A randomized triple-blind clinical trial to compare the effectiveness of topical triamcinolone acetonate (0.1%), clobetasol propionate (0.05%), and tacrolimus orabase (0.03%) in the management of oral lichen planus

BACKGROUND: Oral lichen planus (OLP) is believed to result from an abnormal T-cell mediated immune response. The most useful agent in the treatment is corticosteroids. The present study will be aimed at evaluation of therapeutic efficiency of two corticosteroids triamcinolone acetonate (0.1%) and clobetasol propionate with tacrolimus orabase (0.03%), an immunomodulator in the management of OLP. AIM: To compare the effectiveness of topical triamcinolone acetonate (0.1%), clobetasol propionate (0.05%), and tacrolimus orabase (0.03%) in the management of OLP and also to compare which has less recurrence. STUDY DESIGN: The study comprises 30 patients, all were diagnosed with OLP clinically and histopathologically. They are randomly divided into three groups: Group A - triamcinolone acetonate (0.1%), Group B - clobetasol propionate (0.05%), and Group C - tacrolimus (0.03%). A formal informed consent was obtained from all of them who participated in the study. RESULTS AND CONCLUSION: Subjects in the Group A (triamcinolone 0.1%) and Group B (clobetasol 0.05%) show a significant reduction in lesion size than that of Group C (tacrolimus 0.03%). Group B (clobetasol 0.05%) shows a better significant reduction in lesion size than that of Group A (triamcinolone 0.1%). The overall treatment response was significant better in the Group B (clobetasol 0.05%). No recurrence was observed in any of the three groups at the end of 3 months. It is concluded that clobetasol propionate 0.05% ointment has higher efficacy when compared to triamcinolone acetonide 0.1% ointment and tacrolimus ointment 0.03% in the management of OLP. It was also inferred that triamcinolone 0.1% has better effects than tacrolimus 0.03%.