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Alqahtani SS, Alabeedi FM. Association of oral candidiasis with oral lichen planus in patients using corticosteroid therapy - Meta-analysis. JOURNAL OF POPULATION THERAPEUTICS AND CLINICAL PHARMACOLOGY = JOURNAL DE LA THERAPEUTIQUE DES POPULATIONS ET DE LA PHARMACOLOGIE CLINIQUE 2023; 30:e1-e13. [PMID: 36631413 DOI: 10.47750/jptcp.2023.1020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/24/2022] [Accepted: 11/09/2022] [Indexed: 01/13/2023]
Abstract
Oral lichen planus (OLP) is a chronic inflammatory disease that commonly affects the skin and mucous membranes. There is a difference of opinion among clinicians about whether OLP has been associated with oral candidiasis. Nonetheless, in OLP patients, the oral candidiasis prevalence rate ranges from 7.7 to 16.6%, as established through biopsy findings, whereas 37-50% of the prevalence rate has been noticed in culture findings. Oral candidiasis has been linked to several local and systemic factors, including salivary gland dysfunction, dental prostheses, topical or inhaled corticosteroids, smoking, and the use of systemic medications. The aim was to highlight the association of Candida in patients diagnosed with OLP, correlate the use of steroid therapy, and enumerate the factors of using steroid therapy as implicated causes for oral candidiasis. A search was made using search engines such as PubMed, Scopus, Cochrane Database of Systematic Reviews, Science Citation Index, NIH Public Access, and Clarivate Analytics (Figure 1). The keywords using the research option for this field were "Oral Candidiasis" AND "Oral Lichen planus" or "Candidiasis" AND "Corticosteroids" or "Topical Corticosteroids" AND Oral Lichen planus or "Inhalation Corticosteroids" AND "Candidiasis" or "Oral Lichen planus" AND "Corticosteroids." The database search was made for the duration of 1991 to -2021 (Table 1). Additional articles were obtained regarding the literature on OLP and oral candidiasis and were considered background material. The incidence of oral candidiasis and associated lichen planus following steroid therapy enlisted by various authors has been addressed. According to the results of this study, there is a positive correlation between the presence of oral candidiasis in the OLP's patients treated with corticosteroids. Finally, this meta-analysis concluded that there is a positive correlation between the presence of Candida species in OLP and steroid medication.
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Affiliation(s)
- Sulaiman S Alqahtani
- Department of Oral & Maxillofacial Surgery and Diagnostic Sciences, Faculty of Dentistry, Najran University, Najran, Saudi Araxbia.;
| | - Faris M Alabeedi
- Department of Oral & Maxillofacial Surgery and Diagnostic Sciences, Faculty of Dentistry, Najran University, Najran, Saudi Araxbia
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The Effect of Mouthrinse with 0.05% Dexamethasone Solution on the Oral Bacterial Community of Oral Lichen Planus Patients: Prospective Pilot Study. APPLIED SCIENCES-BASEL 2021. [DOI: 10.3390/app11146286] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Few studies have already been performed to assess oral bacteria during steroid therapy for oral lichen planus (OLP). Thus, the aim of our study was to analyze the effect of dexamethasone mouthrinse treatment on the oral bacteria of OLP patients. This prospective study was conducted on patients who were diagnosed with OLP and treated with 0.05% dexamethasone mouthrinse twice per day for 4 weeks. Using unstimulated saliva of the patients before and after treatment, the qualitative and quantitative changes in oral bacteria were analyzed using quantitative real-time polymerase chain reaction (qPCR). The qPCR results were analyzed using Wilcoxon signed-rank test to the quantitative changes with dexamethasone mouthrinse. The statistical significance was considered at a level of 0.05. In total, 20 patients were enrolled in this study, wherein all were noted to show improved symptoms of OLP. Fifteen patients (75%) had a qualitative change in the oral microbial species and an improved relative periodontitis risk score (from 26.1 ± 10.7 to 20.9 ± 9.2; p = 0.008). However, quantitative changes in all species were determined to be not statistically different before and after the treatment. Most OLP patients had a changed microbial community composition after 0.05% dexamethasone mouthrinse for 4 weeks. In particular, the composition of the periodontopathic bacteria was improved after the treatment.
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Lorenzo-Pouso AI, Rodríguez-González F, Blanco-Carrión A, García-García A, Chamorro-Petronacci C, López-Jornet P, Pérez-Sayáns M. Validity, reliability and optimisation of the TOPICOP questionnaire for oral lichen planus. Acta Odontol Scand 2020; 78:501-508. [PMID: 32189543 DOI: 10.1080/00016357.2020.1739329] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Objectives: Due to their anti-inflammatory and immunosuppressive effects, topical corticosteroids (TCs) are commonly used for the treatment of patients with oral lichen planus (OLP) with an erosive or ulcerative component. It has been suggested that many of these patients may suffer from fear or anxiety as a result of prolonged treatment with TCs. The objective of this study was twofold: (1) to optimise a patient reported outcome measure (PROM) in order to explore this feature, and (2) to evaluate this PROM in the treatment of OLP patients.Methods: A group of qualitative researchers adapted the TOPICOP questionnaire in order for it to be used as a PROM for OLP via structural equation modelling (SEM) and internal consistency (IC) analysis. Consequently, 34 patients with symptomatic OLP who were undergoing treatment with TCs completed a questionnaire and underwent a clinical assessment.Results: SEM presented an adequate fit (RMSA = 0.07, CFI = 0.94 and WRMR = 1.18), as well as a high IC (α = 0.81). A total of 16 patients (47.1%) reported TCs phobia. The receiver operating characteristic analysis (ROC) revealed that a TOPICOP value ≥50% predicted the presence of TCs phobia with a sensitivity of 93% and a specificity of 100%.Conclusions: The optimised TOPICOP scale proved valuable as a PROM in OLP. TCs phobia can be a real consideration in OLP, nonetheless, it does not appear to be an impediment to treatment adherence.
