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Non-invasive ALA-PDT offers durable therapeutic benefits for reticular and erosive oral lichen planus.
A novel photodynamic therapy (PDT) using 5-aminolevulinic acid (ALA) has emerged as a safe, effective, and long-lasting treatment for oral lichen planus (OLP), according to a recent 4-year prospective study.
OLP, a chronic oral mucosal disease, carries a risk of malignant transformation and is traditionally managed with corticosteroids—treatments that can cause local and systemic side effects when used long-term. Researchers investigated whether a less invasive, safer approach using ALA-mediated PDT could provide sustained relief.
In this study, 44 patients diagnosed with OLP through histological confirmation received 10 weekly sessions of PDT, involving topical application of a 5% ALA formulation followed by exposure to a 630 nm red light source. Clinical outcomes—including lesion surface area, reticular-erosive-ulcerative (REU) scores, and pain intensity measured via a visual analog scale (VAS)—were assessed at baseline, immediately post-treatment, and at 12- and 48-month follow-ups.
The results showed remarkable and sustained improvements. Lesion size, REU scores, and pain levels steadily dropped over the 4-year follow-up period. Benefits were observed across all oral mucosal sites, including both keratinized and non-keratinized regions. Crucially, patients experienced no complications, emphasizing the procedure’s safety.
Researchers concluded that ALA-mediated PDT offers a durable, non-invasive alternative to corticosteroids, effectively tackling both reticular and erosive forms of OLP while minimizing the risk of complications.
Pharmaceuticals (Basel)
Long-Term Efficacy of 5-ALA Photodynamic Therapy in Oral Lichen Planus Patients
Magdalena Sulewska et al.
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