Efficacy of Photodynamic Therapy With 5-Aminolevulinic Acid-Loaded Oromucosal Emulgel in Patients With Oral Lichen Planus: A Randomized Controlled Clinical Study

INTRODUCTION AND AIMS: Oral lichen planus (OLP) is a frequently encountered chronic mucosal condition that may predispose individuals to malignant transformations. Currently, the aetiology of OLP remains undefined, leading to a focus on alleviating clinical symptoms and subjective discomfort. The study aimed to clinically compare the effectiveness of photodynamic therapy with 5-aminolevulinic acid-loaded oromucosal emulgel (ALA-PDT) vs conventional corticosteroid therapy (CT) in treating patients with symptomatic OLP. METHODS: The study included 90 patients aged 29 to 88 years, randomly assigned to receive either ALA-PDT or CT. The lesion size, as well as Reticulation, Erythema, Ulceration index, and visual analogue scale were assessed before treatment, directly after treatment, and 6 months after treatment. RESULTS: The findings revealed that ALA-PDT resulted in a healing rate of 54.84% (51 out of 93 lesions), significantly higher than the 19.12% (13 out of 68 lesions) observed in the CT group. ALA-PDT also resulted in a notable reduction in lesion size from an average of 2.45 to 0.69 cm² after 6 months. The Reticulation, Erythema, Ulceration index (Reticulation, Erythema, Ulceration) and visual analogue scale scores indicated more favourable outcomes and sustained pain relief for patients receiving ALA-PDT. CONCLUSION: While both therapies demonstrated effectiveness, ALA-PDT exhibited better long-term results in terms of lesion size reduction and symptom alleviation, suggesting its potential as a preferred treatment option for OLP. The study underscores the need for further research into optimizing ALA-PDT protocols and developing commercially available photosensitizer formulations specifically for oral mucosa applications. CLINICAL RELEVANCE: PDT using adhesive emulgel with 5-aminolevulinic acid allows the achievement of satisfactory effects of OLP treatment.