Oral erosive lichen planus with desquamative gingivitis: A case report- Innovative approaches and review of treatment modalities

Oral Lichen planus is a common immunological inflammatory mucocutaneous disorder. A 38-year-old female patient reported to the Department of Oral Medicine and Radiology with the chief complaint of burning sensation of oral cavity and bleeding gums since one year. A provisional diagnosis of erosive lichen planus with desquamative gingivitis was given. After initial treatment, drug delivery tray for increased efficacy of drug at local level was considered. Maxillary and mandibular drug delivery trays were made and trimmed upto the level of marginal gingiva. 10mg Prednisolone tablet was crushed and mixed with normal saline and applied on the margins of both the trays. The trays were placed in the oral cavity such that the paste comes in contact with the marginal gingiva. The trays were kept in mouth in same position for 20 minutes. The patient was given instructions to repeat the procedure three times daily and was asked to report after 7 days. After 7 days there was 50% reduction in gingival erythema and burning sensation was reduced to (VAS 1/10). The patient was kept under periodic follow up since one year and is free of lesions. In the present case report we have explored the use of local drug delivery system for treatment of desquamative gingivitis in OLP and also have reviewed other new treatment modalities. Continuous development in management protocol for OLP is required due to recent in¬crease in the incidence of malignant transformation rate even in the non-risk population group.