Photodynamic Therapy Plus Topical Corticosteroid for Erosive Oral Lichen Planus: A Randomized Clinical Trial

INTRODUCTION AND AIMS: Erosive oral lichen planus (E-OLP) is a chronic inflammatory condition that poses a therapeutic challenge due to its recurrent nature and potential for malignant transformation. This study aims to evaluate the efficacy and safety of methylene blue-mediated photodynamic therapy (MB-PDT) combined with topical corticosteroid in treating E-OLP. METHODS: This single-centre, single-blinded, randomized, controlled trial was performed from March 2024 to August 2025. A total of 74 patients with E-OLP were randomly assigned to the MB-PDT group (n = 37) receiving MB-PDT plus 0.1% triamcinolone acetonide (TA) and the TA group (n = 37) treating with topical TA alone. The primary outcome was the clinical efficacy rate between the two groups. RESULTS: After 4 weeks of treatment, the clinical efficacy rate was significantly higher in the MB-PDT group than in the TA group (P = .006). Change in the Numeric Rating Scale scores were significantly greater in the MB-PDT group compared to the TA group consistently from week 4 to week 12 (P < .01). The recurrence rate was also significantly lower in MB-PDT group compared to TA group at the 12-week follow-up (P = .038). No adverse events were observed during and after treatment. CONCLUSION: MB-PDT combined with topical corticosteroid appears to be a safe and effective therapeutic approach for E-OLP, with findings suggesting superior pain relief, lesion healing, and reduced recurrence compared with topical corticosteroid. CLINICAL RELEVANCE: This combination therapy is expected to become a promising management option for patients with E-OLP, with potential to improve long-term disease control and quality of life.