Evaluation of the Efficacy of Topical Timolol Therapy on Oral Lichen Planus: Clinical and Immunohistochemical Study

Abstract

Aims: To evaluate the efficacies of Timolol topical therapy in patients with atrophic- erosive Oral Lichen Planus (OLP). Study Design: This study was conducted in outpatient clinic of Department of Oral Medicine, Oral Diagnosis and Periodontology, Faculty of Dentistry, Minia University and Department of Oral Pathology, Faculty of Dentistry, Tanta University. Methodology: This study included 20 patients with symptomatic OLP of 4-7 years duration. They were classified into two groups; Group A: treated by 0.1% topical triamcinolone acetonide paste and Group B: treated by 10 drops of 0.5% Timolol. Each patient was monitored 4 times every 2 weeks for 2 months. The objective and subjective clinical progress was assessed using the clinical score (CS) and a Visual Analog Scale (VAS). Biopsies were taken at baseline and after treatment, stained with H&E and immunohistochemically for VEGF, Ki-67 and CD34. Results: All patients showed significant improvement in all outcomes within the follow up periods when compared with the baseline (P < 0.05). Both drugs resulted in reduction of pain and lesion size. No significant difference was found between both studied groups at the end of week 8 in terms of VAS and CS scores (P > 0.05). In Timolol group, VEGF expression was reduced and Ki-67 labeling index was decreased from 19% to 11%. The mean number of MVD was (44.50±6.03) at baseline became (25.56±6.44) after treatment. The degree of inflammation was also decreased. Conclusion:  Topical Timolol has similar therapeutic effects of triamcinolone acetonide paste on atrophic-erosive OLP that could be used a second alternative therapy. Further studies on a larger sample for longer period is required to evaluate the efficacy, safety and the molecular mechanism behind Timolol therapeutic effects on OLP.