Objective: The purpose of this study was to evaluate the usefulness
of topical sulfasalazine in the treatment of oral lichen
planus (OLP) resistant to corticosteroid therapy. Method
and Materials: Twenty-one unresponsive OLP patients were
treated with topical sulfasalazine 3 times a day for 4 weeks.
Each patient’s symptoms and lesion size were evaluated at the
beginning of therapy, and then after 4 weeks to determine the
efficacy of topical sulfasalazine. Inflammatory cytokines levels
in saliva were measured by ELISA. Results: Seventeen patients (81%) reported improvement of discomfort and 12 patients
(57%) had lesions decrease in size over 50%. Patients who had
higher levels of IL-1β and IL-8 were more responsive to topical
sulfasalazine therapy. Conclusion: Topical sulfasalazine
should be considered when OLP does not respond to corticosteroid
therapy. Furthermore, high concentrations of IL-1β and
IL-8 in the saliva are useful indicators for the application of topical
sulfasalazine in OLP patients refractory to steroid treatment.