These agents are used to treat painful, erythematous, or erosive oral lichen planus lesions.
Betamethasone (Celestone, Soluspan)
Decreases inflammation by suppressing migration of polymorphonuclear leukocytes and reversing increased capillary permeability. Affects the production of lymphokines and has an inhibitory effect on the Langerhans cells.
Fluocinolone (Synalar, Synalar-HP, Fluonid)
Medium potency. Use 0.01% or 0.025% cream, gel, or ointment with or without Orabase. Inhibits cell proliferation, is immunosuppressive, antiproliferative, and anti-inflammatory.
Clobetasol (Cormax, Olux, Temovate)
High potency. Use 0.05% ointment, gel, or cream with or without Orabase. Class I superpotent topical steroid. Suppresses mitosis and increases synthesis of proteins that decrease inflammation and cause vasoconstriction. Ointment is recommended for intraoral use. Most pharmacists mix 15 g of clobetasol with 15 g of Orabase; this mixture should be indicated on the prescription.
Beclomethasone (Beclovent, Vanceril)
Corticosteroid inhalant typically used to treat asthma. Use MDI with 50 mcg per puff. Direct inhaler to sites of greatest erythema or erosion.
Triamcinolone (Amcort, Aristocort, Aristospan)
Medium potency. Use 0.1% triamcinolone acetonide in 1% carboxy cellulose for dental paste. Alternately, use 0.1% cream in Orabase or alone as a cream, ointment, or suspension for intralesional administration.
Prednisolone (Delta-Cortef, Prednisol TBA injection)
Systemic therapy. Decreases inflammation by suppressing migration of polymorphonuclear leukocytes and by reducing capillary permeability.
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