Management of reticular oral lichen planus patients with burning mouth syndrome-like oral symptoms: a pilot study

Objectives: We sought to determine the efficacy of psychotropic drug in the management of BMS-like oral symptoms in patients with reticular oral lichen planus (R-OLP) refractory to conventional therapies, and its impact on anxious and depressive symptoms. Materials and methods: We enrolled 28 cases of symptomatic R-OLP. The Numeric Rating Scale (NRS), the Total Pain Rating Index (T-PRI), the Hamilton rating scales for Depression (HAM-D) and Anxiety (HAM-A) were performed at baseline (time 0), after 2 months of topical clonazepam (time 1) and after 6 months of benzodiazepine and antidepressant drugs (time 2). Results: R-OLP patients showed a statistically significant improvement in the NRS and T-PRI scores from time 0 [median: 9.0 (IQR: 7.2–10.0) and 10.5 (IQR: 7.0–13.0), respectively] to time 2 [(median: 2.0 (IQR: 2.0-3.0) (p <.001) and 3.0 (IQR: 2.0–4.7) (p <.001), respectively]. Similarly, the HAM-A and HAM-D scores showed an improvement from time 0 [(median: 15.0 (IQR: 10.2–17.8) and 13.0 (IQR: 12.0–15.0), respectively] to time 2 [median: 6.0 (IQR: 4.0–7.0) (p <.001) and 5.5 (IQR: 4.25–6.0) (p <.001), respectively]. Conclusions: Psychotropic drugs turned out to be effective in the management of BMS-like oral symptoms in R-OLP patients refractory to conventional immunosuppressive therapy, although in a long-term period.