in the management of oral leukoplakia and to play a role in the chemoprevention of oral cancer. [13],[14] Its role in the management or prevention of OLP has not been investigated. However, as significantly decreased levels of lycopene have been reported in patients with atrophic and erosive OLP, [8] its role in the disease pathology needed further investigation. Further, by virtue of its antioxidant and anticancer properties, [9] it may be useful in the prevention of malignant transformation in the OLP.
In view of these data which highlight the potential usefulness of lycopene in OLP and also in recognition of the need for a specific therapeutic regimen for OLP, this study was conducted to assess the response of treatment with lycopene in OLP.
| Materials and Methods | |  |
The present prospective, randomized, placebo-controlled, double-blind study was conducted in the Department of Oral Medicine and Radiology, College of Dental Sciences, Davangere, India. Thirty systemically healthy persons of either sex with clinically and histopathologically diagnosed and symptomatic OLP were included in the study. Patients who were on any treatment for the OLP were asked to stop the same 2 weeks prior to the administration of study medications.
Ethical and legal approvals were obtained from the Legal and Ethical Committee of the institute, headed by the Dean of the institute.
Patients were randomly allocated into two groups, group A and group B of 15 each, and were administered softgel capsule lycopene 8 mg/day (Lycored® 2 mg, Jagsonpal Pharmaceuticals, New Delhi, India) in two divided doses and an identical placebo, respectively, for eight consecutive weeks. Burning sensation using Visual Analogue Scale (VAS) of score 0-100, and the overall treatment response were recorded at baseline, at 2 weeks intervals and 30 and 60 days after completion of the therapy. The overall treatment response was recorded using Tel Aviv-San Francisco scale as follows: Score 4 ⇒90-100% remission of sign and symptoms; Score 3 ⇒70-80% benefit, treatment not required; Score 2 ⇒50% benefit; Score 1 ⇒ 30-50% improvement, treatment still needed; Score 0 ⇒ little improvement or no change; Score -1 ⇒ deterioration or regression. [1]
The data so obtained were analyzed statistically. The comparative analysis was carried out by using Wilcoxon Rank Test for intra-group comparison and Mann-Whitney Test and Fischer's Exact Test for inter-group analysis.
| Results | | |
The study group comprised 19 males and 11 females, showing slight male predilection with a male to female ratio of 1.72:1. The mean age of the patients enrolled in the study was 37.73 ± 16.6 years, with an age range of 14-75 years [Table 1].
The statistical analysis of the pre-treatment data revealed no statistically significant differences between both the groups at the start of the study.
The mean score for the burning sensation in group A (lycopene) reduced significantly by 84% (P=0.001) after the treatment, with 47.0 ± 20.4 at baseline to 7.6 ± 9.2 at the end of 8 th week. The post-treatment follow-up at 1 st and 2 nd months did not reveal any significant change in the severity of symptoms [Table 2]. | Table 2: Comparison of burning sensation before and after treatment (VAS scores)
Click here to view |
In group B (placebo) too, the mean score for the burning sensation reduced significantly by 67% (P=0.006) after the treatment, i.e. from 49.0 ± 22.9 at baseline to 16.3 ± 18.3 at the end of 8 th week. However, one patient showed deterioration with increase in VAS score of 30 at baseline to 70 at the end of 8 th week, and another patient did not show any improvement. The post-treatment follow-up at 1 st and 2 nd months did not reveal any significant change in the severity of symptoms [Table 2].
Thus, though there was significant reduction in the mean scores of burning sensation in both the groups after the treatment, this reduction was more in lycopene group (84%) as compared to the placebo group (67%) [Table 2].
As per Tel Aviv-San Francisco scale, at the end of the treatment, all the patients in group A showed 50% or more benefit, with 11 (73.3%) patients showing 70-100% relief in signs and symptoms and did not require further treatment [Table 3]. | Table 3: Comparison of overall treatment response as per the Tel Aviv-San Francisco scale
Click here to view |
In the placebo group, though 10 (66.7%) patients showed 50% or more benefit, only 4 (26.7%) patients showed 70-100% relief in signs and symptoms and did not require further treatment. Two patients showed little or no improvement, with one of them showing deterioration of signs and symptoms [Table 3].
If stages 3 and 4 are taken together as cured and stage 2 or lesser as partially cured/uncured, then at the end of the treatment, 11 (73.3%) patients in group A were cured and 4 (26.7%) remained partially cured or uncured, while in group B, 4 (26.7%) and 11 (73.3%) patients fell in these categories, respectively, showing a statistically significant (P=0.02) difference [Table 3].
