What do systematic reviews say?

1% pimecrolimus cream vs Placebo (vehicle cream)

1% pimecrolimus cream showed no clear difference in physician Global Assessment (surface of erosive lesions) compared with placebo (vehicle cream); GRADE not reported.

• Interventions for erosive lichen planus affecting mucosal sites 2012 · Cochrane All outcomes
  MD -0.50 [-1.39, 0.39]
  1 study · 12 participants
  GRADE not reported

0.1% triamcinolone acetonide in orabase vs ciclosporin

0.1% triamcinolone acetonide in orabase led to higher pain reduction (VAS 0-100) compared with ciclosporin solution; GRADE not reported.

• Interventions for erosive lichen planus affecting mucosal sites 2012 · Cochrane All outcomes
  MD 45.17 [8.73, 81.61]
  1 study · 11 participants
  GRADE not reported

Topical ciclosporin 1.5% gel vs Topical clobetasol propionate 0.025% gel

• Interventions for erosive lichen planus affecting mucosal sites 2012 · Cochrane All outcomes
  Topical clobetasol gave less stable results than ciclosporin when therapy ended and showed a higher incidence of side-effects (Conrotto 2006, n=40).
  1 study · 40 participants
  GRADE not reported

Topical clobetasol propionate 0.025% vs clobetasol cream 0.05% cream

Topical clobetasol propionate 0.025% showed no clear difference in pain reduction (VAS) compared with topical clobetasol propionate 0.05%; GRADE not reported.

• Interventions for erosive lichen planus affecting mucosal sites 2012 · Cochrane All outcomes
  MD -0.26 [-1.42, 0.90]
  1 study · 30 participants
  GRADE not reported

Brief motivational interviewing (BMI) vs usual treatment alone

Brief one-session, manual-guided discussion based on the principles… led to lower alcohol consumption: consuming more than 21 units of alcohol per week compared with treatment at the outpatient clinic as usual; GRADE not reported.

• One‐to‐one dietary interventions undertaken in a dental setting to change dietary behaviour 2012 · Cochrane All outcomes

  12 months
  RR 0.52 [0.32, 0.85]
  1 study · 151 participants
  GRADE not reported

1% pimecrolimus cream vs Placebo (vehicle cream)

• Interventions for erosive lichen planus affecting mucosal sites 2012 · Cochrane All outcomes
  Table 3 (Side-effects). Passeron 2007: 1% pimecrolimus well-tolerated, transient burning (2) during the first 2 weeks. Swift 2005: pimecrolimus - slight burning of the tip of the tongue after applying 1% pimecrolimus…
  3 studies · 52 participants
  GRADE not reported

1% pimecrolimus cream vs Placebo (vehicle cream)

1% pimecrolimus cream led to higher physician Global Assessment (strong improvement) compared with placebo (vehicle cream); GRADE not reported.

• Interventions for erosive lichen planus affecting mucosal sites 2012 · Cochrane All outcomes
  RR 7.00 [1.04, 46.95]
  1 study · 20 participants
  GRADE not reported

1% pimecrolimus cream vs Placebo (vehicle cream)

• Interventions for erosive lichen planus affecting mucosal sites 2012 · Cochrane All outcomes
  One study (Passeron 2007) assessed participant global self-assessment on a 5-point scale: 5/6 participants in the 1% pimecrolimus group rated their improvement as moderate or important versus 1/6 in the placebo group…
  1 study · 12 participants
  GRADE not reported

Sulodexide (heparin plus dermatan sulphate chains) vs prednisone

• Systemic interventions for recurrent aphthous stomatitis (mouth ulcers) 2012 · Cochrane All outcomes
  A comparison between sulodexide (n=10) and prednisone (n=10) was made in a trial at high risk of bias (Femiano 2003). Data presented as ranges/totals only with no estimate of variability, precluding further analysis.…
  1 study · 20 participants
  GRADE not reported

Any topical or systemic intervention (topical/systemic steroids, ciclosporin, tacrolimus, retinoids, anti-malarials, biologics, phototherapy, surgery) vs Placebo, no treatment, another active intervention, or a different dose of the same intervention

The review found no eligible studies for this question.

