Removal of refractory erosive-atrophic lichen planus by the CO2 laser.

UNLABELLED AIM, STUDY AND BACKGROUND: The erosive-atrophic form of Oral lichen Planus (OLP) is often associated with severe pain and burning sensation. This study investigated the efficacy of CO2 laser surgery for management of refractory erosive-atrophic OLP. METHODS Ten patients with thirteen erosive-atrophic OLP resistant to standard therapy participated in this study. The size and clinical scores of the lesions and the level of pain/discomfort were recorded before treatment. The lesions were then removed with a CO2 laser device (10600 nm, continuous wave, 5 W, slightly defocused). The subjects were evaluated 1 month and 3 months later and the response rate was assessed according to the decrease in pain, sign scores and size of the lesions. RESULTS There was a significant reduction in pain and lesion size at 1 and 3 months following laser treatment (p<0.05). The sign scores of the lesions were also significantly improved at follow-up periods compared to the pretreatment state (p<0.05). At the end of the follow-up period, 54% of the lesions showed 3 or 4 degrees of improvement in the clinical score and 23% improved 1 or 2 degrees, whereas 23% remained unchanged post-operatively compared to the pretreatment evaluation. CONCLUSION The present results indicate that the CO2 laser surgery is an effective modality for management of erosive-atrophic OLP and can be considered as a suitable alternative to standard treatment.