Upon further modifying the criteria and taking stages 2, 3 and 4 together as partially/completely cured and 1, 0 and −1 as uncured, all the 15 patients in group A were partially/completely cured in comparison to only 10 in group B [Table 3]. This difference in the treatment response too was statistically significant (P<0.05).
Thus, with respect to overall treatment response, patients in lycopene group showed significantly better (P<0.01) results than patients in placebo group.
| Discussion | | |
LP is a chronic inflammatory mucocutaneous disease that occurs in about 0.2-4% of the general population, affecting skin and/or mucosa. [1]
Although the exact etiology of the disease is unknown, the role of free radicals and oxidative stress has been implicated in its pathogenesis. [6],[15],[16] Further, an affirmative treatment remains elusive and a vast array of empirical treatments reported in the literature indicates the continuing search for the solution. [2],[3],[4]
The role of lycopene, a potent antioxidant being used in the management of various systemic and few oral diseases including cancer and precancerous lesions, suggested to be caused by the oxidative stress, [9],[10],[11],[12],[13] has not been assessed in the prevention or treatment of OLP. However, one study has reported significantly decreased levels of lycopene in patients with atrophic and erosive OLP, [8] and its role in the disease pathology needs further investigation.
In our study, we treated 15 OLP patients with lycopene 8 mg/day and another 15 with an identical placebo.
The doses of lycopene used for the various conditions reported in the literature vary in the range of 6-60 mg/day. [9],[10],[11],[12],[13]
A dose regimen of 8 mg/day was found effective for the management of oral leukoplakia. [13] LP is a chronic condition and various studies have reported longer duration of treatment, ranging from 2 to 32 weeks, and most of the studies, using retinoids, have used the medications for 8 weeks. [1],[2],[3],[4] Therefore, we decided to use 8 mg/day of lycopene for a period of 8 weeks.
Relief from the symptoms or burning sensation is an important goal in the management of OLP. In our study, patients in both lycopene and placebo groups showed a significant reduction in the burning sensation at the end of the treatment (84% and 67%, respectively). However, this reduction in burning sensation was higher in lycopene group than in the placebo group.
The better relief seen in the medicine group can be attributed to the effects of the drug, while the relief seen in the placebo group can be related to the spontaneous remission of the disease, which occurs infrequently in OLP as a natural course of disease process, [17] or to the positive psychological effect of undergoing treatment and continuous reassurance by the treating clinicians.
The overall treatment response measured by the Tel Aviv-San Francisco scale evaluating both signs and symptoms was significantly better in lycopene group than in placebo group (P=0.01). At the end of the treatment, all the patients showed 50% or more benefit (total or partial cure), with 11 (73.3%) patients showing 70-100% relief (total cure) and did not require further treatment. In contrast, in the placebo group, only 10 patients showed 50% or more benefit and only 4 patients showed 70-100% relief. In one patient, no improvement was seen, while one patient deteriorated. Even patients with severe erosive cases showed a good response from lycopene therapy [Figure 1] and [Figure 2]. | Figure 2: Postoperative photograph of same case after treatment with lycopene for 8 weeks
Click here to view |
Thus, our study indicates that lycopene was effective in controlling the signs and symptoms in the OLP patients.
Since no other study has assessed the role of lycopene in the management of LP, the results of our study could not be compared directly with the results of any other study. However, various retinoids with pro-vitamin A activity, which are shown to have antioxidant properties, have been used in the management of OLP. [1],[2],[3],[4]
Gorskey et al., [1] and Hersle et al., [17] in their study using systemic etretinate, obtained results similar to our study, with more than 50% and 92% patients, respectively, showing improvement in signs and symptoms of the disease. However, Fergueson et al., [18] using the same medication, and Camiesa et al., [19] using systemic isotretinoin, found the beneficial effects to be minimal.
Patients in all these studies showed severe adverse effects, [1],[17],[18],[19] which has proved to be a major disadvantage and limiting factor of the retinoid therapy. In contrast, lycopene is a safe drug with no reported adverse effects, [20] and none of the patients in our study showed any adverse effects. Thus, it can be a better alternative than other retinoids in the management of OLP.
Further, most of these studies reported recurrences, in most of the cases, within 2-3 months of the completion of the treatment. [1],[2],[3],[4],[17],[18],[19] Though none of the patients showed any recurrence of lesions in our study, the follow-up period was short and further studies with longer follow-up periods are warranted.
