Steroids Alone, Versus Steroids with Antihistamines, in the Treatment of Oral Lichen Planus – A Comparative Study from Chennai, India

BACKGROUND Lichen planus (LP) is a chronic T cell mediated autoimmune disorder affecting the skin and mucosa of the oral cavity. Mainstays of treatment are corticosteroids which are mostly used topically, and severe cases require systemic management. Recalcitrant or severe cases may require steroid sparing immune-modulators. Mast cells are predominant in the active phase of LP and antihistamines reduce mast cell numbers. The purpose of this study was to evaluate the effectiveness of antihistamines in oral lichen planus. METHODS This study was conducted from June 2019 to March 2020 in oral medicine department. A total of 54 patients were included in which group – 1 (n = 27) patients were treated with both systemic antihistamine with topical steroids, group – 2 (n = 27) patients were treated with topical steroids only. The Challacombe scale was used to assess the severity of disease at baseline, 15 days and 30 days. RESULTS Results showed that patients were in the age group of 51 - 60 years (27.8 %), female predilection (63 %), erosive OLP (50 %) and reticular OLP (38.8 %) was most commonly reported. Mean difference and standard deviation at first review and second review for group 1 was 9.85 ± 2.349, 8.14 ± 2.685; group 2 was 4.74 ± 2.297, 4.37 ± 2.436 respectively with a statistically significant value (< 0.05). In between the reviews, group - 1 showed a rapid reduction in severity of disease when compared to group - 2. CONCLUSIONS A combined therapy of topical steroids and systemic antihistamines was more effective in active reduction of disease and are easily available with no adverse effects reported. KEY WORDS Antihistamines; Challacombe Scale; Mast Cells; Oral Lichen Planus