• Interventions for erosive lichen planus affecting mucosal sites 2012 · Cochrane All outcomes
  No studies reported this outcome.
  0 studies
  No studies found

Fluticasone propionate spray vs Betamethasone sodium phosphate mouthwash

• Interventions for erosive lichen planus affecting mucosal sites 2012 · Cochrane All outcomes
  In the Hegarty 2002 cross-over trial (n=22), no statistical testing of the pain score (VAS 0 to 100) was reported; it is not clear whether the difference is statistically significant (fluticasone mean score 19.8 versus…
  1 study · 22 participants
  GRADE not reported

Fluocinonide in adhesive base vs placebo

Fluocinonide in adhesive base showed no clear difference in physician Global Assessment (clinical signs, complete response) compared with placebo; GRADE not reported.

• Interventions for erosive lichen planus affecting mucosal sites 2012 · Cochrane All outcomes
  RR 4.67 [0.24, 88.96]
  1 study · 27 participants
  GRADE not reported

Clobetasol-17-propionate 0.025% lipid-loaded microspheres vs Clobetasol propionate 0.025% ointment

• Interventions for erosive lichen planus affecting mucosal sites 2012 · Cochrane All outcomes
  Table 3 (Side-effects). Campisi 2004: oral candidiasis (1 in the lipid-loaded microspheres group, 2 in the conventional ointment group). None serious.
  1 study · 50 participants
  GRADE not reported

Tacrolimus 0.1% vs Topical clobetasol propionate 0.05% ointment

• Interventions for erosive lichen planus affecting mucosal sites 2012 · Cochrane All outcomes
  Table 3 (Side-effects). Radfar 2008: burning sensation with topical tacrolimus; transient burning within the first 2 weeks resulted in withdrawal of therapy in 1 participant.
  1 study · 29 participants
  GRADE not reported

Fluticasone propionate spray vs Betamethasone sodium phosphate mouthwash

• Interventions for erosive lichen planus affecting mucosal sites 2012 · Cochrane All outcomes
  No statistical testing of the mean surface area of lesions was reported in Hegarty 2002 (fluticasone mean score 547.2 mm2 versus betamethasone mean score 671.9 mm2).
  1 study · 22 participants
  GRADE not reported

Any topical or systemic intervention (topical/systemic steroids, ciclosporin, tacrolimus, retinoids, anti-malarials, biologics, phototherapy, surgery) vs Placebo, no treatment, another active intervention, or a different dose of the same intervention

The review found no eligible studies for this question.

• Interventions for erosive lichen planus affecting mucosal sites 2012 · Cochrane All outcomes
  None of the included studies assessed the effectiveness of treatments of genital ELP; thus, this outcome was not reported.
  0 studies
  No studies found

1% pimecrolimus cream vs Placebo (vehicle cream)

1% pimecrolimus cream showed no clear difference in complete clinical response (complete clearance) compared with placebo (vehicle cream); GRADE not reported.

• Interventions for erosive lichen planus affecting mucosal sites 2012 · Cochrane All outcomes
  RR 3.50 [0.95, 12.90]
  1 study · 20 participants
  GRADE not reported

Sulodexide (heparin plus dermatan sulphate chains) vs prednisone

• Systemic interventions for recurrent aphthous stomatitis (mouth ulcers) 2012 · Cochrane All outcomes
  Sulodexide was without significant adverse events; one significant adverse event (gastritis) was reported for the prednisone group.
  1 study · 20 participants
  GRADE not reported

Topical ciclosporin 1.5% gel vs Topical clobetasol propionate 0.025% gel

Topical ciclosporin 1.5% gel led to higher partial response (partial or complete response) compared with topical clobetasol propionate 0.025% gel; GRADE not reported.

• Interventions for erosive lichen planus affecting mucosal sites 2012 · Cochrane All outcomes
  RR 1.46 [1.04, 2.04]
  1 study · 40 participants
  GRADE not reported

1% pimecrolimus cream vs Placebo (vehicle cream)

• Interventions for erosive lichen planus affecting mucosal sites 2012 · Cochrane All outcomes
  In Passeron 2007 (n=12), all participants who improved during treatment relapsed within 1 month of ceasing treatment.
  1 study · 12 participants
  GRADE not reported