Comparison of topical purslane & topical 0.1% triamcinolone acetonide in the management of oral lichen planus - a double blinded clinical trial.
Antioxidant
Clinical improvement
Oral lichen planus
Steroids
Topical purslane
Journal
BMC oral health
ISSN: 1472-6831
Titre abrégé: BMC Oral Health
Pays: England
ID NLM: 101088684
Informations de publication
Date de publication:
19 09 2023
19 09 2023
Historique:
received:
11
05
2023
accepted:
04
09
2023
medline:
21
9
2023
pubmed:
20
9
2023
entrez:
19
9
2023
Statut:
epublish
Résumé
Oral lichen planus (OLP) is a chronic autoimmune mucocutaneous disorder of unknown etiology and treatment is targeted at alleviating symptoms. At present, corticosteroids are the mainstay treatment, and their side effects hamper their long-term use, demanding alternative therapy. This study intended to assess the efficacy of topical purslane (Portulaca oleracea) at two concentrations, 5% and 10%, in OLP and to compare the level of clinical improvement in comparison to topical 0.1% triamcinolone acetonide gel. After sample size determination, thirty-four subjects confirmed histopathologically with OLP were included in the study. They were divided into 3 groups, Group 1(Control) was treated with 0.1% triamcinolone acetonide, and Group 2(Case) and 3 (Case) were treated with topical purslane 5% and 10%, respectively. They were examined at baseline, 14 days, 30 days, 60 days, and 90 days. Clinical improvement was then analyzed at the end of 90 days using a visual analog scale (VAS) and Thongprasom's criteria. The study was analyzed statistically and a P value of < 0.05 was considered statistically significant. Intragroup comparison revealed a statistically significant difference between the five time periods (baseline, 14 days, 30 days, 60 days, and 90 days) for the study variables (burning sensation, pain, lesion score, clinical response, symptomatic response) for all three groups (p = 0.001). Alleviation of all symptoms and remission of the lesion were noted for all three groups at the end of three months. Purslane is a magical herb with a plethora of rich nutrients, ease in accessibility and devoid of side effects. It was concluded that its preparation is beneficial and can be a safer alternative long-term drug for the management of OLP. With available literature evidence, our present study is the first of its kind to formulate a topical gel with purslane to treat symptomatic OLP. Our study had a longer follow-up of 3 months compared to other studies in the literature.
Sections du résumé
AIM AND BACKGROUND
Oral lichen planus (OLP) is a chronic autoimmune mucocutaneous disorder of unknown etiology and treatment is targeted at alleviating symptoms. At present, corticosteroids are the mainstay treatment, and their side effects hamper their long-term use, demanding alternative therapy. This study intended to assess the efficacy of topical purslane (Portulaca oleracea) at two concentrations, 5% and 10%, in OLP and to compare the level of clinical improvement in comparison to topical 0.1% triamcinolone acetonide gel.
MATERIALS AND METHODS
After sample size determination, thirty-four subjects confirmed histopathologically with OLP were included in the study. They were divided into 3 groups, Group 1(Control) was treated with 0.1% triamcinolone acetonide, and Group 2(Case) and 3 (Case) were treated with topical purslane 5% and 10%, respectively. They were examined at baseline, 14 days, 30 days, 60 days, and 90 days. Clinical improvement was then analyzed at the end of 90 days using a visual analog scale (VAS) and Thongprasom's criteria.
RESULTS
The study was analyzed statistically and a P value of < 0.05 was considered statistically significant. Intragroup comparison revealed a statistically significant difference between the five time periods (baseline, 14 days, 30 days, 60 days, and 90 days) for the study variables (burning sensation, pain, lesion score, clinical response, symptomatic response) for all three groups (p = 0.001). Alleviation of all symptoms and remission of the lesion were noted for all three groups at the end of three months.
CONCLUSION
Purslane is a magical herb with a plethora of rich nutrients, ease in accessibility and devoid of side effects. It was concluded that its preparation is beneficial and can be a safer alternative long-term drug for the management of OLP.
CLINICAL SIGNIFICANCE
With available literature evidence, our present study is the first of its kind to formulate a topical gel with purslane to treat symptomatic OLP. Our study had a longer follow-up of 3 months compared to other studies in the literature.
Identifiants
pubmed: 37726676
doi: 10.1186/s12903-023-03385-1
pii: 10.1186/s12903-023-03385-1
pmc: PMC10507837
doi:
Substances chimiques
Triamcinolone Acetonide
F446C597KA
Banques de données
CTRI
['CTRI/2021/09/036647']
Types de publication
Randomized Controlled Trial
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
678Informations de copyright
© 2023. BioMed Central Ltd., part of Springer Nature.
Références
Warnakulasuriya S, Kujan O, Aguirre-Urizar JM, Bagan JV, González-Moles MÁ, Kerr AR, Lodi G, Mello FW, Monteiro L, Ogden GR, Sloan P, Johnson NW. Oral potentially malignant disorders: a consensus report from an international seminar on nomenclature and classification, convened by the WHO Collaborating Centre for Oral Cancer. Oral Dis. 2021;27(8):1862–80.
doi: 10.1111/odi.13704
pubmed: 33128420
López-Jornet P, Camacho-Alonso F. Quality of life in patients with oral lichen planus. J Eval Clin Pract. 2010;16(1):111–3.
doi: 10.1111/j.1365-2753.2009.01124.x
pubmed: 20367822
Gupta S, Jawanda MK. Oral lichen planus: an update on etiology, pathogenesis, clinical presentation, diagnosis and management. Indian J Dermatol. 2015;60(3):222–9.
doi: 10.4103/0019-5154.156315
pubmed: 26120146
pmcid: 4458931
Glick M, Greenberg MS, Lockhart PB, Challacombe SJ. Burket’s oral medicine. 13th ed. Hoboken: Wiley; 2021. p. 1122.
doi: 10.1002/9781119597797
Alshami ML, Al-Rikaby HH, Majeed AA. Oral lichen planus: a review study. JPAD. 2022;32(3):574–84.
