Original Article

Efficacy of Aloe Vera and Clobetasol Propionate in the Management of Oral Lichen Planus: A Randomized Parallel Clinical Trial

Aloe Vera & Clobetasol Propionate in Lichen Planus

Abstract

Objectives: The purpose of this randomized parallel clinical trial was to assess and compare the efficacy of 97% Aloe Vera (AV) gel and 94.7% AV juice against an active control (0.05% Clobetasol Propionate) in the treatment of oral lichen planus (OLP).
Materials and Methods: Age and sex matched patients with histologically proven OLP were divided into two groups. One group received 97% AV gel for topical application and 10ml 94.7% AV juice to consume twice daily. The active control group received topical 0.05% Clobetasol Propionate ointment twice daily. Treatment lasted two months followed by four months of observation. Monthly evaluation of various clinical features of OLP was done using the OLP disease scoring criteria. Burning sensation was evaluated using Visual Analog Scale (VAS). Mann Whitney–U (followed by Bonferroni adjustment) and Wilcoxon’s signed-rank tests were used for intergroup and intragroup comparisons, respectively. Interclass correlation-coefficient test was applied to assess the intra-observer variation (P<0.05).
Results: In total, 41 females and 19 males participated in this study. The most common site was the buccal mucosa followed by the gingivobuccal vestibule. The reticular variant was most frequently encountered. Wilcoxon’s signed-rank test showed significant differences in both groups between baseline and end-of-treatment for VAS, site-score, reticular/plaque/papular score, erosive/atrophic score and OLP disease score (P<0.05). Mann–Whitney revealed significant difference between both groups in the 2nd, 3rd and 4th months (P<0.0071).
Conclusion: Clobetasol Propionate is more effective for OLP management but in our study AV proved to be a safe treatment alternative for OLP management.

