Efficacy of Aloe Vera Compared to Corticosteroid in Topical Treatment of Oral Lichen Planus and on Salivary Levels of Tumor Necrosis Factor Alpha

Efficacy of Aloe Vera Compared to Corticosteroid in Topical Treatment of Oral Lichen Planus and on Salivary Levels of Tumor Necrosis Factor Alpha (A Randomized Controlled Clinical Trial With Biochemical Analysis)

Aloe Vera Herbal treatment has been widely used as an anti-inflammatory and antioxidant the objective of this study was to evaluate the clinical efficacy of Aloevera gel compared to corticosteroid gel o for symptomatic oral lichen planus, and to investigate the effect of Aloe Vera or corticosteroids on the expression of Tumor necrosis factor alpha in oral lichen planus as an early marker of inflammation.

Twenty four patients with erosive or atrophic OLP were randomly assigned into two equal groups to receive Aloevera gel (70%) three times per day ( Group 1) , topical steroid ( triamcinolone acetonide 0.1%), four times per day ( Group 2 ),all groups are given treatment for 8 weeks and 4 weeks follow up period without treatment. Photographs of the most severe lesion were taken ( marker lesion ) in each patient and analyzed for total ulcerative area (TUA), total atrophic area (TAA). patients were also assessed using clinical scores (CS) and visual analogue scale (VAS). pre treatment and post treatment specimens were collected through salivary sample to test for expressionof tumor necrosis factor alpa.

Inclusion Criteria:

• Both genders, aged ranged from 25 to 60 years.
• Clinically proven painful symptomatic forms of OLP confirmed by the presence of red or erythematous changes, or shallow ulcerations with fine lacy lines at the periphery of the lesion accentuated by stretching and not eliminated by rubbing (Wickham's striae)
• Histopathological proven symptomatic OLP

Exclusion Criteria:

• History of drug induced lichenoid lesion.
• Presence of systemic conditions as; serious active or recurrent infections, malignancy, diabetes mellitus, hypertension, or significant heart, liver, or renal diseases. Assessed using medical questionnaire guided by Cornell Medical Index.
• Smoking
• Known hypersensitivity or severe adverse effects to the treatment drugs or to any ingredient of their preparation as mentioned in history
• Pregnancy or breast-feeding.
• History of previous treatments potentially effective on OLP such as antimalarial agents, retinoid, corticosteroids, or immunosuppressive drugs from less than 2 weeks for topical medications, and 4 weeks for systemic medications prior to starting the study.
• Loss of pliability or flexibility in the tissues involved by the lesions of OLP.
• Histological signs of epithelial dysplasia or lichenoid lesions within the biopsied sites.
• Patients with extensive skin lesions and indicated for systemic corticosteroids.
• Vulnerable groups (Handicapped, orphans or prisoners)