Int J Stomatol

Int J Stomatol ›› 2022, Vol. 49 ›› Issue (6): 633-640.doi: 10.7518/gjkq.2022099

• Original Articles • Previous Articles     Next Articles

Oral beta-carotene in the treatment of non-erosive oral lichen planus: a randomized controlled trial

Zhang Shenyi1(),Wang Xiangjian1,2,Shi Liran1,Shi Jiahong1,Wang Yuhong1,3(),Zhou Hongmei1   

  1. 1.State Key Laboratory of Oral Diseases & National Center of Stomatology & National Clinical Research Center for Oral Diseases & Frontier Innovation Center for Dental Medicine Plus & Dept. of Oral Medicine, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
    2.Dept. of Oral Medicine, The Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou 310009, China
    3.Dept. of Oral Medicine, School of Stomatology, The Air Force Medical University, Xi’an 710032, China
  • Received:2022-02-05 Revised:2022-06-02 Online:2022-11-01 Published:2022-11-03
  • Contact: Yuhong Wang E-mail:2019224035147@stu.scu.edu.cn;wangyuhonghuaxi@163.com
  • Supported by:
    National Natural Science Foundation of China(82071124)

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Abstract:

Objective This study aims to illustrate the efficacy and safety of oral beta-carotene in the treatment of non-erosive oral lichen planus (OLP) by designing and conducting a randomized controlled clinical trial. Methods A total of 74 patients with non-erosive OLP and widespread white lesions were randomized into the experimental group (n=38) who received oral beta-carotene soft capsules (6 mg p.o. q.d.) or the control group (n=36) who received oral vitamin E soft capsules (100 mg p.o. q.d.) for 6 months continuously. Then, the white area, keratotic degree, pain level, and adverse effects were recorded at the first visit and after 3 and 6 months of treatment. If the white lesions disappeared, any recurrence du-ring the follow-up period was recorded. Results The final diminution in white lesion areas (both P<0.001) and keratotic degree scores (P=0.018, P=0.001) were significantly greater with beta-carotene than with vitamin E after 3 and 6 months of treatment, respectively. However, the intergroup differences in the reduction of pain level were not significant (P>0.05). No severe adverse reactions were found in both groups. Recurrence rates did not significantly differ between groups (P>0.05). Conclusion Oral beta-carotene is an effective and safe alternative for the treatment of non-erosive OLP.

Key words: oral lichen planus, beta-carotene, vitamin E, white lesions, non-erosive type

CLC Number: 

  • R 781.5

TrendMD: 

Fig 1

A graphical semi-quantitative scoring system for the keratotic degree score of white lesions in OLP"

Fig 2

Flow diagram of the trial process"

Tab 1

Comparison of baseline characteristics of the patients enrolled in this trial"

测量项目试验组（n=38）对照组（n=36）P值
年龄/岁xˉ±s40.6±12.741.2±11.10.824
范围18.0~60.021.0~60.0
性别/例（%）男17（44.7）15（41.7）0.790
女21（55.3）21（58.3）
病程/月xˉ±s16.6±7.917.0±10.80.825
范围2.0~36.02.0~48.0
白色病损面积/cm2xˉ±s11.6±6.39.8±5.30.252
角化程度评分xˉ±s2.2±0.62.4±0.50.404
NRS评分xˉ±s1.9±1.02.0±1.10.421

Tab 2

Comparison of white lesion areas, degree of keratinization, and NRS scores of the patients who completed the trial"

