ABSTRACT
Objectives:
The objective of the current research was to evaluate the role of vitamin D in the management of oral lichen planus.
Materials and Method:
Based on their vitamin D levels, 90 individuals with oral lichen planus were equally divided into three groups. Deficient subjects received oral vitamin D supplementation.
Result:
The majority of improvements were observed in patients who were taking vitamin D supplements. It was discovered that the data comparison was statistically considerable.
Conclusion:
It was determined that vitamin D was crucial for the management of oral lichen planus.
KEYWORDS: Deficiency, oral lichen planus, supplement, vitamin D
INTRODUCTION
The skin and mucous membranes, especially the oral mucosa, are affected by the chronic, inflammatory condition lichen planus. It is an autoimmune condition in which the immune system targets skin cells and mucosal surfaces.[1] The immune system is considered to benefit greatly from vitamin D. Additionally, innate and adaptive immune responses can be modified by vitamin D.[2]
The objective of this research was to find whether vitamin D supported oral lichen planus treatment.
MATERIALS AND METHODS
Ninety patients identified with oral lichen planus with both genders from the age group of 25 to 60 years were included after obtaining ethical approval and informed consent from participants.
A total of 90 participants were divided into three groups with 30 samples in each according to the vitamin D levels in the serum. Severe vitamin deficiency patients in Group i had serum vitamin D levels less than 15 ng/mL. Patients in Group ii had moderate vitamin deficiency and blood vitamin D levels between 15 and 20 ng/mL. Patients in group iii with blood vitamin D levels greater than 30 ng/mL were considered normal. For this study, the Kaliakatsou et al. scoring method for clinical diagnosis and treatment outcome of the condition was applied. Scoring was performed using the VAS scoring system with reading from 0 to 10 for mild to severe scores.[3]
All participants were given oral supplementation of vitamin D of 60,000 IU weekly. To avoid bias, the topical steroid application was introverted during the treatment period.
Patients with moderate vitamin D deficiency were kept as controls without vitamin D supplementation. All patients were recalled after 12 weeks and screening was performed.
RESULTS
The data were evaluated statistically using the SPSS software, version 21.0, and analysis of variance (ANOVA) test, with P < 0.05. Tables 1 and 2 show pretreatment and post-treatment objective symptoms among patients in three tested groups. The improvement in symptoms among Group i patients was found to be statistically significant. The burning feeling improved in patients who took vitamin D pills daily.
Table 1.
Pretreatment objective symptoms among patients in various groups
| Pre-treatment objective symptoms | Score 4 | Score 5 | Total |
|---|---|---|---|
| Group I | 14 (15%) | 16 (17.7%) | 30 (100%) |
| Group II | 13 (14%) | 17 (18.8%) | 30 (100%) |
| Group III | 10 (11%) | 20 (22%) | 30 (100%) |
| Total | 37 (41%) | 53 (58.8%) | 90 (100%) |
Table 2.
Post-treatment objective symptoms among various groups
| Post-treatment objective | VAS scoring | Total | ||||
|---|---|---|---|---|---|---|
|
| ||||||
| 0 | 1 | 2 | 3 | 4 | ||
| Group I | 3 (3.3%) | 8 (8.8%) | 10 (11.1%) | 6 (6.6%) | 3 (3.3%) | 30 (100%) |
| Group II | 2 (2.2%) | 9 (10%) | 9 (10%) | 8 (8.8%) | 22.2 (%) | 30 (100%) |
| Group III | 0 (0%) | 8 (8.8%) | 12 (13.3%) | 7 (7.7%) | 3 (3.3%) | 30 (100%) |
| Total | 5 (5.5%) | 25 (27.7%) | 31 (34.4%) | 21 (23.3%) | 8 (8.8%) | 90 (100%) |
DISCUSSION
The current findings showed a significant reduction in the burning sensation in Group I oral lichen planus patients receiving vitamin D therapy. Reduced sun exposure is to blame for the rising vitamin D deficiency in the general population.
A person’s chance of developing autoimmune illnesses increases when they are vit D-deficient.[4] According to a study, vitamin D encourages natural killer T (NKT) cell proliferation and increases their production of cytokines such as interleukin-4 and interferon-gamma.[5]
A chronic inflammatory condition known as lichen planus can affect the oral mucosa as well as the skin and mucous membranes. Activated vit D inhibits the growth of T lymphocytes, specifically CD8+ cells, and consequently the generation of interleukin-2.[6] A lack of vitamin D may contribute to the development of oral lichen planus by disrupting the regulation of T cell proliferation.[7]
The most frequent factor cited as contributing to oral lichen planus is stress. A 40-year-old woman was reported to have experienced a significant improvement in her oral lichen planus following an intramuscular injection of 300,000 units of cholecalciferol.[8] Due to its impact on the NF-kB signaling system, 1,25(OH)2D3 has an anti-inflammatory effect on oral lichen planus.[9]
We can therefore infer from the results that low vitamin D levels are a major factor in the development of oral lichen planus. Our study provides evidence that vitamin D supplementation can aid in the earlier and more effective treatment of oral lichen planus.
CONCLUSION
It is clear from the current results that vitamin D is crucial in the management of oral lichen planus.
Financial support and sponsorship
Nil.
Conflicts of interest
There are no conflicts of interest.
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