Estimation and comparison of clinical staging and candidal colony counts in oral leukoplakia before and after treatment with 1 %topical antifungal therapy

Aim: The aim of this study to observe and evaluate effectiveness of 1 % Topical clotrimazole therapy on Clinical and Histopathologic behavior of Oral Leukoplakia and to compare the Candida colony count in saliva before and after 1%Topical clotrimazole therapy in patients with Oral Leukoplakia.
Methods: Clinical behavior of 50 cases of oral leukoplakia were assessed according to the OLEP staging. Samples of unstimulated saliva were collected and candidal colonies counted. Patients were prescribed 1% topical Clotrimazole antifungal therapy thrice daily for 15 days. Same procedures were repeated after treatment to compare pre and post OLEP staging of Leukoplakia and colony forming units.
Results: Clinical and histopathological staging of leukoplakia showed statistically significant difference in pre and post treatment with 1% topical Clotrimazole antifungal therapy, as well as in salivary candida colony count. Paired t test showed statistically significant reduction in CFU with a p value of <0.001
Conclusion: Candidal infection may be one of the most important factors inducing dysplasia of epithelia and malignant transformation of oral leukoplakia. Since the lesion showed significant improvement in the clinical staging of leukoplakia as well as decrease in the candidal colony count in saliva following antifungal therapy, 1%Topical clotrimazole is recommended for oral leukoplakia patients to eliminate the candidal infection and further improvement in the clinical staging and prevention of progression of leukoplakia. Hence, prescription of 1% topical clotrimazole antifungal therapy can be recommended to all oral leukoplakia patients as a part of regular management protocol for oral leukoplakia.