Treatment of oral lichen planus by surgical excision and acellular dermal matrix grafting: Eleven case reports and review of literature

Abstract

BACKGROUND

Oral lichen planus (OLP) is a chronic inflammatory disorder, and it can affect normal oral function. The conventional treatments for OLP are not always effective, and relapse easily occurs. Therefore, treatment of OLP is difficult and challenging. In this study, we evaluated over a long period the clinical efficacy of surgical excision and acellular dermal matrix (ADM) grafting in patients with refractory OLP.

CASE SUMMARY

Eleven patients with refractory OLP underwent a standardized protocol of surgical excision and ADM grafting. The condition of the area of the grafted wound, the intraoperative maximum mouth opening, pain, and clinical healing were assessed at postoperative follow-up visits. All patients had a flat surgical area with similar mucosal tissue coverage and local scar formation. Patients had no irritation and pain in their mucous membranes when eating acidic and spicy food. All patients’ mouth openings returned to normal within 2-6 mo after surgery. During follow-up, none of the patients had recurrence of OLP after surgery. The longest follow-up was 11 yr and the shortest was 6 mo, and none of the patients relapsed during follow-up.

CONCLUSION

Surgical excision and ADM grafting could be an effective method to treat refractory OLP.

Keywords: Lichen planus; Surgical excision; Acellular dermal matrix; Case report; Oral

Core Tip: We report 11 patients with oral lichen planus who were treated with medication but with poor efficacy, and relapse easily occurred. In order to relieve pain and avoid malignant transformation, we removed the lesions surgically and repaired the postoperative mucosal defect with acellular dermal matrix. The postoperative effect was good, the pain disappeared, and the degree of mouth opening returned to normal. No immunological rejection or recurrence of oral lichen planus was seen during follow-up of 6 mo to 11 yr.