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Oral Lichen Planus Treated With Plasma Rich in Growth Factors

Cutis. 2022 March;109(3):163-166 | doi:10.12788/cutis.0468
March 3, 2022|Cutis
Eduardo Anitua, DDS, MD, PhD;Asier Eguia, DDS, PhD;Mohammad Hamdan Alkhraisat, MH, DDS, PhD;Laura Piñas, DDS, PhD
Author and Disclosure Information

From the University Institute for Regenerative Medicine and Oral Implantology (UPV/EHU-Fundación Eduardo Anitua), Vitoria-Gasteiz, Álava, Spain. Dr. Eguia also is from the University of the Basque Country UPV/EHU, Leioa, Vizcaya, Spain. Dr. Alkhraisat also is from BTI Biotechnology Institute, Vitoria-Gasteiz.

Dr. Anitua is the Scientific Director of BTI Biotechnology Institute and the President of Eduardo Anitua Foundation. Drs. Eguia and Piñas are researchers at the Eduardo Anitua Foundation. Dr. Piñas also served as a speaker for BTI Biotechnology Institute. Dr. Alkhraisat is a researcher at BTI Biotechnology Institute.

Correspondence: Eduardo Anitua, DDS, MD, PhD, Jose Maria Cagigal Ave, 19, 01007 Vitoria-Gasteiz, Álava, Spain (eduardo@fundacioneduardoanitua.org).

The use of plasma rich in growth factors (PRGF) is a treatment for erosive oral lichen planus (OLP) resistant to steroid therapy. An anonymous database at a clinical center was reviewed to collect demographic data, lesion type, treatment protocol, number of infiltrations, pain score, and healing time of the lesions. Fifteen patients were included in this study. All patients were diagnosed with erosive OLP. The lesions in all patients were refractory to steroid therapy (topical and systemic). Results showed that the use of plasma rich in growth factors (PRGF) could be a promising alternative for the treatment of erosive OLP refractory to steroid therapy, though new prospective studies are needed to confirm these preliminary observations.

Practice Points

  • Treating erosive oral lichen planus lesions refractory to conventional steroid treatments can be challenging for clinicians.
  • Complete re-epithelialization and total pain relief could be observed after 1 to 3 weekly perilesional infiltrations with plasma rich in growth factors.
  • No relapse of the lesions in the same area or other complications could be observed during the follow-up time.

Statistical Analysis—A Shapiro-Wilk test was carried out with the obtained data to check the normal distribution of the sample. The evolution of pain during the study was compared by paired t test. The qualitative variables were described by means of a frequency analysis. Quantitative variables were described by the mean and the SD. The data were analyzed with SPSS V15.0 for Windows (SPSS Inc). P<.05 showed statistical significance.

Results

A total of 15 patients were included in the study, all with atrophic-erosive lichen planus. Two patients were male, and 13 were female. The mean age (SD) of the patients included in the study was 55.27 (14.19) years. The mean number of outbreaks per year (SD) was 3.2 (1.7), with a range of 1 to 8 outbreaks.

Healing of OLP Lesions—The number of treatment sessions to achieve complete healing varied among the patients (Figures 1 and 2). Ten patients (66.7%) required a single session, 2 patients (13.3%) required 2 sessions, and 3 patients (20%) required 3 sessions. The mean time (SD) without lesions for the patients who required a single session was 10.9 (5.2) months (range, 6–24 months).

A, Atrophic-erosive and ulcerative recalcitrant lesions of oral lichen planus after topical and systemic corticosteroid administration. B, Total healing after 3 weekly perilesional infiltrations with plasma rich in growth factors.
FIGURE 1. A, Atrophic-erosive and ulcerative recalcitrant lesions of oral lichen planus after topical and systemic corticosteroid administration. B, Total healing after 3 weekly perilesional infiltrations with plasma rich in growth factors.

Pain Assessment—The mean (SD) score obtained on the VAS before treatment with PRGF was 8.27 (1.16); this score dropped to 1.27 (1.53) after the first treatment session and was a statistically significant difference (P=.006).

A, An oral lichen planus lesion resistant to treatment with topical and systemic corticosteroids. B, Re-epithelialization 1 week after a single perilesional infiltration with plasma rich in growth factors.
FIGURE 2. A, An oral lichen planus lesion resistant to treatment with topical and systemic corticosteroids. B, Re-epithelialization 1 week after a single perilesional infiltration with plasma rich in growth factors.

For those patients requiring more than 1 session, the mean (SD) pain scores decreased by 0.75 (0.97) points and 0 points after the first and second sessions of treatment, respectively. The mean (SD) amount of PRGF infiltrated in each patient in the first session was 2.60 (0.63) mL. In the second session, the mean (SD) amount was 1.2 (0.33) mL; these differences were statistically significant (P=.008). In the last session, the mean (SD) amount was 1.1 (0.22) mL.

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