الفهرس 
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Abstract
Introduction: Lichen planus is a chronic autoimmune, mucocutaneous disease which affects the oral mucosa and the skin. In most of the patients, OLP is asymptomatic while some patients may report sensitivity of the oral mucosa to hot or spicy foods and painful oral mucosa especially in the erosive/atrophic form. One of most common treatment modalities of oral lichen planus is corticosteroids which minimize the painful symptoms of the disease. Since corticosteroids are taken in very high doses, it has several side effects which harm the patients. One such promising treatment modality is LLLT as well as photodynamic therapy (PDT) which are considered safe and reliable in reducing the painful symptoms of the disease with minimal side effects. The inflammatory mediators; cytokines as (interleukin- 4 & interleukin- 17) were found to play a crucial role in the pathogenesis of atrophic/erosive OLP. That’s why the level of both cytokines was analyzed using ELISA kits to assess the severity of the disease before and after treatment. Aim of the study: The aim of this study was to investigate and compare the effect of LLLT, PDT & topical corticosteroids by measuring VAS (pain scale), interleukin -4 in saliva and interleukin-17 in serum to detect the response of OLP patients to these different modalities. Methodology: The study was conducted on 30 patients, 21 females and 9 males divided into 3 groups. Each group consisted of 10 patients receiving either of 3 treatments; LLLT, PDT or topical corticosteroids. OLP lesions were subjected to one of these treatment modalities, then blood and saliva samples were collected to measure the level of interleukin -4 in saliva and the level of interleukin -17 in serum and visual analogue scale (VAS) at base line, immediately after the first session, at 2 months and finally at 4 months (end of study) to detect the efficiency of each type of treatment. A follow-up period of 3 months was performed after cessation of treatment. Results: The study revealed that at 4 months (end of the study): 1- VAS was markedly reduced by LLLT 2- IL-4 level was markedly reduced by PDT 3- IL-17 level was reduced in the 3 groups, however the improvement achieved by the end of the study revealed that the best improvement of: • The level of IL-17 was seen in TCS group • The level of IL-4 was seen in PDT group and • VAS was seen in LLLT group. Each parameter was affected by a different treatment modality and the improvement % was noticeable according to this specific treatment. No correlation was found between any of the used parameters, this shows that each one of the parameters was efficient on its own in monitoring the effectiveness of the three treatment modalities used.