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Affiliation(s)
- Alejandro I. Lorenzo-Pouso
- Oral Medicine, Oral Surgery and Implantology Unit, Faculty of Medicine and Dentistry, University of Santiago de Compostela, Health Research Institute of Santiago de Compostela (IDIS), A Coruña, Spain
| | - Fernando Rodríguez-González
- Oral Medicine, Oral Surgery and Implantology Unit, Faculty of Medicine and Dentistry, University of Santiago de Compostela, Health Research Institute of Santiago de Compostela (IDIS), A Coruña, Spain
| | - Andrés Blanco-Carrión
- Oral Medicine, Oral Surgery and Implantology Unit, Faculty of Medicine and Dentistry, University of Santiago de Compostela, Health Research Institute of Santiago de Compostela (IDIS), A Coruña, Spain
| | - Abel García-García
- Oral Medicine, Oral Surgery and Implantology Unit, Faculty of Medicine and Dentistry, University of Santiago de Compostela, Health Research Institute of Santiago de Compostela (IDIS), A Coruña, Spain
| | - Cintia Chamorro-Petronacci
- Oral Medicine, Oral Surgery and Implantology Unit, Faculty of Medicine and Dentistry, University of Santiago de Compostela, Health Research Institute of Santiago de Compostela (IDIS), A Coruña, Spain
| | - Pía López-Jornet
- Department of Oral Medicine, Faculty of Medicine, Regional Campus of International Excellence “Campus Mare Nostrum”, University of Murcia, Espinardo, Spain
| | - Mario Pérez-Sayáns
- Oral Medicine, Oral Surgery and Implantology Unit, Faculty of Medicine and Dentistry, University of Santiago de Compostela, Health Research Institute of Santiago de Compostela (IDIS), A Coruña, Spain
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4
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Shibagaki K, Yuki T, Taniguchi H, Aimi M, Miyaoka Y, Yuki M, Ishimura N, Oshima N, Mishiro T, Tamagawa Y, Mikami H, Izumi D, Yamashita N, Sato S, Ishihara S, Kinoshita Y. Prospective multicenter study of the esophageal triamcinolone acetonide-filling method in patients with subcircumferential esophageal endoscopic submucosal dissection. Dig Endosc 2020; 32:355-363. [PMID: 31361925 DOI: 10.1111/den.13496] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/22/2019] [Accepted: 07/26/2019] [Indexed: 12/12/2022]
Abstract
BACKGROUND AND AIM The esophageal triamcinolone acetonide (TA)-filling method is a novel local approach for stenosis prevention after extensive esophageal endoscopic submucosal dissection (ESD). We evaluated this method after subcircumferential ESD. METHODS We enrolled 20 patients with esophageal cancer requiring subcircumferential ESD in a prospective multicenter study. Esophageal TA filling was carried out 1 day and 1 week after ESD, with follow-up endoscopy every 2 weeks. We treated severe stenosis preventing endoscope passage with endoscopic balloon dilatation (EBD) and additional TA filling, and mild stenosis allowing endoscope passage with additional TA filling only. Primary endpoint was incidence of severe stenosis; secondary endpoints were total number of EBD, rate of additional TA filling, time to stenosis and complete re-epithelialization, dysphagia score, and adverse events. Horizontal resection grade was divided into grades 1 (≥ 9/12 and <10/12 of the circumference), 2 (≥ 10/12 and <11/12), and 3 (≥ 11/12 but not circumferential) and analyzed statistically for correlation with endpoints. RESULTS Incidence of severe stenosis was 5.0% (1/20; 0.1-24.8%) and was treated with three EBD. Six patients showed mild stenosis. Additional TA filling was carried out in these seven patients: 0% (0/9) for grade 1 resection, 40% (2/5) for grade 2, and 83% (5/6) for grade 3 (P < 0.05). Median time to stenosis and re-epithelialization was 3 and 7 weeks, respectively. Dysphagia score deteriorated in one patient. No adverse events occurred. CONCLUSIONS The esophageal TA-filling method prevented stenosis after subcircumferential ESD. Grade ≥2 resection showed a high risk for stenosis, but additional TA filling for mild stenosis inhibited stenosis progression (UMIN000024384).
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Affiliation(s)
- Kotaro Shibagaki
- Department of Gastroenterology, Faculty of Medicine, Shimane University, Shimane, Japan
| | - Takafumi Yuki
- Department of Gastroenterology, Matsue Red Cross Hospital, Shimane, Japan
| | - Hideaki Taniguchi
- Department of Gastroenterology, Tottori Municipal Hospital, Tottori, Japan
| | - Masahito Aimi
- Department of Gastroenterology, Tottori Municipal Hospital, Tottori, Japan
| | - Yoichi Miyaoka
- Department of Gastroenterology, Shimane Prefectural Central Hospital, Shimane, Japan
| | - Mika Yuki
- Department of Gastroenterology, Izumo Municipal Medical Center, Shimane, Japan
| | - Norihisa Ishimura
- Department of Gastroenterology, Faculty of Medicine, Shimane University, Shimane, Japan
| | - Naoki Oshima
- Department of Gastroenterology, Faculty of Medicine, Shimane University, Shimane, Japan
| | - Tsuyoshi Mishiro
- Department of Gastroenterology, Faculty of Medicine, Shimane University, Shimane, Japan
| | - Yuji Tamagawa
- Department of Gastroenterology, Faculty of Medicine, Shimane University, Shimane, Japan
| | - Hironobu Mikami
- Department of Gastroenterology, Faculty of Medicine, Shimane University, Shimane, Japan
| | - Daisuke Izumi
- Department of Gastroenterology, Faculty of Medicine, Shimane University, Shimane, Japan
| | - Noritsugu Yamashita
- Department of Gastroenterology, Faculty of Medicine, Shimane University, Shimane, Japan
| | - Shuichi Sato
- Department of Gastroenterology, Faculty of Medicine, Shimane University, Shimane, Japan
| | - Shunji Ishihara
- Department of Gastroenterology, Faculty of Medicine, Shimane University, Shimane, Japan
| | - Yoshikazu Kinoshita
- Department of Gastroenterology, Faculty of Medicine, Shimane University, Shimane, Japan
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The effect of triamcinolone in liposomes on oral wound healing in rats. ACTA VET BRNO 2019. [DOI: 10.2754/avb201988020225] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
The purpose of this study was to determine whether oral mucosa wounds in rats can be successfully treated with triamcinolone acetonide (TA), incorporated into liposomes. A round wound was inflicted on the oral mucosa of female Wistar rats divided into four groups of 12 animals. This wound was treated topically from day 1 with liposomes without the inclusion of TA and liposomes containing 0.01% or 0.05% TA. The wounds of the animals in the control group were not treated. Polymethyl metacrylate was used as an ointment for mixing in liposomes. The size of the wound was measured until day 6. The area of inflammatory infiltrate under the wound was evaluated by histopathology, the expression of iNOS (inducible nitric oxide synthase) enzyme under the wound was evaluated by immunohistochemistry until day 6. On the sixth day of experiment, the size of the wound and the area of the inflammatory infiltrate was the smallest in the group receiving empty liposomes (EL). Expression of iNOS was the most reduced in the group receiving EL. We conclude that oral mucosa wounds can be successfully treated with liposomes, although the incorporated drug triamcinolone would not be the appropriate drug for treating wounds of traumatic origin.
