EVALUATION OF LYCOPENE IN THE TREATMENT OF EROSIVE ORAL LICHEN PLANUS (A RANDOMIZED CLINICAL TRIAL)

Document Type : Original Article

Authors

1 Oral Medicine, Periodontology, Diagnosis and Radiology Department,Faculty of Dentistry, Alexandria University, Alexandria, Egypt.

2 Oral Medicine, Periodontology, Diagnosis and Radiology Department, Faculty of Dentistry, Alexandria University, Alexandria , Egypt.

3 Medical Biochemistry Department, Faculty of Medicine, Alexandria University, Alexandria, Egypt.

Abstract

Introduction: Oral lichen planus is an autoimmune disorder of unknown etiology. It is believed that oxidative stress plays an important role in its pathogenesis. Topical corticosteroids are the gold standard treatment for oral lichen planus. However, for resistant and severe lesions systemic corticosteroids are indicated. The side effects of oral steroids necessitate searching for safer lines of treatment. Lycopene is an antioxidant with promising effects on human health. It is also found to play roles in the treatment of various oral mucosal diseases especially oral lichen planus.
Objectives: The aim of this study was to evaluate the effect of oral lycopene and systemic steroids in the treatment of erosive oral lichen planus and compare between the two therapeutic modalities.
Materials and methods: Twenty patients were recruited and randomly assigned in one of two groups, the test (lycopene) and control (corticosteroids) group. Subjective assessment using Visual Analogue Scale and objective assessment using Thongprasom et al. lesion scoring were taken at baseline and after one, two and five months from baseline (three months after treatment termination).
Results: In both study groups, there was a significant decrease in the scores of objective and subjective outcomes after one, two and five months. The mean score values of both outcomes were in favor of the test group after two and five months. However, there was no statistically significant difference between the test and control groups throughout the study period.
Conclusions: Lycopene is an effective therapeutic modality for erosive oral lichen planus.

Keywords

Main Subjects

References

  1. Rajendran R, Sivapadasundaram B. Shafer's Textbook of Oral Pathology, 7th ed. New Delhi, India: Elsevier; 2012.
  2. Roopashree MR, Gondhalekar RV, Shashikanth MC, George J, Thippeswamy SH, Shukla A. Pathogenesis of oral lichen planus--a review. J Oral Pathol Med. 2010;39:729-34. 
  3. Au J, Patel D, Campbell JH. Oral lichen planus. Oral Maxillofac Surg Clin North. Am. 2013;25:93-100.
  4. Ergun S, Troşala SC, Warnakulasuriya S, Özel S, Önal AE, Ofluoğlu D, Güven Y, Tanyeri H. Evaluation of oxidative stress and antioxidant profile in patients with oral lichen planus. J Oral Pathol Med. 2011;40:286-93. 
  5. Rekha VR, Sunil S, Rathy R. Evaluation of oxidative stress markers in oral lichen planus. J Oral Maxillofac Pathol. 2017;21:387-93.
  6. Azizi A, Farshchi F. Comparison of salivary and plasma antioxidant levels in lichen planus patients and healthy subjects. J Oral Pathol Med. 2012;41:524-6.
  7. Williams DM. Clinical Pharmacology of Corticosteroids. Respir Care. 2018;63:655-70.
  8. Patil RP, Khandelwal S, Sinha N, Kaswan S. Treatment modalities of oral lichen planus: an update. J Oral Diag. 2016;01:e3.
  9. Story EN, Kopec RE, Schwartz SJ, Harris GK. An update on the health effects of tomato lycopene. Annu Rev Food Sci Technol. 2010;1:189-210.

10. Milani A, Basirnejad M, Shahbazi S, Bolhassani A. Carotenoids: biochemistry, pharmacology and treatment. Br. J. Pharmacol. 2017;174:1290-324.

11. Krinsky NI, Johnson EJ. Carotenoid action and their relation to health and disease. Mol. Aspects Med. 2005;26:459–516.

12. Böhm F, Edge R, Truscott TG. Interaction of dietary carotenoids with activated singlet oxygen (1O2) and free radicals potential effects for human health. Mol Nutr Food Res. 2012;56:205–216.

13. Bacanli M, Başaran N, Başaran AA. Lycopene: Is it Beneficial to Human Health as an Antioxidant?. Turk J Pharm Sci. 2017;14:311-18.

