Objectives
The aim of this study was to examine the clinical behavior and response to topical
methyl 5-aminolevulinate (MAL) photodynamic therapy (PDT) of oral lichen planus and
to describe the buildup and biodistribution of photoactive porphyrins in normal and
lichen planus–affected oral mucosa after MAL application.
Study Design
The difference in clinical expression in 14 patients with buccal oral lichen planus
was compared before and after treatment. MAL-induced photoactive porphyrins were monitored
using noninvasive in situ fluorescence measurements. Microfluorometry was used to
study the biodistribution.
Results
The absorption and conversion of protoporphyrin IX (PpIX) in epithelial and subepithelial
T cells was demonstrated in histologic sections. As a result of 1 treatment session,
there was a significant improvement of oral lichen planus after 6 months (P = 0.02) and during a 4-year follow-up period.
Conclusions
MAL is absorbed and converted to PpIX in T cells. Oral lichen planus treated with
MAL-PDT showed lasting improvement after a single treatment.
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References
- Definition of leukoplakia and related lesion: an aid to studies on oral precancer.Oral Surg Oral Med Oral Pathol. 1978; 46: 518-539
- Oral lichen planus: clinical features and management.Oral Dis. 2005; 11: 338-349
- Oral lichen planus: a review.Semin Dermatol. 1994; 13: 87-90
- Oral lichen planus: a review.Br J Oral Maxillofac Surg. 2000; 38: 370-377
- Pathophysiology, etiologic factors, and clinical management of oral lichen planus, part I: facts and controversies.Clin Dermatol. 2010; 28: 100-108
- Oral lichen planus—a demographic study.Community Dent Oral Epidemiol. 1987; 15: 52-56
- Oral lichen planus: an update on pathogenesis and treatment.J Oral Maxillofac Pathol. 2011; 15: 127-132
- CD27 and CD38 lymphocytes are detected in oral lichen planus lesions.Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2011; 111: 211-217
- The possible premalignant character of oral lichen planus and oral lichenoid lesions: a prospective study.Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2003; 96: 164-171
- Current controversies in oral lichen planus: report of an international consensus meeting.Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2005; 100: 40-51
- Methylene blue-mediated photodynamic therapy: a possible alternative treatment for oral lichen planus.Lasers Surg Med. 2006; 38: 33-38
- Clinical management of oral lichen planus.Br J Oral Maxillofac Surg. 1999; 37: 338-343
- The management of oral lichen planus.Clin Exp Dermatol. 2000; 25: 176-182
- Effectiveness of extracorporeal photochemotherapy in the treatment of a case of refractory erosive lichen planus.J Dermatolog Treat. 2010; 21: 119-121
- Treatment of oral lichen planus with methylene blue mediated photodynamic therapy—a clinical study.Photodermatol Photoimmunol Photomed. 2012; 28: 97-101
- Double-blind, crossover, placebo-controlled clinical trial with clobetasol propionate in desquamative gingivitis.Braz Dent J. 2009; 20: 231-236
- Topical tacrolimus and pimecrolimus in the treatment of oral lichen planus: an update.J Oral Pathol Med. 2010; 39: 201-205
- Update on oral lichen planus: etiopathogenesis and management.Crit Rev Oral Biol Med. 1998; 9: 86-122
- A prospective follow-up study of 570 patients with oral lichen planus: persistence, remission, and malignant association.Oral Surg Oral Med Oral Pathol. 1985; 60: 30-34
- Mouth PUVA: new treatment for recalcitrant oral lichen planus.Photodermatol. 1987; 4: 165-166
- An open clinical trial of a new mouth-PUVA variant in the treatment of oral lichenoid lesions.Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 1997; 84: 502-505
- A clinical trial of PUVA treatment in oral lichen planus.Proc Finn Dent Soc. 1989; 85: 29-33