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Edens MH, Carpenter MD, Napeñas JJ, Brennan MT. Impact of salivary hypofunction on incidence of orofungal infections with use of topical steroids for management of oral lichen planus and xerostomia. Oral Surg Oral Med Oral Pathol Oral Radiol 2018; 126:501-505. [PMID: 30309830 DOI: 10.1016/j.oooo.2018.06.012] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2018] [Revised: 06/22/2018] [Accepted: 06/25/2018] [Indexed: 01/20/2023]
Abstract
OBJECTIVES The aim of this study was to determine if salivary hypofunction increases the incidence of oral fungal infections (OFIs) after topical steroid use for the management of oral lichen planus (OLP). STUDY DESIGN Patients with a diagnosis of OLP, treated for at least 2 weeks with topical steroids, had baseline salivary flow evaluations completed, and had a follow-up visit within 5 weeks of steroids being prescribed were assessed. Patients were evaluated for clinical signs of fungal infection at follow-up visits. RESULTS Forty-Seven patients (91% female) met the inclusion criteria, with 21.3% developing an OFI after topical steroid use. Demographic characteristics, type of OLP, steroid used, and antifungal used did not impact the development of an OFI. The mean stimulated salivary flow was significantly lower in the group that developed an OFI compared with the group that did not develop an OFI (8.31 mL/15 min vs 15.4 mL/15 min, respectively; P = 0.0006). A higher incidence of OFIs occurred in the low stimulated flow group versus the normal flow group (39% vs 4%, respectively). Most patients in the OFI group received a preventative antifungal (90%). CONCLUSIONS OFIs increased after steroid treatment in patients with OLP who had low stimulated salivary flows. Antifungals (90%) were not effective in preventing OFIs in patients with OLP who had salivary hypofunction and were treated with topical steroids.
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Affiliation(s)
- Mary Hil Edens
- Oral Medicine Resident, Department of Oral Medicine, Carolinas Medical Center, Charlotte, NC, USA
| | - Michael D Carpenter
- Research Assistant, Department of Oral Medicine, Carolinas Medical Center, Charlotte, NC, USA
| | - Joel J Napeñas
- Associate Professor, Oral Medicine Residency Director, Department of Oral Medicine, Carolinas Medical Center, Charlotte, NC, USA
| | - Michael T Brennan
- Professor and Department Chair, Department of Oral Medicine, Carolinas Medical Center, Charlotte, NC, USA.
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Abstract
In many mucocutaneous disorders, corticosteroids therapy is currently central. Systemic therapy is restricted to severe disorders whereas topical applications are considered as the first-line treatment. The oral cavity environment, the medication form and other factors related to the delivery method are key factors for the therapy efficiency and effectiveness. Current marketed medications are not able to avoid wrong drug exposure and scarce patients' compliance. Innovative in situ delivery systems are able to prolong the drug retention time on the mucosa and to avoid the drawbacks of conventional formulations. This review is intended to give a general overview of oral mucocutaneous pathologies and highlight the potential of new technologies in designing innovative delivery systems able to release corticosteroids in situ for the treatment of various oral cavity disorders.
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8
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Yang XY, Zhang SN, Li XZ, Wang Y, Yin XD. Analysis of human serum metabolome for potential biomarkers identification of erosive oral lichen planus. Clin Chim Acta 2017; 468:46-50. [PMID: 28215546 DOI: 10.1016/j.cca.2017.02.010] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2016] [Revised: 01/13/2017] [Accepted: 02/14/2017] [Indexed: 02/06/2023]
Abstract
BACKGROUND Oral lichen planus (OLP) is a chronic auto-inflammatory mucositis and potentially oral premalignant lesion. Erosive OLP patients display the higher canceration rate as compared to the patients with non-erosive OLP. Identification of the potential biomarkers associated with erosive OLP may help to investigate the disease pathogenesis and to improve clinical treatment. METHODS Ultra-performance liquid chromatography-quadrupole time-of-flight-mass spectrometry (UPLC-QTOF-MS) combined with pattern recognition approaches were integrated to acquire differentially expressed metabolites for the pathways analysis and elucidate mechanisms of disease. RESULTS Totally, 10 modulated metabolites were characterized as the potential biomarkers of erosive OLP, whose dysregulations could affect multiple metabolic pathways and pathological processes in the disease. CONCLUSION These findings indicated that the analysis of human serum metabolome might be conducive to the achievement of the objectives of this study.
