Topical Clotrimazole/Betamethasone use in Oral Erosive Lichen Planus

 Oral Lichen Planus (OLP) is a mucosal subtype of lichen planus, a chronic inflammatory disorder that affects the skin and mucous membranes. The manifestations of oral lichen planus vary from reticular, white papules and plaques to erythematous, atrophic, and erosive, with frank ulcers. Reticular OLP is often asymptomatic, but atrophic and erosive form can cause symptoms from burning to severe pain. The buccal mucosa and gingiva are commonly involved. The specific pathology is not understood, however a common theory is that an immune reaction against an exogenous antigen triggers the onset of an aberrant immune response, resulting in the onset of the disease.   Oral lichen planus is considered to be a T-cell mediated chronic inflammatory tissue reaction against epithelial basal cells. The pain and discomfort of this condition can significantly impair the quality of life of patients is often the reason most seek treatment[1]. Oral lichen planus is not a curable condition, and as such, treatment is mostly palliative and focused on alleviating symptoms and minimizing scarring. This includes both non-pharmacologic and pharmacologic therapy. Non-pharmacologic measures may help to reduce exacerbations of oral lichen planus, and include the following: good oral hygiene, elimination of mechanical irritation from dental equipment, avoidance of chewing on lips or mucosa, smoking cessation, and minimization of consumption of acidic, salty, spicy, hot, or sharp foods[1].