1. Conrotto D, Carbone M, Carrozzo M, Arduino P, Broccoletti R, Pentenero M, Gandolfo S. Ciclosporin vs. clobetasol in the topical management of atrophic and erosive oral lichen planus: a double-blind, randomized controlled trial. Br J Dermatol. 2006 Jan;154(1):139-45.
2. Gonzalez-Moles MA, Morales P, Rodriguez-Archilla A, Isabel IR, Gonzalez-Moles S. Treatment of severe chronic oral erosive lesions with clobetasol propionate in aqueous solution. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2002 Mar;93(3):264-70.
3. Rödström PO, Hakeberg M, Jontell M, Nordin P. Erosive oral lichen planus treated with clobetasol propionate and triamcinolone acetonide in Orabase: a double-blind clinical trial. J Dermatolog Treat. 1994 Jan 1;5(1):7-10.
4. Hayes SM. Lichen planus--report of successful treatment with aloe vera. Gen Dent. 1999 May-Jun;47(3):268-72.
5. Raksha B, Pooja S, Babu S. Bioactive compounds and medicinal properties of Aloe vera L.: an update. J Plant Sci. 2014;2(3):102-7.
6. Rajeswari R, Umadevi M, Rahale CS, Pushpa R, Selvavenkadesh S, Kumar KS, et al. Aloe vera: the miracle plant its medicinal and traditional uses in India. J Pharmacogn Phytochem. 2012;1(4):118-24.
7. Saeed MA, Ahmad I, Yaqub U, Akbar S, Waheed A, Saleem M, Din N. Aloe vera: A plant of vital significance. Sci. Vision. 2003;9(1-2):1-3.
8. Reddy RL, Reddy RS, Ramesh T, Singh TR, Swapna LA, Laxmi NV. Randomized trial of aloe vera gel vs triamcinolone acetonide ointment in the treatment of oral lichen planus. Quintessence Int. 2012 Oct;43(9):793-800.
9. Carbone M, Arduino PG, Carrozzo M, Caiazzo G, Broccoletti R, Conrotto D. et all, Topical clobetasol in the treatment of atrophic-erosive oral lichen planus: a randomized controlled trial to compare two preparations with different concentrations. J Oral Pathol Med. 2009 Feb;38(2):227-33.
10. Choonhakarn C, Busaracome P, Sripanidkulchai B, Sarakarn P. The efficacy of aloe vera gel in the treatment of oral lichen planus: a randomized controlled trial. Br J Dermatol. 2008 Mar;158(3):573-7.
11. Pol JS, Patil BA, Sodhi A, Tadiparthi J. Evaluation of therapeutic effect of Aloe Vera juice and gel in the management of symptomatic oral lichen planus. Int J Med Dent Sci. 2016 July;5(2): 1138-44
12. 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 Nov;21(10):456-8.
13. Piboonniyom SO, Treister N, Pitiphat W, Woo SB. Scoring system for monitoring oral lichenoid lesions: a preliminary study. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2005 Jun;99(6):696-703.
14. Park HK, Hurwitz S, Woo SB. Oral lichen planus: REU scoring system correlates with pain. Oral Surg Oral Med Oral Pathol Oral Radiol. 2012 Jul;114(1):75-82.
15. Escudier M, Ahmed N, Shirlaw P, Setterfield J, Tappuni A, Black MM. et all, A scoring system for mucosal disease severity with special reference to oral lichen planus. Br J Dermatol. 2007 Oct;157(4):765-70.
16. Wang J, van der Waal I. Disease scoring systems for oral lichen planus; a critical appraisal. Med Oral Patol Oral Cir Bucal. 2015 Mar 1;20(2):e199-204.
17. Pindborg JJ, Mehta FS, Daftary DK, Gupta PC, Bhonsle RB. Prevalence of oral lichen planus among 7639 Indian villagers in Kerala, South India. Acta Derm Venereol. 1972;52(3):216-20.
18. Chainani-Wu N, Silverman S Jr, Lozada-Nur F, Mayer P, Watson JJ. Oral lichen planus: patient profile, disease progression and treatment responses. J Am Dent Assoc. 2001 Jul;132(7):901-9.
19. Salazar-Sánchez N, López-Jornet P, Camacho-Alonso F, Sánchez-Siles M. Efficacy of topical Aloe vera in patients with oral lichen planus: a randomized double-blind study. J Oral Pathol Med. 2010 Nov;39(10):735-40.
20. Gallagher J, Gray M. Is aloe vera effective for healing chronic wounds? J Wound Ostomy Continence Nurs. 2003 Mar;30(2):68-71.
21. Mangaiyarkarasi SP, Manigandan T, Elumalai M, Cholan PK, Kaur RP. Benefits of Aloe vera in dentistry. J Pharm Bioallied Sci. 2015 Apr;7(Suppl 1):S255-9.
22. Nair GR, Naidu GS, Jain S, Nagi R, Makkad RS, Jha A. Clinical Effectiveness of Aloe Vera in the Management of Oral Mucosal Diseases- A Systematic Review. J Clin Diagn Res. 2016 Aug;10(8):ZE01-7.
23. Nidhin N, Prashanth S, Laxmikanth C, Veena KM, Rao PK, Prabhu RV. et all, Aloe vera: a boon to dentistry. World J Pharm Pharm Sci. 2014;3(8):334-40.
24. Sahu PK, Giri DD, Singh R, Pandey P, Gupta S, Shrivastava AK. et all, Therapeutic and medicinal uses of Aloe vera: a review. Pharmacol Pharm. 2013 Nov 8;4(08):599.
25. Mansourian A, Momen-Heravi F, Saheb-Jamee M, Esfehani M, Khalilzadeh O, Momen-Beitollahi J. Comparison of aloe vera mouthwash with triamcinolone acetonide 0.1% on oral lichen planus: a randomized double-blinded clinical trial. Am J Med Sci. 2011 Dec;342(6):447-51.
26. Choi S, Chung MH. A review on the relationship between Aloe vera components and their biologic effects. Sem integr Med 2003 Mar 1;1(1):53-62.
27. Steenkamp V, Stewart MJ. Medicinal applications and toxicological activities of Aloe. Products. Pharm Biol. 2007 Jan 1;45(5):411-20.
28. Reynolds T, Dweck AC. Aloe vera leaf gel: a review update. J Ethnopharmacol. 1999 Dec 15;68(1-3):3-37.
29. Shelton RM. Aloe vera. Its chemical and therapeutic properties. Int J Dermatol. 1991 Oct;30(10):679-83.
IssueVol 20 (Continuously Published Article-Based) QRcode
SectionOriginal Article
DOI https://doi.org/10.18502/fid.v20i4.12358
Keywords
Medicine Traditional Aloe; Clobetasol Clinical Trial Oral Lichen Planus

Rights and permissions
Creative Commons License This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
How to Cite
1.
Vaidya A, Khorate M, Chinam N, Figueiredo N. Efficacy of Aloe Vera and Clobetasol Propionate in the Management of Oral Lichen Planus: A Randomized Parallel Clinical Trial. Front Dent. 2023;20.