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Affiliation(s)
- Xu-Yan Yang
- First Affiliated Hospital, Heilongjiang University of Chinese Medicine, Harbin 150040, PR China
| | - Shuai-Nan Zhang
- Department of Pharmacy, Guiyang University of Chinese Medicine, Guiyang 550025, PR China.
| | - Xu-Zhao Li
- Department of Pharmacy, Guiyang University of Chinese Medicine, Guiyang 550025, PR China.
| | - Yu Wang
- Chinese Medicine Toxicological Laboratory, Heilongjiang University of Chinese Medicine, Harbin 150040, PR China
| | - Xiao-Dong Yin
- School of Stomatology, Harbin Medical University, Harbin 151000, PR China
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Urine metabolic profiling for the pathogenesis research of erosive oral lichen planus. Arch Oral Biol 2016; 73:206-213. [PMID: 27771589 DOI: 10.1016/j.archoralbio.2016.10.014] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2015] [Revised: 08/05/2016] [Accepted: 10/14/2016] [Indexed: 12/21/2022]
Abstract
OBJECTIVE Oral lichen planus (OLP) is a relatively common chronic immune-pathological and inflammatory disease and potentially oral precancerous lesion. Erosive OLP patients show the higher rate of malignant transformation than patients with non-erosive OLP. Identifying the potential biomarkers related to erosive OLP may help to understand the pathogenesis of the diseases. METHODS Metabolic profiles were compared in control and patient subjects with erosive OLP by using ultra-performance liquid chromatography-quadrupole time-of-flight-mass spectrometry (UPLC-QTOF-MS) coupled with pattern recognition methods An integrative analysis was used to identify the perturbed metabolic pathways and pathological processes that may be associated with the disease. RESULTS In total, 12 modulated metabolites were identified and considered as the potential biomarkers of erosive OLP. Multiple metabolic pathways and pathological processes were involved in erosive OLP. CONCLUSION The dysregulations of these metabolites could be used to explain the pathogenesis of the disease, which could also be the potential therapeutic targets for the disease.
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Marable DR, Bowers LM, Stout TL, Stewart CM, Berg KM, Sankar V, DeRossi SS, Thoppay JR, Brennan MT. Oral candidiasis following steroid therapy for oral lichen planus. Oral Dis 2016; 22:140-7. [DOI: 10.1111/odi.12399] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2015] [Revised: 11/04/2015] [Accepted: 11/09/2015] [Indexed: 11/25/2022]
Affiliation(s)
- DR Marable
- Department of Oral Medicine; Carolinas Healthcare System; Charlotte NC USA
| | - LM Bowers
- Department of Oral Medicine; Carolinas Healthcare System; Charlotte NC USA
| | - TL Stout
- Department of Oral Medicine; Carolinas Healthcare System; Charlotte NC USA
| | - CM Stewart
- Oral & Maxillofacial Surgery and Diagnostic Sciences; University of Florida College of Dentistry; Gainesville FL USA
| | - KM Berg
- Oral & Maxillofacial Surgery and Diagnostic Sciences; University of Florida College of Dentistry; Gainesville FL USA
| | - V Sankar
- Department of Comprehensive Dentistry; University of Texas Health Science Center School of Dentistry; San Antonio TX USA
| | - SS DeRossi
- Oral Health and Diagnostic Sciences; Georgia Regents University - College of Dental Medicine; Augusta GA USA
| | - JR Thoppay
- Oral Health and Diagnostic Sciences; Georgia Regents University - College of Dental Medicine; Augusta GA USA
| | - MT Brennan
- Department of Oral Medicine; Carolinas Healthcare System; Charlotte NC USA
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11
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Wang H, Zhang D, Han Q, Zhao X, Zeng X, Xu Y, Sun Z, Chen Q. Role of distinct CD4(+) T helper subset in pathogenesis of oral lichen planus. J Oral Pathol Med 2015; 45:385-93. [PMID: 26693958 DOI: 10.1111/jop.12405] [Citation(s) in RCA: 55] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/18/2015] [Indexed: 02/05/2023]
Abstract
Oral lichen planus (OLP) is one of the most common chronic inflammatory oral mucosal diseases with T-cell-mediated immune pathogenesis. In subepithelial and lamina propria of OLP local lesions, the presence of CD4(+) T helper (CD4(+) Th) cells appeared as the major lymphocytes. These CD4(+) T lymphocytes can differentiate into distinct Th cell types such as Th1, Th2, Treg, Th17, Th22, Th9, and Tfh within the context of certain cytokines environment. Growing evidence indicated that Th1/Th2 imbalance may greatly participate into the cytokine network of OLP immunopathology. In addition, Th1/Th2 imbalance can be regulated by the Treg subset and also greatly influenced by the emerging novel CD4(+) Th subset Th17. Furthermore, the presence of novel subsets Th22, Th9 and Tfh in OLP patients is yet to be clarified. All these Th subsets and their specific cytokines may play a critical role in determining the character, extent and duration of immune responses in OLP pathogenesis. Therefore, we review the roles of distinct CD4(+) Th subsets and their signature cytokines in determining disease severity and susceptibility of OLP and also reveal the novel therapeutic strategies based on T lymphocytes subsets in OLP treatment.
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Affiliation(s)
- Hui Wang
- Department of Oral Medicine, School of Stomatology, Capital Medical University, Beijing, China.,State Key Laboratory of Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Dunfang Zhang
- State Key Laboratory of Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China.,Mucosal Immunology Section, National Institute of Dental and Craniofacial Research, National Institutes of Health, Bethesda, MD, USA
| | - Qi Han
- State Key Laboratory of Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Xin Zhao
- State Key Laboratory of Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Xin Zeng
- State Key Laboratory of Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Yi Xu
- State Key Laboratory of Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Zheng Sun
- Department of Oral Medicine, School of Stomatology, Capital Medical University, Beijing, China
| | - Qianming Chen
- State Key Laboratory of Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China
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Wang X, Zhang L, Luo J, Wu Z, Mei Y, Wang Y, Li X, Wang W, Zhou H. Tacrolimus 0.03% ointment in labial discoid lupus erythematosus: A randomized, controlled clinical trial. J Clin Pharmacol 2015; 55:1221-8. [PMID: 25951426 DOI: 10.1002/jcph.537] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2015] [Accepted: 05/01/2015] [Indexed: 02/05/2023]
Abstract
In this randomized, controlled clinical trial to compare efficacy and safety, 41 patients with labial discoid lupus erythematosus (DLE) were randomized to 2 groups, either receiving tacrolimus 0.03% ointment (n = 22) or triamcinolone acetonide 0.1% cream (n = 19). Each patient was treated with 3, 2, and 1 daily doses in the first, second, and third weeks, respectively, for 1 course. After the 3 week treatment, patients with complete disappearance of erosion were followed up for 3 months. After the 3 week application, 20 participants in the tacrolimus group and 19 in the triamcinolone acetonide group completed the study. The rates of complete response were 70% and 89.5% in tacrolimus-treated and triamcinolone acetonide-treated patients, respectively, with no significant difference (P = .235). Reduction in erosion and erythema showed no significant difference between groups (P > .05). Final reduction in reticulation areas and numeric rating scale scores were significantly greater in the tacrolimus group than in the triamcinolone acetonide group (P = .013; P = .048, respectively). Only 1 patient receiving tacrolimus presented with slight discomfort. There was no significant difference in 3 month recurrence rate between the groups (P > .05). Topical tacrolimus is considered as effective as triamcinolone acetonide for the management of labial DLE.