Fitzpatrick SG, Hirsch SA, Gordon SC. The malignant transformation of oral lichen planus and oral lichenoid lesions: a systematic review. J Am Dent Assoc. 2014;145(1):45–56.
doi: 10.14219/jada.2013.10
pubmed: 24379329
Rotaru D, Chisnoiu R, Picos AM, Picos A, Chisnoiu A. Treatment trends in oral lichen planus and oral lichenoid lesions (Review). Exp Ther Med. 2020;20(6):198.
doi: 10.3892/etm.2020.9328
pubmed: 33123228
pmcid: 7588785
Dhar S, Seth J, Parikh D. Systemic side-effects of topical corticosteroids. Indian J Dermatol. 2014;59(5):460–4.
doi: 10.4103/0019-5154.139874
pubmed: 25284850
pmcid: 4171913
Pazhanivel K, Ganesan A. Clinical effectiveness of aloe vera in the treatment of oral mucosal diseases –a double blinded randomized clinical trial. IJCBS. 2022;22:34–40.
Pourshahidi S, Sheykhbahaei N. Effectiveness of herbal based medications in the treatment of oral lichen planus: a review article. J Herb Med. 2021;1(29):100458.
doi: 10.1016/j.hermed.2021.100458
Agha-Hosseini F, Borhan-Mojabi K, Monsef-Esfahani HR, Mirzaii-Dizgah I, Etemad-Moghadam S, Karagah A. Efficacy of purslane in the treatment of oral lichen planus. Phytother Res. 2010;24(2):240–4.
doi: 10.1002/ptr.2919
pubmed: 19585472
Uddin MK, Juraimi AS, Hossain MS, Nahar MA, Ali ME, Rahman MM. Purslane weed (Portulaca oleracea): a prospective plant source of nutrition, omega-3 fatty acid, and antioxidant attributes. ScientificWorldJournal. 2014;10(2014):951019.
Yesoda Aniyan K, Krithika CL, Anuradha G, Kannan A, Swathi KV. A systematic review of randomized controlled trials on the efficacy of purslane for the treatment of systemic disorders. IJCBS. 2022;21:219–23.
Bao J, Chen C, Yan J, Wen Y, Bian J, Xu M, Liang Q, He Q. Antioxidant therapy for patients with oral lichen planus: a systematic review and meta-analysis. Front Pharmacol. 2022;10(13):1030893.
doi: 10.3389/fphar.2022.1030893
Sander CS, Cooper SM, Ali I, Dean D, Thiele JJ, Wojnarowska F. Decreased antioxidant enzyme expression and increased oxidative damage in erosive lichen planus of the vulva. BJOG. 2005;112(11):1572–5.
doi: 10.1111/j.1471-0528.2005.00743.x
pubmed: 16225582
Murugan AJ, Ganesan A, Aniyan Y, Kannan A, Krithika CL, Umapathy D. Formulation of topical Herbal Gel from the extract of Purslane (Portulaca oleracea) leaves in two concentration and its evaluation. Int J Chem Biochem Sci. 2022;22:110–8.
Amirchaghmaghi M, Pakfetrat A, Delavarian Z, Ghalavani H, Ghazi A. Evaluation of the efficacy of curcumin in the treatment of oral lichen planus: a randomized controlled trial. J Clin Diagn Res. 2016;10(5):ZC134-7.
pubmed: 27437348
pmcid: 4948524
Mankapure PK, Humbe JG, Mandale MS, Bhavthankar JD. Clinical profile of 108 cases of oral lichen planus. J Oral Sci. 2016;58(1):43–7.
doi: 10.2334/josnusd.58.43
pubmed: 27021539
Bakhshi M, Gholami S, Mahboubi A, Jaafari MR, Namdari M. Combination therapy with 1% nanocurcumin gel and 0.1% Triamcinolone acetonide mouth rinse for oral lichen planus: a randomized double-blind placebo controlled clinical trial. Dermatol Res Pract. 2020;2020:4298193.
doi: 10.1155/2020/4298193
pubmed: 32518558
pmcid: 7256737
Kia SJ, Shirazian S, Mansourian A, KhodadadiFard L, Ashnagar S. Comparative efficacy of topical curcumin and triamcinolone for oral lichen planus: a randomized, controlled clinical trial. J Dent (Tehran). 2015;12(11):789–96.
pubmed: 27507989
Choonhakarn C, Busaracome P, Sripanidkulchai B, Sarakarn P. The efficacy of aloe vera gel in the treatment of oral lichen planus: a randomized controlled trial. Br J Dermatol. 2008;158(3):573–7.
doi: 10.1111/j.1365-2133.2007.08370.x
pubmed: 18093246
Nashat E, Ali A, Madkour G. Efficacy and safety of topical chamomile in treatment of oral lichen planus. Adv Dent J. 2021;3(2):101–8.
doi: 10.21608/adjc.2021.73435.1096
Najafi S, Mohammadzadeh M, Monsef Esfahani HR, Meighani G, Rezaei N. The effect of Purslane in the treatment of recurrent aphthous stomatitis. TUMJ. 2013;71(2):102–8.