14. Sonune S, Tupsakhare S, Kandalgaonkar S, Patil K, Gabhane M, Saraf K. Lycopene: potent antioxidant for oral premalignancy and oral cancer. European J Biomed Pharm Sci. 2015;2:135-44.

15. Schulz KF, Altman DG, Moher D, CONSORT Group. CONSORT 2010 statement: updated guidelines for reporting parallel group randomised trials. Int J Surg. 2011;9:672-7.

16. van der Meiji EH, van der Waal I. Lack of clinicopathological correlation in the diagnosis of oral lichen planus based on the presently available diagnostic criteria and suggestions for modifications. J Oral Pathol Med. 2003;32:507-12.

17. World Medical Association. World Medical Association Declaration of Helsinki. Ethical principles for medical research involving human subjects. JAMA. 2013;310: 2191-4.

18. Kushwaha RP, Rauniar GP, Rimal J. Comparative study of the efficacy of lycopene versus prednisolone in the management of oral lichen planus-a randomized, double blind clinical trial. World J Pharm Pharm Sci. 2017;6:1103-15.

19. Kaur G, Sandal A, Dhillon NS. Lycopene and human health-A review. Agric Rev.  2017;38:282-9.

20. Kini R, Nagaratna DV, Saha A, Praveen BN. Therapeutic management of oral lichen planus: A review for the clinicians. World J Dent. 2011;2:249-53.

21. Saawarn N, Shashikanth MC, Saawarn S, Jirge V, Chaitanya NC, Pinakapani R. Lycopene in the management of oral lichen planus: a placebo-controlled study. Indian J Dent Res. 2011;22:639-43.

22. Thongprasom K, Luangjarmekorn L, Sererat T, Taweesap W. Relative efficacy of fluocinolone acetonide compared with triamcinolone acetonide in treatment of oral lichen planus. J Oral Pathol Med. 1992;21:456-8.

23. Gobbo M, Rupel K, Zoi V, Perinetti G, Ottaviani G, Di Lenarda R et al. Scoring systems for Oral Lichen Planus used by differently experienced raters. Med Oral Patol Oral Cir Bucal. 2017;22:e562-71.

24. El Shenawy HM, Eldin AM, Nasry SA. Management of pain in oral lichen planus patients: a comparative pilot study. Bull Natl Res Cent. 2018;42:15.

25. Chow SC, Shao J, Wang H. Sample Size Calculations in Clinical Research. 2nd ed.
Boca Raton, FL : CRC Press; 2018.

26. Hylown Consulting LLC. Power and Sample Size Calculator. 2013. Available at http://powerandsamplesize.com/Calculators/Compare-2-Means/2-Sample-Equality.

27. Schulz KF, Grimes DA. Generation of allocation sequences in randomised trials: chance, not choice. Lancet. 2002;359:515-9.  

28. Schulz KF, Grimes DA. Allocation concealment in randomised trials: defending against deciphering. Lancet. 2002;359:614-8. 

29. Nagarajappa AK, Pandya D, Sreedevi, Ravi KS. Role of Free Radicals and Common Antioxidants in Oral Health, an Update. BJMMR. 2015;9:1-12.

30. Singh M , Krishanappa R,  Bagewadi A, Keluskar V. Efficacy of oral lycopene in the treatment of oral leukoplakia. Oral Oncol. 2004;40:591-6.

31. Selvam NP, Dayanand AA. Lycopene in the maanagement of Oral submucuos fibrosis. Asian J Pharm Clin Res. 2013;6:58-61.

32. Choi H, Lee DG.Lycopene induces apoptosis in Candida albicans through reactive oxygen species production and mitochondrial dysfunction. Biochimie. 2015;115:108-15.

33. Ramamoorthy S, Rheum JA. Corticosteroids-Mechanisms of Action in Health and Disease. Dis Clin North Am. 2016;42:15-31.  

34. Sandhu SV, Sandhu JS, Bansal H, Dua V. Oral lichen planus and stress: An appraisal. Contemp Clin Dent. 2014;5:352-356.

35. Salvemini D, Little JW, Doyle T, Neumann WL. Roles of reactive oxygen and nitrogen species in pain. Free Radic Biol Med. 2011;51:951-66.

Alexandria Dental Journal
Volume 47, Issue 2
A (Oral and maxillofacial surgery, oral medicine, periodontology, oral radiology, oral pathology, oral biology)
August 2022
Pages 91-95

Files

Share

How to cite

Statistics