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Affiliation(s)
- Xiangjian Wang
- State Key Laboratory of Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, P. R. China
| | - Lin Zhang
- State Key Laboratory of Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, P. R. China
- Department of Stomatology, Daping Hospital and the Research Institute of Surgery of the Third Military Medical University, Chongqing, P. R. China
| | - Jingjing Luo
- State Key Laboratory of Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, P. R. China
| | - Zhongting Wu
- State Key Laboratory of Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, P. R. China
| | - Yingying Mei
- State Key Laboratory of Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, P. R. China
| | - Yuhong Wang
- State Key Laboratory of Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, P. R. China
| | - Xiaoying Li
- Department of Oral Medicine, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, P. R. China
| | - Wanchun Wang
- Department of Oral Medicine, Qingdao Stomatological Hospital, Qingdao, Shandong, P. R. China
| | - Hongmei Zhou
- Department of Oral Medicine, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, P. R. China
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Werneck JT, Costa TDO, Stibich CA, Leite CA, Dias EP, Silva Junior A. Oral lichen planus: study of 21 cases. An Bras Dermatol 2015; 90:321-6. [PMID: 26131860 PMCID: PMC4516094 DOI: 10.1590/abd1806-4841.20153704] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2014] [Accepted: 07/26/2014] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND: Lichen planus is considered to be the most common dermatological disease involving
the oral mucosa. OBJECTIVE: To investigate the profile, clinical features, and the presence of dysplasia and
candidiasis in patients with oral lichen planus. METHODS: A total of 21 patients were selected from 258 patients at risk for oral cancer
development. RESULTS: Most of the patients were white (76,2%), female (66,6%), with mean age of 58.8
years. Eight were smokers and seven were alcohol consumers. The buccal mucosa was
the most affected site, followed by the tongue and the gingiva. The reticular
pattern was the most common appearance. Histopathology depicted dysplasia in nine
cases and cytopathology was positive for Candida in eight cases in the first
appointment. CONCLUSION: Our data are similar to the literature. Cytopathology was important for the
diagnosis of candidiasis. Although the presence of dysplasia was verified, further
studies are necessary to clarify the importance of this finding.
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14
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Yin J, Yang X, Zeng Q, Yang L, Cheng B, Tao X. The positive correlation of the CCL2-CCR2 axis with the disease activity may indicate the fundamental role in the pathogenesis of oral lichen planus. J Oral Pathol Med 2015; 45:41-7. [DOI: 10.1111/jop.12325] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/10/2015] [Indexed: 12/18/2022]
Affiliation(s)
- Jingfang Yin
- Department of Oral Medicine; Guanghua School of Stomatology; Guangdong Provincial Key Laboratory of Stomatology; Sun Yat-sen University; Guangzhou China
| | - Xi Yang
- Department of Periodontology; Guangdong Provincial Stomatological Hospital; Southern Medical University; Guangzhou China
| | - Qi Zeng
- Department of Oral Medicine; Guanghua School of Stomatology; Guangdong Provincial Key Laboratory of Stomatology; Sun Yat-sen University; Guangzhou China
| | - Linglan Yang
- Department of Oral Medicine; Guanghua School of Stomatology; Guangdong Provincial Key Laboratory of Stomatology; Sun Yat-sen University; Guangzhou China
| | - Bin Cheng
- Department of Oral Medicine; Guanghua School of Stomatology; Guangdong Provincial Key Laboratory of Stomatology; Sun Yat-sen University; Guangzhou China
| | - Xiaoan Tao
- Department of Oral Medicine; Guanghua School of Stomatology; Guangdong Provincial Key Laboratory of Stomatology; Sun Yat-sen University; Guangzhou China
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15
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Gangeshetty N, Kumar BP. Oral lichenplanus: Etiology, pathogenesis, diagnosis, and management. World J Stomatol 2015; 4:12-21. [DOI: 10.5321/wjs.v4.i1.12] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/28/2014] [Revised: 12/01/2014] [Accepted: 01/12/2015] [Indexed: 02/06/2023] Open
Abstract
Oral Lichen planus (OLP) is a common chronic mucocutaneous disorder with an immune mediated pathogenesis. Its appearance may vary from presence of keratotic to erythematous areas. Etiology of OLP is unknown, but it is thought to be the result of an autoimmune process with an unknown predisposing factor. Oral lichen planus is a complex and poorly understood clinical condition with periods of remissions and exacerbations. Management of the OLP is diversified with few lesions requiring treatment for years and few others are mild, requiring no treatment.