- Oral cancer development in patients with oral lichen planus.J Oral Pathol Med. 1993; 22: 421-424
- Lichen planus and lichenoid lesions of the oral cavity.Ann Otol Rhinol Laryngol. 1994; 103: 495-497
- The possible association between oral lichen planus and oral squamous cell carcinoma: a clinical evaluation on 14 cases and a review of the literature.Oral Oncol. 1998; 34: 239-246
- Clinical guidelines in early detection of oral squamous cell carcinoma arising in oral lichen planus: a 5-year experience.Oral Oncol. 2001; 37: 262-267
- A review of the recent literature regarding malignant transformation of oral lichen planus.Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 1999; 88: 307-310
- 5-Aminolevulinic acid-based photodynamic therapy.Cancer. 1997; 79: 2282-2303
- Editorial: photodynamic therapy and detection.J Environ Pathol Toxicol Oncol. 2006; 25: 1-5
- An overview of topical photodynamic therapy in dermatology.Photodiagnosis Photodyn Ther. 2010; 7: 16-23
- ALA and its clinical impact, from bench to bedside.Photochem Photobiol Sci. 2008; 7: 283-289
- Efficacy of photodynamic therapy in vulvar lichen sclerosus treatment based on immunohistochemical analysis of CD34, CD44, myelin basic protein, and Ki67 antibodies.Int J Gynecol Cancer. 2010; 20: 879-887
- Photodynamic therapy in dentistry.J Dent Res. 2007; 86: 694-707
- Photodynamic treatment of oral lesions.J Environ Pathol Toxicol Oncol. 2007; 26: 127-133
- Photodynamic therapy using 5-aminolevulinic acid for premalignant and malignant lesions of the oral cavity.Cancer. 1996; 78: 1374-1383
- Treatment of oral leukoplakia by topical application of 5-aminolevulinic acid.Int J Oral Maxillofac Surg. 1998; 27: 466-469
- Successful treatment of oral verrucous hyperplasia and oral leukoplakia with topical 5-aminolevulinic acid–mediated photodynamic therapy.Lasers Surg Med. 2005; 37: 114-122
- Photodynamic therapy with topical 5-aminolevulinic acid for mycosis fungoides: clinical and histological response.Acta Derm Venereol. 2001; 81: 184-188
- Topical 5-aminolevulinic acid photodynamic therapy for the treatment of unilesional mycosis fungoides: a report of two cases and review of the literature.Int J Dermatol. 2008; 47: 410-413
- Photodynamic therapy with methylaminolevulinate as a valuable treatment option for unilesional cutaneous T-cell lymphoma.Photodermatol Photoimmunol Photomed. 2006; 22: 254-258
- Lichenoid drug eruptions.J Am Acad Dermatol. 1993; 29: 249-255
- Clinical evaluation in treatment of oral lichen planus with topical fluocinolone acetonide: a 2-year follow-up.J Oral Pathol Med. 2003; 32: 315-322
- Guidelines for practical use of MAL-PDT in non-melanoma skin cancer.J Eur Acad Dermatol Venereol. 2010; 24: 505-512
- Effect of dental plaque control on gingival lichen planus.Oral Surg Oral Med Oral Pathol. 1990; 69: 585-590
- Mechanism of cell death by 5-aminolevulinic acid–based photodynamic action and its enhancement by ferrochelatase inhibitors in human histiocytic lymphoma cell line U937.Cell Biochem Funct. 2009; 27: 503-515
- Deletion of alloantigen-activated cells by aminolevulinic acid-based photodynamic therapy.Photochem Photobiol. 1999; 69: 560-565
- Fluorescence diagnostics of basal cell carcinomas comparing methyl-aminolaevulinate and aminolaevulinic acid and correlation with visual clinical tumour size.Acta Derm Venereol. 2011; 91: 398-403
- Oral lichen planus versus oral lichenoid reaction: difficulties in the diagnosis.Indian J Dent Res. 2009; 20: 361-364
- Side effects and photosensitization of human tissues after aminolevulinic acid.J Surg Res. 1997; 68: 31-37
Article info
Publication history
Accepted:
August 20,
2012
Received in revised form:
August 14,
2012
Received:
May 4,
2012
Identification
Copyright
© 2013 Elsevier Inc. Published by Elsevier Inc. All rights reserved.
