Fig. 1. A method to determine the size of oral lichen planus lesion on buccal mucosa. (A) A Flexible, transparent ruler as measuring tool for lesion size. (B-D) The lesion size was measured at the lesion periphery of the (B) area of reticulation, (C) erythema, and (D) ulceration, independently. The lesion sizes are 19 mm, 14 mm, and 9 mm for reticulation, erythema, and ulceration, respectively, based on this method.
Fig. 2. The favorable clinical forms of U-OLP and E-OLP. Changes in the clinical form from U-OLP or E-OLP to R-OLP or normal mucosa were recorded. U-OLP, ulcerative oral lichen planus (OLP); E-OLP, erythematous OLP; R-OLP, reticular OLP; Normal, normal mucosa.
Fig. 3. Comparison of subjective symptoms. (A) The numeric rating scale (NRS) scores for pain or burning sensation were significantly decreased in both groups (p=0.000), and there were no intergroup differences (p=0.058). (B) After the first injection, the improvement of symptoms was significantly greater in group B (p=0.002).
Fig. 4. Comparison of lesion size by the clinical type of oral lichen planus. The areas of reticulation, erythema, and ulceration were significantly decreased in both groups (p=0.000). Whereas erythema and ulceration did not significantly differ between the groups (p=0.595 and p=0.497, respectively), reticulation in group B was significantly decreased in each follow-up visit compared with reticulation in group A (p=0.002). R, reticulation; E, erythema; U, ulceration.
Fig. 5. The favorable conversion of clinical form of U-OLP and E-OLP. The percentage of favorable conversion into R-OLP or normal mucosa was greatest in group B at week 1 for U-OLP lesions and week 4 for E-OLP lesions (p=0.001 for E-OLP). U-OLP, ulcerative oral lichen planus (OLP); E-OLP, erythematous OLP; R-OLP, reticular OLP; normal, normal mucosa.
Fig. 6. Comparison of clinical response. The percentage of NR was decreased and the percentage of CR was increased in both groups. These changes were significantly greater in group B (p=0.269 and p=0.000 for group A and group B, respectively). CR, complete remission; PR, partial remission; NR, no response.
Fig. 7. Clinical photographs of oral lichen planus lesions. (A) An ulcerative lesion at the right buccal mucosa of a 54-year-old female patient. (B) The same patient after the 1-week treatment with 0.5 mL of triamcinolone acetonide injection showed complete response. (C) The condition of normal mucosa was maintained at week 4 without additional injection.
Fig. 8. Secondary candidiasis in group B. (A, B) The fungal colonies appeared after two consecutive injections of 0.5 mL of triamcinolone acetonide (arrows). (A’, B’) Underlying mucosa after wiping off the fungal colonies.
Table 1. Baseline characteristics of the study lesions