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Arunkumar S, Kalappanavar AN, Annigeri RG, Kalappa SG. Relative efficacy of pimecrolimus cream and triamcinolone acetonide paste in the treatment of symptomatic oral lichen planus. Indian J Dent 2015; 6:14-9. [PMID: 25767355 PMCID: PMC4357072 DOI: 10.4103/0975-962x.151692] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
BACKGROUND AND OBJECTIVES Oral lichen planus (OLP) is a relatively common, chronic inflammatory condition that frequently presents with symptoms of pain and burning sensation. It is generally a very unrelenting disorder despite several kinds of treatment. Only symptomatic OLP requires treatment, and it remains a challenging predicament. Efforts are made in a sustained manner for searching for novel therapies for symptomatic OLP. Therefore, this study was aimed to compare the efficacy of treatment with topical pimecrolimus cream 1% with that of triamcinolone acetonide oral paste 0.1% in subjects with symptomatic OLP. MATERIALS AND METHODS A prospective, parallel-group, randomized, active control clinical study was conducted among 30 symptomatic OLP subjects (20 females and 10 males, with 15 patients in each treatment group) treated with topical pimecrolimus 1% cream and triamcinolone acetonide 0.1% oral paste four times daily for two consecutive months and treatment-free follow-up was performed for 2 months. Pain or burning sensation, mean clinical score and presence of erythematous areas were assessed. The data obtained were statistically analyzed using Wilcoxon's Rank test and the Mann Whitney test. RESULTS Subjects in both the groups showed significant improvement in symptom scores; however, the overall treatment response was higher in the pimecrolimus group compared with the triamcinolone acetonide group. On intergroup comparison, there was no statistically significant difference between the groups in the reduction in burning sensation (P = 0.18) and erythematous area (P = 0.07), but there was a statistically highly significant improvement in reduction of clinical scoring (P < 0.01%). Following the termination of the treatment, sustained remission of symptoms and long-lasting therapeutic effects was detected in 93.3% of the patients treated with pimecrolimus. INTERPRETATION AND CONCLUSION Topical pimecrolimus 1% cream showed better therapeutic response compared with triamcinolone acetonide 0.1% oral paste in subjects with symptomatic OLP.
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Affiliation(s)
- Shantala Arunkumar
- Department of Oral Medicine and Radiology, Sri Dharmasthala Manjunatheshwara College of Dental Sciences and Hospital, Dharwad, India
| | - Anupama N Kalappanavar
- Department of Oral Medicine and Radiology, College of Dental Sciences and Hospital, Davangere, Karnataka, India
| | - Rajeshwari G Annigeri
- Department of Oral Medicine and Radiology, College of Dental Sciences and Hospital, Davangere, Karnataka, India
| | - Shakuntala G Kalappa
- Department of Oral Medicine and Radiology, MAHE Institute of Dental Sciences and Hospital, Mahe, Pondicherry, India
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Otero-Rey EM, Suarez-Alen F, Peñamaria-Mallon M, Lopez-Lopez J, Blanco-Carrion A. Malignant transformation of oral lichen planus by a chronic inflammatory process. Use of topical corticosteroids to prevent this progression? Acta Odontol Scand 2014; 72:570-7. [PMID: 24850508 DOI: 10.3109/00016357.2014.914570] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
BACKGROUND Oral lichen planus is a potentially malignant disorder with a capacity, although low, for malignant transformation. Of all the factors related to the process of malignant transformation, it is believed that the chronic inflammatory process plays a key role in the development of oral cancer. This inflammatory process is capable of providing a microenvironment based on different inflammatory cells and molecules that affect cellular growth, proliferation and differentiation. OBJECTIVES The objectives of our study are: to review the available evidence about the possible relationship between the chronic inflammatory process present in oral lichen planus and its malignant transformation, to discuss the potential therapeutic implications derived from this relationship and to study the role that topical corticosteroids play in the control of oral lichen planus inflammation and its possible progression to malignant transformation. CONCLUSION The maintenance of a minimum dose of topical corticosteroids could prevent the inflammatory progression of oral lichen planus to oral cancer.
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Affiliation(s)
- Eva Maria Otero-Rey
- Department of Stomatology, School of Dental Medicine, University of Santiago de Compostela , Spain
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18
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Bokor-Bratic M, Cankovic M, Dragnic N. Unstimulated whole salivary flow rate and anxiolytics intake are independently associated with oralCandidainfection in patients with oral lichen planus. Eur J Oral Sci 2013; 121:427-33. [DOI: 10.1111/eos.12073] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/13/2013] [Indexed: 11/29/2022]
Affiliation(s)
- Marija Bokor-Bratic
- Dental Clinic; Faculty of Medicine; University of Novi Sad; Novi Sad; Serbia
| | - Milos Cankovic
- Dental Clinic; Faculty of Medicine; University of Novi Sad; Novi Sad; Serbia
| | - Natasa Dragnic
- Institute for Public Health of Vojvodina; Novi Sad; Serbia
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19
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Choi SG, Baek EJ, Davaa E, Nho YC, Lim YM, Park JS, Gwon HJ, Huh KM, Park JS. Topical treatment of the buccal mucosa and wounded skin in rats with a triamcinolone acetonide-loaded hydrogel prepared using an electron beam. Int J Pharm 2013; 447:102-8. [PMID: 23467084 DOI: 10.1016/j.ijpharm.2013.02.053] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2012] [Revised: 02/01/2013] [Accepted: 02/22/2013] [Indexed: 11/27/2022]
Abstract
In this study, a triamcinolone acetonide-loaded hydrogel was prepared by electron beam irradiation and evaluated for use as a buccal mucoadhesive drug delivery system. A poloxamer was modified to have vinyl end groups for preparation of the hydrogel via an irradiation cross-linking reaction. Carbopol was introduced to improve the mucoadhesive properties of the hydrogel. The in vitro release of triamcinolone acetonide from the hydrogel was examined at 37 °C. To investigate the topical therapeutic effect of triamcinolone acetonide on wounded rat skin and buccal mucosa, the appearance and histological changes were evaluated for 15 days after treatment with saline, triamcinolone acetonide solution, triamcinolone acetonide hydrogel, and blank hydrogel, respectively. Triamcinolone acetonide was released constantly from the gel formulation at 37 °C and reach 100% at about 48 h. After 15 days, in the skin of the group treated with the triamcinolone acetonide-loaded hydrogel, the wound was almost completely free of crust and a number of skin appendages, including hair follicles, had formed at the margins of the tissue. Moreover, the inflammatory response in the buccal mucosa was milder than that in the other groups, and the wound surface was completely covered with regenerating, hyperkeratotic, thickened epithelial cells. Our results indicate that the triamcinolone-acetonide hydrogel showed sustained drug release behavior, while causing no significant histopathological changes in buccal and skin tissues. Therefore, this hydrogel system may be a powerful means of drug delivery for buccal administration with controlled release and no tissue irritation.
