{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,18]],"date-time":"2026-09-18T19:01:12Z","timestamp":1789758072262,"version":"4.0.1"},"reference-count":26,"publisher":"American Medical Association (AMA)","issue":"1","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JAMA Dermatol"],"published-print":{"date-parts":[[2024,1,1]]},"abstract":"Importance<\/jats:title>Symptomatic oral lichen planus (OLP) can be challenging to treat.<\/jats:p><\/jats:sec>Objective<\/jats:title>To compare the efficacy of oral acitretin plus topical triamcinolone acetonide (TAC), 0.1%, with TAC monotherapy in patients with symptomatic OLP.<\/jats:p><\/jats:sec>Design, Setting, and Participants<\/jats:title>This monocentric, investigator-initiated, placebo-controlled, investigator- and patient-blinded randomized clinical trial was conducted from December 2018 to June 2020 at the Postgraduate Institute of Medical Education and Research, a tertiary referral center in Chandigarh, India. Sixty-four patients 18 years or older with symptomatic OLP were recruited by consecutive sampling. Data were analyzed from July to December 2020.<\/jats:p><\/jats:sec>Intervention<\/jats:title>The patients were randomized to receive either a combination of oral acitretin (25-35 mg\/d) and TAC (treatment group) or TAC in combination with placebo (placebo group) for 28 weeks, with an additional 8 weeks of treatment-free follow-up after the end of treatment (36 weeks of total study duration).<\/jats:p><\/jats:sec>Main Outcomes and Measures<\/jats:title>The disease severity and treatment response were assessed using Oral Disease Severity Score (ODSS), Oral Health Impact Profile 14 (OHIP-14), and visual analog scale (VAS). The primary aim was to assess the number of patients achieving ODSS-75 (75% reduction in ODSS compared with baseline) in both groups at 28 weeks and at the end of 36 weeks.<\/jats:p><\/jats:sec>Results<\/jats:title>Among 64 patients, 31 in the treatment group and 30 in the placebo group completed the study (mean [SD] age, 50.6 [15.2] years vs 49.2 [14.4] years; male-female ratio, 13:19 vs 16:16). Baseline ODSS, visual analog scale, and Oral Health Impact Profile 14 scores were comparable in both groups. In the intention-to-treat analysis, there was a statistically significant higher number of patients achieving 75% or higher reduction in ODSS in the treatment group compared with the placebo group at the end of 28 weeks (28 [88%] vs 15 [47%], a 41 [95% CI, 20-61] percentage point difference between groups; P<\/jats:italic>\u2009&amp;lt;\u2009.001; Cram\u00e9r V<\/jats:italic>\u2009=\u20090.47) and 36 weeks (27 [84%] vs 13 [41%], a 43 [95% CI, 23-67] percentage point difference between groups; P<\/jats:italic>\u2009&amp;lt;\u2009.001; Cram\u00e9r V<\/jats:italic>\u2009=\u20090.47). Relapses during the posttreatment follow-up of 8 weeks were low among patients in both treatment and placebo groups (1 [3%] vs 2 [6%], a 3 [95% CI, \u221213 to 7] percentage point difference between groups; P<\/jats:italic>\u2009&amp;gt;\u2009.99; Cram\u00e9r V<\/jats:italic>\u2009=\u20090.07).<\/jats:p><\/jats:sec>Conclusion and Relevance<\/jats:title>In this randomized clinical trial, the combination of oral acitretin and TAC was more effective than TAC monotherapy in patients with symptomatic OLP.<\/jats:p><\/jats:sec>Trial Registration<\/jats:title>Clinical Trial Registry of India Identifier: CTRI\/2018\/11\/016448<\/jats:ext-link><\/jats:p><\/jats:sec>","DOI":"10.1001\/jamadermatol.2023.4889","type":"journal-article","created":{"date-parts":[[2023,12,6]],"date-time":"2023-12-06T16:03:52Z","timestamp":1701878632000},"page":"80","source":"Crossref","is-referenced-by-count":17,"title":["Oral Acitretin Plus Topical Triamcinolone vs Topical Triamcinolone Monotherapy in Patients With Symptomatic Oral Lichen Planus"],"prefix":"10.1001","volume":"160","author":[{"given":"Keshavamurthy","family":"Vinay","sequence":"first","affiliation":[{"name":"Department of Dermatology, Venereology and Leprology, Postgraduate Institute of Medical Education and Research, Chandigarh, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sheetanshu","family":"Kumar","sequence":"additional","affiliation":[{"name":"Department of Dermatology, Venereology and Leprology, Postgraduate Institute of Medical Education and Research, Chandigarh, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anubha","family":"Dev","sequence":"additional","affiliation":[{"name":"Department of Dermatology, Venereology and Leprology, Postgraduate Institute of Medical Education and Research, Chandigarh, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Simone","family":"Cazzaniga","sequence":"additional","affiliation":[{"name":"Department of Dermatology, Inselspital University Hospital of Bern, Bern, Switzerland"},{"name":"Centro Studi GISED, Bergamo, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luca","family":"Borradori","sequence":"additional","affiliation":[{"name":"Department of Dermatology, Inselspital University Hospital of Bern, Bern, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vishal","family":"Thakur","sequence":"additional","affiliation":[{"name":"Department of Dermatology, Venereology and Leprology, Postgraduate Institute of Medical Education and Research, Chandigarh, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sunil","family":"Dogra","sequence":"additional","affiliation":[{"name":"Department of Dermatology, Venereology and Leprology, Postgraduate Institute of Medical Education and Research, Chandigarh, 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