Corticosteroids are the mainstay in the treatment of OLP. [2],[3],[4] However, here too, the associated adverse effects are a limiting factor. Therefore, the safety of lycopene can be an advantage over corticosteroids for the management of OLP.
The results obtained from 8 mg/day systemic lycopene in the management of oral leukoplakia were similar to our study, with 80% of the patients showing resolution of signs and symptoms. [13] The results of this study and our study suggest that lycopene can be beneficial in the management of various oral premalignant lesions and conditions.
The beneficial effect shown by lycopene in our study can be attributed to its ability to scavenge free radicals, [9],[10],[11],[12] and various studies have shown an evidence for the role of oxidative stress in the pathogenesis of LP. [6],[15] Also, lycopene deficiency has been reported in the patients with erosive or atrophic OLP, [8] and lycopene supplementation may have shown positive results, suggesting a role of decreased lycopene levels in the disease pathogenesis.
Further, the drug used in the study, "Lycored", also contained Vitamin A, α-tocopherol, zinc and selenium, which are known to have antioxidant properties, and might have added synergistically to the positive effects of lycopene.
The marginal benefit shown by the patients in placebo group can be attributed to the spontaneous remission of the disease or the psychological effects, as discussed above.
To conclude, the results obtained from our study are encouraging; the use of lycopene has shown favorable results in OLP patients. The therapeutic effect of a potent antioxidant like lycopene also indirectly substantiates the hypothesis of the role of oxidative stress in the pathogenesis of LP. Therefore, our results justify the need for the addition of this therapeutic regimen (lycopene) to the armamentarium for the management of OLP.
However, since the sample size in our study was small, further studies are recommended on a larger sample size with a longer follow-up period, possibly along with the evaluation of oxidative stress markers and antioxidant enzyme level assessments at pre- and post-treatment stages to further elucidate the role of antioxidants in the management of this disease and the role of oxidative stress in its pathogenesis.
| References | | |
| 1. | Gorsky M, Raviv M. Efficacy of etretinate (Tigason) in symptomatic oral lichen planus. Oral Surg Oral Med Oral Pathol 1992;73:52-5. 
[PUBMED] |
| 2. | Eisen D. The therapy of oral lichen planus. Crit Rev Oral Biol Med 1993;4:141-58.
[PUBMED] [FULLTEXT] |
| 3. | Sugerman PB, Savge NW. Oral lichen planus: Causes, diagnosis and management. Aust Dent J 2002;47:290-7.
|
| 4. | Scully C, Beyli M, Ferreiro MC, Ficarra G, Gill Y, Griffiths M, et al. Update on oral lichen planus: Etiopathogenesis and management. Crit Rev Oral Biol Med 1998;9:86-122.
[PUBMED] [FULLTEXT] |
| 5. | Sander CS, Ali I, Dean D, Thiele JJ, Wojanarowska F. Oxidative stress is implicated in the pathogenesis of lichen sclerosus. Br J Dermatol 2004;151:627-35.
|
| 6. | Brennan PA, Umar T, Callender MP, Spedding AV, Mellor TK, Buckley J, et al. A study to assess inducible nitric oxide synthase expression in oral lichen planus. J Oral Pathol Med 2000;29:249-54.
|
| 7. | Rollman O, Vahlquist A. Vitamin A in skin and serum-studies of acne vulgaris, atopic dermatitis, ichthyosis vulgaris and lichen planus. Br J Dermatol 1985;113:405-13.
[PUBMED] |
| 8. | Nagao T, Warnakulasuriya S, Ikeda N, Fukano H, Yamamoto S, Yano M, et al. Serum antioxidant micronutrient levels in oral lichen planus. J Oral Pathol Med 2001;30:264-7.
[PUBMED] [FULLTEXT] |
| 9. | Levy J, Sharoni Y. The functions of tomato lycopene and its role in human health. Herbalgram 2004;62:49-56.
|
| 10. | Stahl W, Sies H. Lycopene: A biologically important carotenoid for humans? Arch Biochem Biophys 1996;336:1-9.
[PUBMED] [FULLTEXT] |
| 11. | Lycopene: Monograph. Alt Med Rev 2003;8:336-42.
|
| 12. | Clinton SK. Lycopene: Chemistry, biology and implications for human health and disease. Nutr Rev 1998;56:35-51.