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Affiliation(s)
- Soon Gil Choi
- College of Pharmacy, Chungnam National University, Daejeon 305-764, Republic of Korea
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20
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Lee YC, Shin SY, Kim SW, Eun YG. Intralesional injection versus mouth rinse of triamcinolone acetonide in oral lichen planus: a randomized controlled study. Otolaryngol Head Neck Surg 2013; 148:443-9. [PMID: 23325710 DOI: 10.1177/0194599812473237] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
OBJECTIVE To compare the efficacy, relapse, and adverse effects between intralesional injection and mouth rinse of triamcinolone acetonide (TA) in patients with oral lichen planus (OLP). STUDY DESIGN A randomized controlled study. SETTING College medical center. SUBJECTS AND METHODS Forty consecutive patients, who had been diagnosed with OLP, were recruited. Participants were randomly divided into 2 groups using intralesional injection or mouth rinse of TA. The severity of pain and burning sensation on a 10-cm visual analog scale (VAS) and the Oral Health Impact Profile-14 (OHIP-14) were assessed at weeks 0, 1, 2, 3, 4, and 6. The signs of OLP were quantified using a special scoring system for OLP. The rate of relapse and the adverse effects were compared between both groups. RESULTS The VAS scores for pain and burning mouth sensation and objective scoring for OLP were significantly improved at 1, 2, 3, 4, and 6 weeks in both groups. The changes in the VAS for burning mouth sensation, OHIP-14, and objective scoring for OLP were similar between both groups. The change in the VAS for pain from baseline to week 1 in the intralesional injection group was significantly higher than in the mouth rinse group. The rate of adverse effects was significantly higher in the mouth rinse group than in the intralesional injection group (44.4% vs 5.0%). CONCLUSION The efficacies of both treatments were similar. The rate of adverse effects was significantly lower for intralesional injection of TA than mouth rinse of TA.
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Affiliation(s)
- Young Chan Lee
- Department of Otolaryngology-Head and Neck Surgery, Kyung Hee University School of Medicine, Seoul, Korea
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21
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Petruzzi M, Lucchese A, Lajolo C, Campus G, Lauritano D, Serpico R. Topical Retinoids in Oral Lichen Planus Treatment: An Overview. Dermatology 2013; 226:61-7. [DOI: 10.1159/000346750] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2012] [Accepted: 12/24/2012] [Indexed: 11/19/2022] Open
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22
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Park HK, Hurwitz S, Woo SB. Oral lichen planus: REU scoring system correlates with pain. Oral Surg Oral Med Oral Pathol Oral Radiol 2012; 114:75-82. [PMID: 22727095 DOI: 10.1016/j.oooo.2012.02.013] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2011] [Revised: 02/13/2012] [Accepted: 02/24/2012] [Indexed: 11/29/2022]
Abstract
OBJECTIVES The objectives of this study were to correlate a semiquantitative scoring system for oral lichen planus (OLP) with pain before versus after treatment and to analyze sites of involvement and candidal status of patients in a retrospective study. STUDY DESIGN Reticulation/keratosis, erythema, and ulceration (REU) scores and numerical rating scale (NRS) for pain were used. Correlation was tested using Spearman rank correlation, and the change in REU and NRS scores using the paired t test. RESULTS One hundred fifteen patients were evaluable with 55 follow-up visits. Pain showed positive correlation with the total weighted score (r = .40), erythema (r = .35), ulceration (r = .31), and reticulation scores (r = .29), all at P < .005. There was improvement in REU and NRS scores before versus after treatment (P < .0001). The internal consistency reliability analysis yielded good reliability with Cronbach coefficient alpha of 0.70. The ventral tongue, floor of mouth, and soft palate were never the only sites affected. Candidal carriage was present in 24% of cases but candidiasis developed in only 10% of carriers. CONCLUSIONS The REU system is easy to use, correlates with an NRS for pain, and reliably reflects improvement attributable to treatment. Ventral tongue, floor of mouth, and soft palate were sites of OLP only if other sites were involved and candidiasis did not always develop in patients who were carriers.
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Affiliation(s)
- Hee-Kyung Park
- Department of Oral Medicine and Oral Diagnosis, School of Dentistry and Dental Research Institute, Seoul National University, Seoul, Republic of Korea.
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Hearnden V, Sankar V, Hull K, Juras DV, Greenberg M, Kerr AR, Lockhart PB, Patton LL, Porter S, Thornhill MH. New developments and opportunities in oral mucosal drug delivery for local and systemic disease. Adv Drug Deliv Rev 2012; 64:16-28. [PMID: 21371513 DOI: 10.1016/j.addr.2011.02.008] [Citation(s) in RCA: 176] [Impact Index Per Article: 14.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2010] [Revised: 02/15/2011] [Accepted: 02/23/2011] [Indexed: 02/08/2023]
Abstract
The oral mucosa's accessibility, excellent blood supply, by-pass of hepatic first-pass metabolism, rapid repair and permeability profile make it an attractive site for local and systemic drug delivery. Technological advances in mucoadhesives, sustained drug release, permeability enhancers and drug delivery vectors are increasing the efficient delivery of drugs to treat oral and systemic diseases. When treating oral diseases, these advances result in enhanced therapeutic efficacy, reduced drug wastage and the prospect of using biological agents such as genes, peptides and antibodies. These technologies are also increasing the repertoire of drugs that can be delivered across the oral mucosa to treat systemic diseases. Trans-mucosal delivery is now a favoured route for non-parenteral administration of emergency drugs and agents where a rapid onset of action is required. Furthermore, advances in drug delivery technology are bringing forward the likelihood of transmucosal systemic delivery of biological agents.
