Evaluation of glutamine combined with topical corticosteroids in the treatment of erosive oral lichen planus

Introduction: Lichen planus (LP) is an inflammatory skin disease of unknown etiology. Increased oxidative stress has been implicated in the pathogenesis of erosive oral lichen planus (EOLP). Glutamine (Gln) is a source of energy for fibroblasts, immunocompetent cells, and intestinal epithelial cells involved in collagen production. It promotes protein and collagen synthesis, imparts immunity, and maintains the alimentary canal mucosa structure. Objectives: The aim of this study was to evaluate the effect of Glutamine combined with topical corticosteroid in the treatment of erosive OLP. Materials and methods: This randomized, parallel, controlled clinical study was conducted on thirty patients with a confirmed clinical and histopathological diagnosis of OLP who were randomly divided into two groups. Group 1 treated with topical steroids plus antifungal; Group 2 treated with Glutamine combined with topical steroids plus antifungal. Subjective symptoms and Visual Analogue Scale (VAS) were recorded at base line, after one month and at three months. The objective sign clinical score was recorded at baseline, one and three months post-treatment. Results:Both groups showed decrease in lesion size and symptoms of OLP. The glutamine treated group showed a significantly higher decrease in pain score in comparison to the corticosteroid treated group. Regarding the healing score, there was no statistically significant difference between the two groups. Conclusions: Glutamine as adjunctive to topical corticosteroid is effective in the treatment of EOLP; it resulted in a decrease in symptoms of the disease and more control of pain when compared to the conventional therapy. However, it has no effect on the signs of the disease.