[PUBMED] |
| 13. | Singh M, Krishanappa R, Bagewadi A, Keluskar V. Efficacy of oral lycopene in the treatment of oral leukoplakia. Oral Oncol 2004;40:591-6.
[PUBMED] [FULLTEXT] |
| 14. | Schwartz B. Can tomatoes fight oral cancer? J Am Dent Assoc 2001;132:154-6.
|
| 15. | Sander CS, Cooper SM, Ali I, Dean D, Thiele JJ, Wojanarowska F. Decreased antioxidant enzyme expression and increased oxidative damage in erosive lichen planus of the vulva. BJOG 2005;112:1572-5.
|
| 16. | Winbrow VR, Winyard PG, Morris CJ, Blake DR. Free radicals in inflammationecond messengers and mediators of tissue destruction. Br Med Bull 1993;49:506-22.
|
| 17. | Hersle K, Mobacken H, Sloberg K, Thilander H. Severe oral lichen planus: Treatment with an aromatic retinoid (etretinate). Br J Dermatol 1982;106:77-80.
[PUBMED] |
| 18. | Ferguson MM, Simpson NB, Hammersley N. The treatment of erosive lichen planus a retinoid-etretinate. Oral Surg 1984;58:283-7.
[PUBMED] |
| 19. | Camisa C, Allen CM. Treatment of oral erosive lichen planus with systemic isotretinoin. Oral Surg Oral Med Oral Pathol 1986;62:393-6.
[PUBMED] |
| 20. | McClain M, Bausch J. Summary of safety studies conducted with synthetic lycopene. Regulat Toxicol Pharmacol 2003;37:274-85.
|
Correspondence Address:
Nisheeth Saawarn
Department of Oral Medicine and Radiology, People's College of Dental Sciences and Research Centre, Bhopal
India
 Source of Support: Study medications (Capsule Lycored & Identical Placebo) provided by Jagsonpal Pharmaceutical, New Delhi, India, Conflict of Interest: None  | Check |
DOI: 10.4103/0970-9290.93448
[Figure 1], [Figure 2]
[Table 1], [Table 2], [Table 3] |
|
| This article has been cited by | | 1 |
Cytotoxicity of lycopene-mediated silver nanoparticles in the embryonic development of zebrafish—An animal study |
|
| Bhavana Garapati, Sankari Malaiappan, S. Rajeshkumar, Karthikeyan Murthykumar | | Journal of Biochemical and Molecular Toxicology. 2022; | | [Pubmed] | [DOI] | | | 2 |
Childhood oral lichen planus: a case series with review of literature |
|
| Shikha, S. Gupta, A. Mahajan, Ambika, R. Garg, S. Ghosh | | European Archives of Paediatric Dentistry. 2022; | | [Pubmed] | [DOI] | | | 3 |
Experimental and clinical trial investigations of phyto-extracts, phyto-chemicals and phyto-formulations in the treatment of oral lichen planus: A systematic review |
|
| Alaka Sahoo, Ajaya K. Jena, Maitreyee Panda | | Journal of Ethnopharmacology. 2022; : 115591 | | [Pubmed] | [DOI] | | | 4 |
Efficacy of lycopene for management of oral potentially malignant disorders: A systematic review and meta-analysis |
|
| Sadeq A. Al-Maweri, Esam Halboub, Gamilah Al-Qadhi, Mohammed Al-Wesabi, Hesham Mohammed Al-Sharani, Sameena Parveen, Najah Alhashimi, Asma Almeslet, Mohammed Nasser Alhajj | | Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology. 2022; | | [Pubmed] | [DOI] | | | 5 |
Oral lichen planus: comparative efficacy and treatment costs—a systematic review |
|
| Shaiba Sandhu, Brittany A. Klein, Malak Al-Hadlaq, Prazwala Chirravur, Amal Bajonaid, Yuanming Xu, Rossella Intini, Mai Hussein, Piamkamon Vacharotayangul, Herve Sroussi, Nathaniel Treister, Stephen Sonis | | BMC Oral Health. 2022; 22(1) | | [Pubmed] | [DOI] | | | 6 |
Antioxidant therapy for patients with oral lichen planus: A systematic review and meta-analysis |
|
| Jie Bao, Chu Chen, Jiayu Yan, Yueqiang Wen, Jiamin Bian, Mengting Xu, Qin Liang, Qingmei He | | Frontiers in Pharmacology. 2022; 13 | | [Pubmed] | [DOI] | | | 7 |
