A retrospective cohort study on the efficacy of metronidazole in oral lichen planus

Abstract

Lichen planus is an inflammatory dermatosis with mucosal variants, including oral lichen planus (OLP). OLP has relapsing chronic courses and may significantly impact quality of life. Following IRB approval, we analyzed the efficacy of metronidazole as a treatment for OLP by retrospective chart review of patients seen at our institution over 10 years with an OLP diagnosis. Thirty patients with OLP were treated with metronidazole 500 mg twice daily. Most patients (n=18, 60.0%) showed improvement with metronidazole, including 10 (33.3%) with complete resolution of symptoms. Our results are limited by the nature of a retrospective review study with a relatively small cohort treated with metronidazole. Given the efficacy, mild side effect profile and the less immunosuppressive nature of metronidazole compared to alternative systemic treatment options, metronidazole is a reasonable option to try in patients with symptomatic OLP who have failed topical treatment options.