Oral lichen planus (OLP) is a chronic inflammatory T cell mediated disease. Because the precise aetiology of this disease remains unknown, the treatment of OLP is focused on reducing symptoms, mainly through inhibiting the local inflammatory response. Topical corticosteroids with high potency are recommended as first choice medications for treating the symptomatic form of OLP. Treatment with topical corticosteroids is usually long-term or should be repeated when the acute symptoms of OLP recur, thus contributing to an increased frequency of adverse effects. Among them, secondary infection with Candida has been reported to occur in 12–30% of cases. Although antifungal drugs are sometimes additionally administered with topical steroids, which should help to prevent secondary oral candidiasis, the efficacy of such an approach has been recently questioned. Here, we present two cases of patients with erosive OLP treated with topical clobetasol that developed secondary acute pseudomembranous candidiasis during steroid treatment. We discuss treatment options and propose a clinical protocol that may be helpful in decision making for the treatment of OLP.

Key words: oral lichen planus; topical corticosteroid treatment; pseudomembranous candidiasis.