测量项目观察期分组例数下四分位数中位数上四分位数Z值P值
白色病损面积/cm2治疗前

试验组

对照组

33

34

6.4

5.2

10.0

8.7

14.9

12.5

-1.186a0.236
治疗3个月后

试验组

对照组

33

34

0.8

2.5

2.2

4.8

5.3

11.1

-4.918b

-4.623b

0.000

0.000

3个月内差值

试验组

对照组

33

34

3.8

0.5

6.1

1.4

11.0

4.8

-3.903a0.000
治疗6个月后

试验组

对照组

33

34

0.0

0.0

0.0

2.5

0.6

8.3

-5.012b

-5.087b

0.000

0.000

6个月内差值

试验组

对照组

33

34

5.9

2.6

9.1

4.1

14.3

8.2

-3.945a0.000
角化程度评分治疗前

试验组

对照组

33

34

2.0

2.0

2.0

2.0

3.0

3.0

-0.860a0.390
治疗3个月后

试验组

对照组

33

34

1.0

1.0

1.0

1.0

1.0

2.0

-5.248b

-5.488b

0.000

0.000

3个月内差值

试验组

对照组

33

34

1.0

1.0

1.0

1.0

1.0

1.0

-2.358a0.018
治疗6个月后

试验组

对照组

33

34

0.0

0.0

0.0

1.0

1.0

2.0

-5.143b

-4.466b

0.000

0.000

6个月内差值

试验组

对照组

33

34

1.5

0.0

2.0

1.0

2.0

2.0

-3.295a0.001
NRS评分治疗前

试验组

对照组

33

34

1.0

2.0

2.0

2.0

3.0

3.0

-0.762a0.446
治疗3个月后

试验组

对照组

33

34

1.0

1.0

2.0

2.0

3.0

3.0

-0.046b

-1.547b

0.963

0.122

3个月内差值

试验组

对照组

33

34

-1.0

0.0

0.0

0.0

1.0

1.0

-1.082a0.279
治疗6个月后

试验组

对照组

33

34

1.0

1.8

2.0

2.0

2.0

3.0

-0.778b

-0.688b

0.437

0.491

6个月内差值

试验组

对照组

33

34

-0.5

0.0

0.0

0.0

1.0

1.0

-0.162a0.871

Fig 3

Efficacy after 3-month and 6-month treatment with oral beta-carotene"

