Comparison of the effectiveness of photodynamic therapy and topical clobetasol in the treatment of oral lichen planus using fractal dimension analysis and lesion autofluorescence.

BACKGROUND: Oral lichen planus (OLP) is an inflammatory condition of mucous membranes with an immunological basis. To date, no standardized treatment protocol has been established. Another complicating factor in clinical research is the assessment of disease activity and treatment efficacy. Fractal dimension analysis offers an objective method for evaluating mucosal irregularities, making it well suited for assessing OLP lesion morphology and treatment outcomes.

OBJECTIVES: The aim of the present study was to assess the effectiveness of photodynamic therapy (PDT) using methylene blue as a photosensitizer and topical clobetasol therapy in the treatment of OLP.

MATERIAL AND METHODS: Fractal dimension analysis of oral mucosa images under white light and 405 + 450 nm light was used as an objective method of treatment evaluation.

RESULTS: The use of autofluorescence at 405 + 450 nm enabled the detection of subtle differences in the pattern of the healed mucosa as compared to the reference mucosa, which were not visible during conventional white-light examination. Both treatment methods (topical clobetasol and PDT using methylene blue) demonstrated comparable efficacy in treating OLP.

CONCLUSIONS: The use of autofluorescence at 405 + 450 nm is an objective method of assessing healing, more accurate than observations under white light.