Systemic absorption of 0.1% triamcinolone acetonide as topical application in management of oral lichen planus.

CONTEXT: Topical corticosteroids are the treatment of choice for oral lichen planus (OLP) due to its potential anti-inflammatory effect. However, chronic nature of OLP often requires long-term and frequent applications, exposing patients to local and systemic side effects.

AIM: To detect the systemic absorption of 0.1% triamcinolone acetonide (TAC) through the oral mucosa of patients with OLP.

SUBJECTS AND METHODS: This was a pilot pharmacokinetic study carried out in the Department of Oral Medicine and Radiology in collaboration with the Department of Toxicology, over 10 months. A total of twenty patients with OLP were included and advised to apply 0.1% TAC 3 times/day for 2 weeks and 2 times/day for next 2 weeks. Blood samples were obtained on the first and second visits and analyzed for triamcinolone using High pressure liquid chromatography (HPLC).

STATISTICAL ANALYSIS USED: Paired t-test was done to compare visual analog scale (VAS) score for burning sensation at the first and second visits, statistically significant if P < 0.05. The baseline demographic data were analyzed using descriptive statistics.

RESULTS: Paired t-test was done to compare VAS score for burning sensation at the first and second visits, which turned to being statistically significant (P = 0.001). Although HPLC is an established method for the detection of TAC, none of the study populations showed evidence of steroid (TAC) in the blood sample during 4 weeks of treatment duration.

CONCLUSIONS: 0.1% triamcinolone is a relatively safe drug to be used with no systemic absorption in the standard dose regimen for oral lichen palnus.