Zinc Therapy in Treatment of Symptomatic Oral Lichen Planus

Abstract

Lichen planus is a chronic inflammatory disease, which involves skin, mucous membrane, and nails. Prevalence of oral lichen planus varies between 0.5% and 2.6% of adult population worldwide with overall female preponderance. It is considered as a potentially malignant disorder with rate of transformation to oral cancer varying between 0.5% and 2%. Oral lichen planus may either be unilateral or bilateral, or may involve multiple sites. Although the exact etio-pathogenesis of this condition is unknown, it is believed that stress, use of medications, dental fillings, genetics, immunity, and hypersensitivity reactions may contribute to its pathogenesis. It is a T-cell-mediated autoimmune disorder in which CD8+ T cells are involved which release various cytokines such as tumor necrosis factor-α and interleuking-12 leading to disruption of basement membrane integrity. Zinc activates caspase-3 and DNA fragmentation, resulting in the apoptosis of keratinocytes. By prevention of matrix metalloproteinase (MMP)-1 activation, it inhibits T-cell accumulation in oral lichen planus, and by inhibiting MMP-9 it prevents cleavage of collagen IV resulting in maintaining the integrity of the basement membrane. The present case series describes the use of oral zinc acetate (50 mg) in patients having symptomatic oral lichen planus with favorable outcome in terms of size of lesion and global index score.