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Comparison of Aloe Vera Mouthwash With Triamcinolone Acetonide 0.1% on Oral Lichen Planus: A Randomized Double-Blinded Clinical Trial. Am J Med Sci 2011; 342:447-51. [DOI: 10.1097/maj.0b013e3182171164] [Citation(s) in RCA: 55] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
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Dalirsani Z, Taghavi Zenouz A, Mehdipour M, Alavi F, Javadzadeh Y. Comparison of the effect of combination of triamcinolone acetonide and vitamin a mouthwash with triamcinolone mouthwash alone on oral lichen planus. J Dent Res Dent Clin Dent Prospects 2010; 4:21-4. [PMID: 22991590 PMCID: PMC3429957 DOI: 10.5681/joddd.2010.006] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2009] [Accepted: 12/07/2009] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND AND AIMS Lichen planus is a relatively common mucocutaneous disease, with an unknown etiology. There is no complete cure for oral lichen planus (OLP), but some drugs, including corticosteroids, retinoids, cyclosporine and antibiotics are commonly used for treatment of OLP. The aim of the present study was to compare the effect of combi-nation of triamcinolone and vitamin A mouthwash with triamcinolone mouthwash alone on OLP. MATERIALS AND METHODS Twenty OLP patients were randomly divided into two groups of 10. The experimental group was treated with combination of triamcinolone and vitamin A mouthwash and the control group was treated with triamcinolone-containing mouthwash alone. The patients were examined once every two weeks and the lesion size, pain and burning sensation were recorded based on visual analogue scale during a two-month period. Data were analyzed by Mann-Whitney U test using SPSS software. RESULTS The use of combination of triamcinolone-vitamin A mouthwash was effective in decreasing the pain and burning sensation of OLP (P = 0.012). Decrease in pain and burning sensation were similar in both groups (P = 0.73). The use of combination of triamcinolone-vitamin A mouthwash led to a decrease in the size of keratotic, atrophic and erosive OLP lesions (P = 0). Decrease in the size of the lesions was significantly greater in the study group compared to the control group (P = 0.029). CONCLUSION The use of combination of triamcinolone-vitamin A mouthwash is effective in decreasing the size of keratotic, atrophic or erosive lesions.
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Affiliation(s)
- Zohreh Dalirsani
- Assistant Professor, Department of Oral Medicine, Faculty of Dentistry, Mashhad University of Medical Sciences, Mashhad, Iran
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26
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Xiong C, Li Q, Lin M, Li X, Meng W, Wu Y, Zeng X, Zhou H, Zhou G. The efficacy of topical intralesional BCG-PSN injection in the treatment of erosive oral lichen planus: a randomized controlled trial. J Oral Pathol Med 2009; 38:551-8. [PMID: 19486267 DOI: 10.1111/j.1600-0714.2009.00796.x] [Citation(s) in RCA: 45] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
BACKGROUND Nowadays, it has been widely accepted that the local cell-mediated immunologic disorders may play an important role in the pathogenesis of oral lichen planus (OLP). Therefore, we sieved out polysaccharide nucleic acid fraction of bacillus Calmette-Guerin (BCG-PSN) from various immunomodulators to evaluate the short-term therapeutic efficacy and clinical safety of intralesional BCG-PSN injection for erosive OLP. METHODS A total of 56 OLP patients were randomly assigned to receive either intralesional injection of 0.5 ml BCG-PSN every other day (31 of 56) or 10 mg triamcinolone acetonide (TA, a positive-controlled group, 25 of 56) every week for 2 weeks. After the cessation of treatment, those cured from erosion were followed up for 3 months. Another two researchers measured erosive areas and recorded visual analog scale (VAS) scores both at the start and the end of the treatment. We also registered adverse reactions and the recurrence intervals. RESULTS After 2-week treatment, 27 of 31 BCG-PSN-treated patients (87.1%) and 22 of 25 TA-treated patients (88.0%) healed. There were no statistical differences between the two groups in erosive areas (27.86 +/- 27.97 vs. 25.68 +/- 34.65, P = 0.801) and VAS scores (2.45 +/- 1.64 vs. 2.40 +/- 1.38, P = 0.946). Three of 31 BCG-PSN-treated patients (9.7%) vs. 2 of 25 TA-treated patients (8.0%) experienced the swelling or burning sensation (P = 0.827). A total of 49 of 56 patients were followed up. There were no statistical differences in the recurrence rates (33.3% vs. 45.5%, P = 0.386) and intervals (80.89 +/- 26.83 vs. 73.48 +/- 28.11, P = 0.419). CONCLUSIONS Topical intralesional BCG-PSN injection is as effective as TA for erosive OLP, which suggests that topical intralesional BCG-PSN injection can be a promising therapeutic alternative for erosive OLP, especially for those insensitive, or even resistant, to glucocorticoids.
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Affiliation(s)
- C Xiong
- State Key Laboratory of Oral Diseases, Sichuan University, Chengdu, Sichuan 610041, China
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Abstract
Steroids have been found to be effective in treating symptomatic oral lichen planus (OLP) by reducing pain and inflammation. In fact, systemic corticosteroids should be reserved for acute exacerbation, and multiple or widespread lesions. They may be indicated in patients whose condition is unresponsive to topical steroids. However, various potent topical steroids have been reported to be effective in the treatment of symptomatic OLP. They can be used as the first line drugs in the treatment of OLP with no serious side-effects. During the therapy, candidiasis was commonly found and in addition, bad taste, nausea, dry mouth, sore throat and swollen mouth may occur as minor side-effects from some topical steroids. Because OLP is a chronic disorder that requires long-term treatment, topical steroids are recommended for the treatment OLP because of minimal side-effects and the cost benefit. This manuscript reviews the use of steroids, especially its topical application, in the treatment of OLP.
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Affiliation(s)
- Kobkan Thongprasom
- Department of Oral Medicine, Faculty of Dentistry, Chulalongkorn University, Bangkok, Thailand
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Cendras J, Bonnetblanc JM. Lichen plan buccal érosif. Ann Dermatol Venereol 2009; 136:458-68; quiz 457, 469-70. [DOI: 10.1016/j.annder.2008.06.015] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2008] [Accepted: 06/25/2008] [Indexed: 10/21/2022]
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