A Review of Oral Lichen Planus and its Management with Herbal Treatment |
|
| Madiha khan Niazi, Kinza Jalal, Huma Amjad, Sana Jamshed, Sahar Imran, Wajeeha Arooj, Nizwa Choudhary, Farooq Hassan | | Pakistan BioMedical Journal. 2022; : 29 | | [Pubmed] | [DOI] | | | 8 |
Novel Treatment Approach of Oral Submucous Fibrosis in a 6-year-old Girl: A Case Report |
|
| Sujoy Ghosh, Sunita Gupta, Prerna Singh, Shikha Gupta, Chetna Chaudhary, Ridam Sharma | | International Journal of Clinical Pediatric Dentistry. 2021; 14(4): 575 | | [Pubmed] | [DOI] | | | 9 |
Therapies with Antioxidant Potential in Psoriasis, Vitiligo, and Lichen Planus |
|
| Fabrizio Guarneri, Lucrezia Bertino, Giovanni Pioggia, Marco Casciaro, Sebastiano Gangemi | | Antioxidants. 2021; 10(7): 1087 | | [Pubmed] | [DOI] | | | 10 |
Serum 8-isoprostane levels in patients with resistant oral lichen planus before and after treatment with lycopene: a randomized clinical trial |
|
| Aliaa Abdelmoniem Bedeir Eita, Azza Mohamed Zaki, Sabah Abdelhady Mahmoud | | BMC Oral Health. 2021; 21(1) | | [Pubmed] | [DOI] | | | 11 |
Elucidating of oxidative distress in COVID-19 and methods of its prevention |
|
| Anna-Maria Barciszewska | | Chemico-Biological Interactions. 2021; 344: 109501 | | [Pubmed] | [DOI] | | | 12 |
Oral Lichen Planus: A review of clinical features, etiologies, and treatments |
|
| Andrea Elenbaas, Reyes Enciso, Kamal Al-Eryani | | Dentistry Review. 2021; : 100007 | | [Pubmed] | [DOI] | | | 13 |
Effectiveness of herbal based medications in the treatment of oral lichen planus: A review article |
|
| Sara Pourshahidi, Nafiseh Sheykhbahaei | | Journal of Herbal Medicine. 2021; 29: 100458 | | [Pubmed] | [DOI] | | | 14 |
European S1 guidelines on the management of lichen planus: a cooperation of the European Dermatology Forum with the European Academy of Dermatology and Venereology |
|
| D. Ioannides, E. Vakirlis, L. Kemeny, B. Marinovic, C. Massone, R. Murphy, A. Nast, J. Ronnevig, T. Ruzicka, S.M. Cooper, R.M. Trüeb, R.M. Pujol Vallverdú, R. Wolf, M. Neumann | | Journal of the European Academy of Dermatology and Venereology. 2020; 34(7): 1403 | | [Pubmed] | [DOI] | | | 15 |
Efficacy of lycopene in management of Oral Submucous Fibrosis– A systematic review and meta-analysis |
|
| Neha Gupta, Ashita Kalaskar, Ritesh Kalaskar | | Journal of Oral Biology and Craniofacial Research. 2020; 10(4): 690 | | [Pubmed] | [DOI] | | | 16 |
Treatment of lichen planus-induced desquamative gingivitis |
|
| Malek Kotab, Maryam Jalili sadrabad, Sina Ebrahimi | | Koomesh Journal. 2020; 22(1): 198 | | [Pubmed] | [DOI] | | | 17 |
Therapeutic effectiveness of alternative medications in oral lichen planus: A systematic review |
|
| JayanthKumar Vadivel, Devaraj Ezhilarasan, Meera Govindarajan, Elangovan Somasundaram | | Journal of Oral and Maxillofacial Pathology. 2020; 24(2): 344 | | [Pubmed] | [DOI] | | | 18 |
Herbal medicine in oral lichen planus |
|
| Atefeh Ghahremanlo,Nadia Boroumand,Kiarash Ghazvini,Seyed Isaac Hashemy | | Phytotherapy Research. 2019; 33(2): 288 | | [Pubmed] | [DOI] | | | 19 |
Herbal medicine in oral lichen planus |
|
| Atefeh Ghahremanlo,Nadia Boroumand,Kiarash Ghazvini,Seyed Isaac Hashemy | | Phytotherapy Research. 2019; 33(2): 288 | | [Pubmed] | [DOI] | | | 20 |
Recent Advancements in Oral Lichen Planus Management: An Overview |
|