1 Li CC, Tang XQ, Zheng XY, et al. Global prevalence and incidence estimates of oral lichen planus: a systematic review and meta-analysis[J]. JAMA Dermatol, 2020, 156(2): 172-181.
2 Iocca O, Sollecito TP, Alawi F, et al. Potentially malignant disorders of the oral cavity and oral dysplasia: a systematic review and meta-analysis of malignant transformation rate by subtype[J]. Head Neck, 2020, 42(3): 539-555.
3 González-Moles MÁ, Warnakulasuriya S, González-Ruiz I, et al. Clinicopathological and prognostic characteristics of oral squamous cell carcinomas arising in patients with oral lichen planus: a systematic review and a comprehensive meta-analysis[J]. Oral Oncol, 2020, 106: 104688.
4 Maymone MBC, Greer RO, Kesecker J, et al. Premalignant and malignant oral mucosal lesions: clinical and pathological findings[J]. J Am Acad Dermatol, 2019, 81(1): 59-71.
5 中华口腔医学会口腔黏膜病学专业委员会, 中华口腔医学会中西医结合专业委员会. 口腔扁平苔藓诊疗指南(修订版)[J]. 中华口腔医学杂志, 2022, 57(2): 115-121.
Society of Oral Medicine, Chinese Stomatological Association; Society of Traditional Chinese Medicine Combined with Western Medicine, Chinese Stomatological Association. Guidelines for the diagnosis and treatment of oral lichen planus (revision)[J]. Chin J Stomatol, 2022, 57(2): 115-121.
6 Carrozzo M, Porter S, Mercadante V, et al. Oral lichen planus: a disease or a spectrum of tissue reactions? Types, causes, diagnostic algorhythms, prognosis, management strategies[J]. Periodontol 2000, 2019, 80(1): 105-125.
7 Tziotzios C, Brier T, Lee JYW, et al. Lichen planus and lichenoid dermatoses: conventional and emerging therapeutic strategies[J]. J Am Acad Dermatol, 2018, 79(5): 807-818.
8 Ioannides D, Vakirlis E, Kemeny L, et al. European S1 guidelines on the management of lichen planus: a cooperation of the European dermatology forum with the European academy of dermatology and venereology[J]. J Eur Acad Dermatol Venereol, 2020, 34(7): 1403-1414.
9 Kunz M, Urosevic-Maiwald M, Goldinger SM, et al. Efficacy and safety of oral alitretinoin in severe oral lichen planus: results of a prospective pilot study[J]. J Eur Acad Dermatol Venereol, 2016, 30(2): 293-298.
10 Le Moigne M, Bulteau S, Grall-Bronnec M, et al. Psychiatric disorders, acne and systemic retinoids: comparison of risks[J]. Expert Opin Drug Saf, 2017, 16(9): 989-995.
11 Papadimitrakopoulou VA, Lee JJ, William WN Jr, et al. Randomized trial of 13-cis retinoic acid compared with retinyl palmitate with or without beta-carotene in oral premalignancy[J]. J Clin Oncol, 2009, 27(4): 599-604.
12 Belal MH. Management of symptomatic erosive-ulcerative lesions of oral lichen planus in an adult Egyptian population using Selenium-ACE combined with topical corticosteroids plus antifungal agent[J]. Contemp Clin Dent, 2015, 6(4): 454-460.
13 Buajeeb W, Kraivaphan P, Amornchat C, et al. Reduction of micronuclei in oral lichen planus supplemented with beta-carotene[J]. J Oral Sci, 2008, 50(4): 461-467.
14 Benner SE, Winn RJ, Lippman SM, et al. Regression of oral leukoplakia with alpha-tocopherol: a community clinical oncology program chemoprevention study[J]. J Natl Cancer Inst, 1993, 85(1): 44-47.
15 Liu CX, Xie B, Yang Y, et al. Efficacy of intralesional betamethasone for erosive oral lichen planus and evaluation of recurrence: a randomized, controlled trial[J]. Oral Surg Oral Med Oral Pathol Oral Radiol, 2013, 116(5): 584-590.
16 Wu Y, Zhou G, Zeng H, et al. A randomized double-blind, positive-control trial of topical thalidomide in erosive oral lichen planus[J]. Oral Surg Oral Med Oral Pathol Oral Radiol Endod, 2010, 110(2): 188-195.
17 Li D, Li QF, Liu CX, et al. Efficacy and safety of probiotics in the treatment of Candida-associated stomatitis[J]. Mycoses, 2014, 57(3): 141-146.
18 Helgesen AL, Warloe T, Pripp AH, et al. Vulvovaginal photodynamic therapy vs. topical corticosteroids in genital erosive lichen planus: a randomized controlled trial[J]. Br J Dermatol, 2015, 173(5): 1156-1162.
19 Dewinter G, van de Velde M, Fieuws S, et al. Transversus abdominis plane block versus perioperative intravenous lidocaine versus patient-controlled intravenous morphine for postoperative pain control after laparoscopic colorectal surgery: study protocol for a prospective, randomized, double-blind controlled clinical trial[J]. Trials, 2014, 15: 476.
20 Williams AL, Pace ND, DeSesso JM. Teratogen update: topical use and third-generation retinoids[J]. Birth Defects Res, 2020, 112(15): 1105-1114.
21 Baldwin H, Webster G, Stein Gold L, et al. 50 years of topical retinoids for acne: evolution of treatment[J]. Am J Clin Dermatol, 2021, 22(3): 315-327.
22 Iqubal MA, Khan M, Kumar P, et al. Role of vitamin e in prevention of oral cancer: a review[J]. J Clin Diagn Res, 2014, 8(10): ZE05-ZE07.
23 Rai B, Kharb S, Jain R, et al. Salivary vitamin E and C in lichen planus[J]. Gomal J Med Sci, 2008, 6(2):91-92.
24 Cortés-Jofré M, Rueda JR, Asenjo-Lobos C, et al. Drugs for preventing lung cancer in healthy people[J]. Cochrane Database Syst Rev, 2020, 3: CD002141.
25 Rotondo Dottore G, Ionni I, Menconi F, et al. Antioxidant effects of β-carotene, but not of retinol and vitamin E, in orbital fibroblasts from patients with Graves’ orbitopathy (GO)[J]. J Endocrinol Investig, 2018, 41(7): 815-820.
26 Chamcheu JC, Afaq F, Syed DN, et al. Delphinidin, a dietary antioxidant, induces human epidermal keratinocyte differentiation but not apoptosis: studies in submerged and three-dimensional epidermal equ-ivalent models[J]. Exp Dermatol, 2013, 22(5): 342-348.
27 Saksida T, Jevtić B, Djedović N, et al. Redox regulation of tolerogenic dendritic cells and regulatory T cells in the pathogenesis and therapy of autoimmunity[J]. Antioxid Redox Signal, 2021, 34(5): 364-382.
28 Sardaro N, Della Vella F, Incalza MA, et al. Oxidative stress and oral mucosal diseases: an overview[J]. In Vivo, 2019, 33(2): 289-296.
29 Darwish WS, Ikenaka Y, Nakayama S, et al. β-carotene and retinol reduce benzo[a]pyrene-induced mutagenicity and oxidative stress via transcriptional modulation of xenobiotic metabolizing enzymes in human HepG2 cell line[J]. Environ Sci Pollut Res Int, 2018, 25(7): 6320-6328.
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