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rev port estomatol med dent cir maxilofac . 2021;62(1):29-34 33

these values are below those documented by the American since those patients were excluded. Moreover, this investiga-
Academy of Oral and Maxillofacial Pathology in 2016, which tion’s results cannot be extrapolated to the general population
stated that, apart from patients who have OLP as the single as these patients were observed and medicated by the same
manifestation of the disease, about 60% of individuals with group of specialists, which represents a bias.
4
CLP presented oral cavity lesions. The low percentage of OLP
lesions in this study may be explained by it being conducted
in a Dermatology Service, where patients invariably have more Conclusions
skin lesions. Moreover, since the most prevalent subtype of
OLP is asymptomatic, patients might not notice their pathol- In this research, LP affected both genders similarly and
ogy and not look for a healthcare professional. manifested itself mainly in adulthood. Its lesions occurred
The higher incidence of oral lesions in the buccal mucosa mostly in the skin, involving more the trunk, limbs, and ex-
is supported by the literature. 5,6,23-25 Moreover, there were no tremities. In a smaller portion, oral and genital mucosa were
cases of malignant transformation of OLP, maybe due to the also affected. In the oral cavity, most lesions were observed
reduced sample of oral lesions. Recent studies reveal the evo- in the buccal mucosa. The most prescribed drugs for LP
lution of OLP lesions to squamous cell carcinoma in 1.09%- management were corticosteroids, followed by antihista-
1.37% of patients. 12,13,28 mines and immunosuppressants. Within corticotherapy,
Regarding therapeutics, the most prescribed drugs were topical drugs were the most common ones, namely clo-
corticosteroids, either alone or in a therapeutic scheme. In fact, betasol propionate and betamethasone dipropionate. The
corticosteroids constitute the first -line treatment for LP. 5,8,29-31 most prescribed systemic corticosteroid was prednisolone.
However, some authors alert to the need for further studies Antihistamines were all administered orally, and ebastine
evaluating the effectiveness of corticotherapy, especially the was the most frequent. It was not possible to conclude which
systemic one, compared to other treatment options. 2,19,22,32-34 therapeutic regimen is more effective. The mean time of the
The topical route of administration was the most widely used disease varied largely, approximately 6.5 months. For the
to apply corticotherapy, which is in agreement with the liter- population with recurrence, the mean time without symp-
ature. 5,19,30-33 Clobetasol propionate was the most prescribed toms was 513 days.
active substance (37.4%), as reported in the literature. 2,19,29-31,35
Prednisolone was the most commonly prescribed drug for sys-
temic administration of corticosteroids (12.3%), generally in a Ethical disclosures
dose of 20mg/day and along with a topical corticosteroid. Patil
et al. and Tziotzios et al. also reported prednisolone as the Protection of human and animal subjects. The authors
most frequent corticosteroid, but with a dosage of 40-80mg/ declare that no experiments were performed on humans or
day and 30-60mg/day, respectively. 29,36 animals for this study.
Antihistamines were the second most prescribed group in
this study. Although their use is controversial, 27,37 their pur- Confidentiality of data. The authors declare that they have
followed their work center protocols on access to patient data
pose is to reduce itching, the most common symptom in
CLP (37) . Immunosuppressants were prescribed much less fre- and for its publication.
quently. However, some recent articles support the use of tac- Right to privacy and informed consent. The authors declare
rolimus 0.1% ointment instead of a topical corticosteroid. 30,31 that no patient data appear in this article.
Regarding the patients’ follow-up, total remission of symp-
toms and resolution of LP lesions (or evolution to residual
post-inflammatory hyperpigmentation) were the criteria con- Conflict of interest
sidered as indicators of cure of the disease. The words “cure”
and “recurrence” are used within the article to ease the read- The authors have no conflicts of interest to declare.
ing, as these terms always refer to events of remission and
exacerbation of symptoms and lesions, respectively, since LP
as an autoimmune disease has no cure. 6,19 Despite the results Acknowledgements
reflecting that “1 corticosteroid” and “1 corticosteroid + 1 an-
tihistamine” were the pharmacological groups more associat- Research Centre of Statistical and Applications of University
ed with situations of cure or improvement, it is not possible to of Lisbon (CEAUL) under the project UIDB/00006/2020, Funda-
conclude that these drugs are better because they are admin- ção Nacional para a Ciência e a Tecnologia (FCT), Portugal.
istered more often than the others.
No seasonal variation in LP manifestations was observed
(p=0.235), similar to Bhattacharya et al.’s epidemiological references
study. Patients who healed after the first appointment took
25
about 6.5 months to cure, similar to 49.1% of patients in that 1. Suresh SS, Chokshi K, Desai S, Malu R, Chokshi A. Medical
25
study. Regarding the disease’s recurrence, that epidemiolog- management of oral lichen planus: A systematic review.
J Clin Diagn Res. 2016;10:10-5.
ical study also revealed a similar rate of relapses (10.3%). 25 2. Davari P, Hsiao HH, Fazel N. Mucosal lichen planus: An
This study has some limitations, including incomplete evidence-based treatment update. Am J Clin Dermatol.
medical records in some cases, which led to information loss 2014;15:181-95.