| Karthikeya Patil, Athira Joshy, Nagabushana Doggalli, Jai Shankar, Chikkarasinakere J Gowda, Prasannasrinivas Deshpande | | World Journal of Dentistry. 2018; 9(3): 249 | | [Pubmed] | [DOI] | | | 21 |
Assessing the Potential Role of Calcitonin in Cancer |
|
| DB Nandini, Shankargouda B Patil | | World Journal of Dentistry. 2018; 9(4): 253 | | [Pubmed] | [DOI] | | | 22 |
Oral Lichen Planus–A Brief Review on Treatment Modalities |
|
| Niharika Swain, Shilpa Patel, Jigna Pathak, Ketki J Shirke, Tanvi Patel, Mitesh N Jain | | Journal of Contemporary Dentistry. 2018; 8(3): 137 | | [Pubmed] | [DOI] | | | 23 |
Interventions for the management of oral lichen planus: a review of the conventional and novel therapies |
|
| S Gupta,S Ghosh,S Gupta | | Oral Diseases. 2017; 23(8): 1029 | | [Pubmed] | [DOI] | | | 24 |
Interventions for the management of oral lichen planus: a review of the conventional and novel therapies |
|
| S Gupta,S Ghosh,S Gupta | | Oral Diseases. 2017; 23(8): 1029 | | [Pubmed] | [DOI] | | | 25 |
Oral submucous fibrosis: a review of the current management and possible directions for novel therapies |
|
| Saman Warnakulasuriya,A. Ross Kerr | | Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology. 2016; 122(2): 232 | | [Pubmed] | [DOI] | | | 26 |
Oral submucous fibrosis: a review of the current management and possible directions for novel therapies |
|
| Saman Warnakulasuriya,A. Ross Kerr | | Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology. 2016; 122(2): 232 | | [Pubmed] | [DOI] | | | 27 |
Oral lichenplanus: Etiology, pathogenesis, diagnosis, and management |
|
| Naresh Gangeshetty | | World Journal of Stomatology. 2015; 4(1): 12 | | [Pubmed] | [DOI] | | | 28 |
Management for premalignant lesions of the oral cavity |
|
| Aru Panwar,Robert Lindau,Aaron Wieland | | Expert Review of Anticancer Therapy. 2014; 14(3): 349 | | [Pubmed] | [DOI] | | | 29 |
Management for premalignant lesions of the oral cavity |
|
| Aru Panwar,Robert Lindau,Aaron Wieland | | Expert Review of Anticancer Therapy. 2014; : 1 | | [Pubmed] | [DOI] | | | 30 |
Mucosal Lichen Planus: An Evidence-Based Treatment Update |
|
| Parastoo Davari,Hui-Hua Hsiao,Nasim Fazel | | American Journal of Clinical Dermatology. 2014; | | [Pubmed] | [DOI] | | | 31 |
Efficacy of intralesional betamethasone for erosive oral lichen planus and evaluation of recurrence: a randomized, controlled trial |
|
| Chuanxia Liu,Bing Xie,Yi Yang,Duanxian Lin,Caixia Wang,Mei Lin,Lin Ge,Hongmei Zhou | | Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology. 2013; 116(5): 584 | | [Pubmed] | [DOI] | | | 32 |
Novel therapies for oral lichen planus |
|
| Kobkan Thongprasom,Chanwit Prapinjumrune,Marco Carrozzo | | Journal of Oral Pathology & Medicine. 2013; 42(10): 721 | | [Pubmed] | [DOI] | | | 33 |
Diagnosis and Management of Mucosal Lesions With the Potential for Malignant Transformation |
|
| Bassam Issa, Ricardo Padilla, Michael T. Brennan | | Journal of the California Dental Association. 2013; 41(5): 343 | | [Pubmed] | [DOI] | | | 34 |
Xeroderma Pigmentosum: Man Deprived of His Right to Light |
|
| Subhash Mareddy,Jithendra Reddy,Subhas Babu,Preethi Balan | | The Scientific World Journal. 2013; 2013: 1 | | [Pubmed] | [DOI] | |
|
|
|
|
|
|
|
|
|
|
|
|
| Article Access Statistics | | | Viewed | 15227 | | | Printed | 585 | | | Emailed | 4 | | | PDF Downloaded | 699 | | | Comments | [Add] | | | Cited by others | 34 | | |
|
|
Users online:
