Absorption of a topical steroid and evaluation of adrenal suppression in patients with erosive lichen planus

This study was designed to investigate the absorption of a topical steroid applied to the gingiva and buccal mucosa of patients with erosive lichen planus and to healthy control patients. In addition, adrenal suppression was assessed by measurements of serum and urine cortisol levels. Ten patients with erosive lichen planus and eight control patients provided urine and blood samples at baseline, day 3, and day 21. After establishment of baseline laboratory values, patients were instructed to apply 500 mg of a 0.05% fluocinonide gel to the gingiva and buccal mucosa three times a day for 3 weeks. Measurements of cortisol levels revealed no significant changes in either the disease or the control group. Although procedures were developed to detect fluocinonide, none of the patients showed evidence of the steroid during the study. It was concluded that the topical application of a fluocinonide gel to the gingiva and buccal mucosa over a 3-week period in patients with erosive lichen planus produced no adrenal suppression.