Clinical Study
Combination Therapy with 1% Nanocurcumin Gel and 0.1%
Triamcinolone Acetonide Mouth Rinse for Oral Lichen Planus: A
Randomized Double-Blind Placebo Controlled Clinical Trial
Mahin Bakhshi ,
1
Shahzad Gholami,
1
Arash Mahboubi,
2
Mahmoud Reza Jaafari,
3
and Mahshid Namdari
4,5
1
Department of Oral Medicine, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran
2
Food Safety Research Center, Department of Pharmaceutics, School of Pharmacy,
Shahid Beheshti University of Medical Sciences, Tehran, Iran
3
Department of Pharmaceutical Nanotechnology, School of Pharmacy, Mashhad University of Medical Sciences, Mashhad, Iran
4
Department of Community Oral Health, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran
5
Department of Biostatistics, School of Allied Medical Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
Correspondence should be addressed to Mahin Bakhshi; mahinbakhshi@yahoo.com
Received 15 March 2020; Revised 24 April 2020; Accepted 5 May 2020; Published 20 May 2020
Academic Editor: E. Helen Kemp
Copyright©2020MahinBakhshietal.isisanopenaccessarticledistributedundertheCreativeCommonsAttributionLicense,
which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Objectives.isstudyaimedtoevaluatetheefficacyofacombinationof1%nanocurcumingelwith0.1%triamcinoloneacetonide
mouthrinsefororallichenplanus(OLP). MaterialsandMethods.isdouble-blindrandomizedclinicaltrialwasconductedon31
patients with erosive or ulcerative OLP. All patients received 0.1% triamcinolone mouth rinse and were then randomly divided
intotwogroupsforcombinationtherapywith(I)%1nanocurcumingelor(II)placebogel.ereticular-erosive-ulcerative(REU)
score was calculated at baseline and at two and four weeks after the intervention. e changes in the mean REU score and the
efficacy index were calculated to determine the level of improvement after two and four weeks. Data were analyzed using
independent t-test, repeated measures ANCOVA, Mann–Whitney test, and chi-square test. P < 0.05 was considered statistically
significant. Results. ere were 14 patients in the nanocurcumin and 17 patients in the placebo group. A significantly higher
decrease in the mean REU score was observed in the nanocurcumin compared with the placebo group (P < 0.001). e efficacy
index was significantly higher in the nanocurcumin group (P < 0.001). Conclusion. Application of 1% nanocurcumin in
combinationwith0.1%triamcinoloneacetonidecanserveasaneffectivetreatmentstrategytoenhancethelevelofimprovement
of lesions compared with the use of triamcinolone acetonide alone.
1. Introduction
Oral lichen planus (OLP) is a chronic mucocutaneous
disorder with an unknown etiology [1–4]. It occurs as a
result of an immunological cytotoxic reaction against ker-
atinocytes, causing vacuolar degeneration of basal cells [5].
e clinical manifestation of OLP includes a white patch
with red components in reticular, papular, plaque-like,
vesicular,erythematous,erosive,orulcerativeforms[4].e
diagnosis and treatment of erosive, atrophic, and ulcerative
typesareclinicallyimportantduetohavingsymptomssuch
as burning sensation and pain as well as the potential for
malignant transformation [6]. Treatment of OLP aims to
decreaseerythema,resolvethemucosalulcers,anddecrease
the disease symptoms during the course of activation and
prolong the remission period. Corticosteroids are the basis
of treatment of symptomatic OLP [4]. However, due to the
chronic nature of the disease, it requires long-term corti-
costeroid therapy, which can have numerous complications
and side effects such as candidiasis, burning sensation, and
badtasteinthemouth,mucosalatrophy,nausea,sorethroat,
and xerostomia. Also, long-term systemic corticosteroid
therapy may even cause adrenal insufficiency [4]. Triam-
cinolone acetonide is a moderate-to-strong corticosteroid
Hindawi
Dermatology Research and Practice
Volume 2020, Article ID 4298193, 7 pages
https://doi.org/10.1155/2020/4298193