Phytomedicine in the Management of Oral Lichen Planus: A Review Article

caused by corticosteroids.8 Some patients exhibit steroid resistance or intolerance, limiting treatment options.Phytomedicine, also referred to as plant-derived or herbal medicine, includes therapeutic agents obtained from medicinal plants that possess anti-inflammatory, antioxidant, immunomodulatory, and wound-healing properties.9 These natural compounds have been increasingly explored as alternatives to conventional therapies, particularly in chronic inflammatory disorders, such as OLP. 10 The bioactive constituents of phytomedicines-including flavonoids, polyphenols, terpenoids, and alkaloids-can modulate inflammatory pathways, reduce oxidative stress, and promote mucosal healing, offering potential benefits in reducing symptom severity, limiting side effects associated with long-term corticosteroid use, and improving patient quality of life.Various herbal agents have demonstrated clinical efficacy in managing systemic conditions, such as diabetes mellitus, cardiovascular disorders, rheumatoid arthritis, and gastrointestinal inflammation, where conventional IntroductIonOral lichen planus (OLP) is a chronic immune-mediated disease of unknown etiology that primarily affects the oral mucous membranes.1 Although its exact pathogenesis remains unclear, genetic, immunological, infectious, and psychosocial factors have been implicated.OLP is widely regarded as a potentially malignant disorder, particularly in its erosive forms, highlighting the need for regular monitoring and appropriate management.[2][3][4] The management of OLP primarily involves alleviating the symptoms, controlling inflammation, and preventing potential malignant transformation.For most patients, topical corticosteroids remain the first-line therapy, particularly for symptomatic erosive or ulcerative lesions, with agents such as clobetasol or fluocinonide applied directly to the affected mucosa.5 Systemic corticosteroids are reserved for severe or widespread disease that does not respond to topical treatment, with careful tapering to minimize side effects.Topical calcineurin inhibitors, such as tacrolimus and pimecrolimus, are alternatives for patients resistant to corticosteroids or those with contraindications.6 Supportive measures, including good oral hygiene, avoidance of irritants, and the use of mild nonalcoholic mouth rinses, to reduce symptom severity.Given the potential risk of malignant transformation, particularly in erosive forms, regular follow-up and monitoring are essential.2 Despite the effectiveness of conventional therapiesparticularly topical and systemic corticosteroids and calcineurin inhibitors-several limitations persist.7 Recurrence is common, requiring long-term monitoring and repeated treatment courses.Mucosal thinning may occur with prolonged steroid use, increasing fragility and susceptibility to trauma.Secondary candidiasis is a frequent complication resulting from local immunosuppression