Combined effect of topical sulfasalazine for oral lichen planus management: a randomized clinical trial

Aim: The present study was designed to assess the effectiveness of topical application of sulfasalazine in combination with topically applied corticosteroids versus using topical steroids alone as the standard control in management of symptomatic oral lichen planus (OLP). Methods: The trial involved 46 participants having symptomatic OLP. Subjects included were divided into two equal groups at random. Group C (control group), in this group patients were treated with topically applied corticosteroids only as the standard treatment of OLP. In Group T (test group) topical sulfasalazine was used in combination with topical corticosteroids in management of the OLP cases. The patients used the topical applications four times per day in an alternate sequence (in Group T). The treatment schedule was continuous for 4 weeks with one visit weekly as a follow-up. Oral hygiene measures were strictly applied with total elimination of plaque with calculus deposits removal as they implement inflammation intra-orally and ‎exaggerate together distribution and signs of OLP lesions. Each group underwent pain assessment and sign score recordings both before and after the used management strategies. Results: The results of all patients reported no unwanted reactions or complications using both treatment strategies. Both study groups reported a significant decrease in the pain scale and sign score recordings over time as shown within the intragroup findings. Group T experienced a significantly higher reduction in pain scale (starting at two weeks) and sign score results (starting at three weeks) as compared to Group C. Conclusions: Based on the data presented in this study, combination of topical sulfasalazine with topical corticosteroids is an efficient treatment in management of OLP in terms of decreasing pain scale and sign score values (Clinical Trials.gov with registration number NCT06060301).