The present situation in treatment for oral lichen planus

Oral lichen planus (OLP), a common and chronic disorder, has no effective treatment or cure because its etiology is complicated and has until now remained unclear. Therefore, effectively controlling the activity of the disease and preventing its recurrence are two primary purposes of clinical treatment for OLP. The available evidence supports the notion that topical steroids are the preferred drug for treating this disease. However, some cases have poor clinical curative responses to steroids or other medicines, mainly because of drug resistance and other factors. Therefore, scholars have explored new drugs and methods with the aim of achieving more effective and safe treatment effects. The current research evidence indicates that glucocorticoid remains the front-line drug for OLP treatment. Topical tacrolimus, pimecrolimus and retinoic acid combined with glucocorticoid can be used as alternative therapies, especially in cases with glucocorticoid drug resistance. The systemic application of glucocorticoid or immunosuppressive agents, such as methotrexate, mycophenolate mofetil, and sulfoxide, should be limited to extensive, refractory cases or those with lesions involving regions outside the oral cavity. Surgery and cryotherapy can be applied in a specific, limited range of lesions. Some previous randomized controlled clinical studies have had limitations, including a small sample size, short treatment and clinical follow-up periods, a lack of reliable questionnaires and differences in evaluation standards. Therefore, future studies should include the following: randomized controlled clinical studies with large sample sizes that offer reliable evidence of a curative effect; assessments of treatment outcomes should be extended as long as possible; the follow-up period should be long enough to assess the recurrence rate; and the methods and standards used to evaluate treatment effects should be standardized.