Evaluation of Efficacy of 1% Curcuminoids as Local Application in Management of Oral Lichen Planus - Interventional Study

Abstract

Introduction: Oral Lichen Planus (OLP) is a chronic inflammatory mucocutaneous disease affecting the oral cavity which has been associated with severe burning sensation which in turn affects the quality of life of the patients. Currently, the effective treatment of choice remains the use of corticosteroids. The chronicity and recalcitrant nature of the disease demand the long term use of these drugs with ensuing adverse effects. Turmeric and its active ingredient, "curcumin", have been found to have anti-inflammatory, antioxidant and anticancer properties. Hence, this intervention study was done to evaluate the efficacy of curcumin oral gel in the management of oral lichen planus.

Aim: The study was conducted to compare the efficacy of 1% curcumin gel with the conventional mid-potent topical corticosteroid, triamcinolone acetonide 0.1% in managing the signs and symptoms of OLP.

Materials and methods: An intervention study was conducted on 75 patients diagnosed with OLP divided into three groups, Group 1 (0.1% triamcinolone acetonide oral paste thrice daily in tapering doses), Group 2 (curcumin oral gel thrice daily) and Group 3 (curcumin oral gel six times daily). The patients were analysed for the symptom (burning) and sign (erythema and ulceration) using the numerical rating score and Modified Oral Mucositis Index (MOMI) for a period of three months on a bimonthly basis. The results were analysed using Students t-test and unpaired t-test.

Results: Intragroup comparison using paired t-test showed statistically significant reduction in burning sensation (p<0.001) as well as erythema and ulceration (p<0.001) in all the three groups. However, when the three groups were compared Group 1 showed the maximum reduction in burning sensation (77%) and erythema and ulceration (67%). Among the curcuminoid group, increased frequency was found to be more beneficial.

Conclusion: Curcumin oral gel can bring about clinical improvements in OLP patients; however it cannot be used as a mainstay drug. Instead, it can be used as a maintenance drug after the patient is treated with an initial course of corticosteroids. Further studies with larger sample size and increased drug concentrations may be required.

Keywords: Anti-inflammatory; Antineoplastic; Antioxidant; Autoimmune; Corticosteroids; Herbal.

[Table/Fig-3]:

Demographic data.

[Table/Fig-7]:

Clinical photographs: a) pre treatment photograph of patient in Group 2; b) post-treatment photograph of patient in Group 2; c) pre-treatment photograph of patient in Group 3; d) post-treatment photograph of patient in Group 3.