Work

Long-Term Efficacy of 5-ALA Photodynamic Therapy in Oral Lichen Planus Patients

Year: 2025

Type: article

Abstract: Background: Oral lichen planus (OLP) is a chronic mucosal disease associated with a risk of malignant transformation. Although topical corticosteroids are the standard therapy, prolonged administration may result in local and systemic complications. Photodynamic therapy (PDT) with 5-aminolevulinic acid (ALA) has been proposed as a less invasive and safer alternative. Methods: In this prospective study, 44 patients with histologically verified OLP underwent a protocol consisting of ten consecutive weekly PDT sessions, each comprising a single irradiation. A 5% ALA formulation was topically applied, followed by illumination with a 630 nm red light device. Clinical outcomes were evaluated at baseline, immediately after therapy, and at 12- and 48-month follow-ups. Changes in lesion surface, REU index, and pain intensity on a visual analog scale (VAS) were analyzed. Results: Significant improvements were noted, with progressive and sustained decreases in lesion extent, REU scores, and VAS values throughout the 4-year observation period. The therapeutic response was consistent across different mucosal sites (keratinized and non-keratinized). No treatment-related adverse reactions were recorded. Conclusions: Long-term follow-up indicates that ALA-mediated PDT is a safe and effective management option for both reticular and erosive variants of OLP. Its durable clinical benefits and favorable safety profile support its role as an alternative to corticosteroid therapy.

Source: Pharmaceuticals

DOI: 10.3390/ph18111676