Treatment of Oral Lichen Planus with Intralesional Injection of Steroids: Case Reports

Abstract

Oral lichen planus (OLP) is a chronic inflammatory disease of unknown etiology affecting the oral mucosa. As it is difficult to cure, long-term management aims to improve the patient’s quality of life by reducing inflammation and alleviating pain. While systemic and topical corticosteroids are commonly used treatments, their efficacy is often limited by side effects or poor compliance. This study investigates the effectiveness of intralesional steroid injections (ILIs) in patients resistant to conventional therapies. Two patients with refractory OLP were treated with intralesional triamcinolone acetonide injections administered directly into affected mucosal sites at minimal intervals. Clinical outcomes were assessed over an extended follow-up period using the Numerical Rating Scale (NRS) for pain and evaluations of lesion severity. Both patients exhibited significant and sustained improvements in pain and lesion severity following ILIs treatment. In one case, the NRS score decreased from 8 to 2 over multiple visits, with no additional injections needed in the last 6 months. In the other case, the NRS score improved from 6 to 1, requiring minimal injections for maintenance. The localized treatment was well-tolerated without significant side effects. ILIs are an effective and safe treatment for refractory OLP, offering durable symptom relief while minimizing systemic exposure and associated side effects. This approach provides a practical option for long-term management of OLP, enhancing patient quality of life when conventional therapies are inadequate. Future research should explore the potential of combining ILI with other immunomodulatory agents to further improve therapeutic outcomes.