Dexamethasone Solution for the Treatment of Oral Lichen Planus

Potentially eligible subjects will be screened by one of the investigators by asking patients
to rate their worst oral pain or pain score (0-10) over the previous week (see Appendix).
Those answering with at least a score of "7" (1/10) and that meet all other eligibility
requirements (see Section 3) will be eligible for enrollment. All patients will sign informed
consent for study participation. Each study visit is anticipated to take approximately 45
minutes.

Treatment will be administered on an outpatient basis. Study medication will be prescribed by
authorized study staff physicians at no expense for the patient.

Subjects will be evaluated clinically at baseline before starting treatment and at the end of
the four-week period, for a total of two visits. Comprehensive subjective and objective data
will be collected and intraoral photographs will be obtained. Oral mucosal disease will be
evaluated using both patient reported (questions/visual analog scales) and clinician assessed
measures.

Subjects will be prescribed compound dexamethasone 0.5mg/5ml solution in Mucolox™ (ARM A) or
dexamethasone 0.5mg/5ml solution only (ARM B). All subjects will also receive a prescription
for fluconazole 200 mg tablets once-a-week as prophylactic antifungal therapy. Any subjects
that are already taking an antifungal oral medication at the time of the study enrollment
will continue their prescribed medication and will not need to take the additional weekly
fluconazole dose. Subjects will return for evaluation after four weeks at which time the
study end-points will be assessed.

If there is worsening of oral lichen planus that requires initiation of new immunomodulatory
medications (systemic or topical), patients will remain on treatment, but will be regarded as
unevaluable for the primary endpoint.

Inclusion Criteria:

- Age 18 years and older.

- Patients with symptomatic oral lichen planus (worst VAS sensitivity score ≥ 7 over the
last week).

Exclusion Criteria:

- Patients already on topical or systemic steroids.

- Inability to comply with study instructions.

- Uncontrolled intercurrent illness or psychiatric illness/social situations that would
limit compliance with study requirements.

- VAS sensitivity score < 7.