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Pedraça ES, da Silva EL, de Lima TB, Rados PV, Visioli F. Systemic non-steroidal immunomodulators for oral lichen planus treatment-a scoping review. Clin Oral Investig 2023; 27:7091-7114. [PMID: 37921879 DOI: 10.1007/s00784-023-05357-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2023] [Accepted: 10/19/2023] [Indexed: 11/05/2023]
Abstract
OBJECTIVE The aim of this scoping review was to evaluate the efficacy and safety of the use of systemic nonsteroidal immunomodulators (SNSI) for oral lichen planus (OLP) treatment. MATERIALS AND METHODS This review was conducted according to PRISMA-ScR guidelines and registered at PROSPERO (CRD42021243524). Consulted databases were Pubmed, Embase, Scopus, and Web of Science. The inclusion criteria was as follows: clinical trials, case series, prospective, and retrospective studies conducted with participants presenting OLP of any sex and age. RESULTS Thirty-two studies were selected, assessing 9 different SNSI: methotrexate, dapsone, levamisole, hydroxychloroquine, thalidomide, metronidazole, azathioprine, mycophenolate mofetil, and colchicine. Methotrexate and dapsone were the drugs with the best evidence among the options included, regarding number and quality of studies. Methotrexate resulted in significant improvement in the clinical condition and remission of symptoms, ranging between 63 and 93% of cases. Dapsone presented a similar effect to the use of topical corticosteroids and tacrolimus CONCLUSION: Among SNSI therapeutic options, methotrexate, and dapsone showed promising efficacy and safety. However, large-scale randomized clinical trials are still needed. CLINICAL RELEVANCE SNSI have been used in the treatment of recalcitrant OLP; however, so far, it is not clear which are the best options. This scoping review highlights the potential use of methotrexate and dapsone.
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Affiliation(s)
- Erick Souza Pedraça
- Oral Pathology, School of Dentistry, Universidade Federal do Rio Grande do Sul, Rua Ramiro Barcelos, 2492, Porto Alegre, RS, 90035-003, Brazil
| | - Eduardo Liberato da Silva
- Oral Pathology, School of Dentistry, Universidade Federal do Rio Grande do Sul, Rua Ramiro Barcelos, 2492, Porto Alegre, RS, 90035-003, Brazil
| | - Taiane Berguemaier de Lima
- Oral Pathology, School of Dentistry, Universidade Federal do Rio Grande do Sul, Rua Ramiro Barcelos, 2492, Porto Alegre, RS, 90035-003, Brazil
| | - Pantelis Varvaki Rados
- Oral Pathology, School of Dentistry, Universidade Federal do Rio Grande do Sul, Rua Ramiro Barcelos, 2492, Porto Alegre, RS, 90035-003, Brazil
| | - Fernanda Visioli
- Oral Pathology, School of Dentistry, Universidade Federal do Rio Grande do Sul, Rua Ramiro Barcelos, 2492, Porto Alegre, RS, 90035-003, Brazil.
- Experimental Research Center, Hospital de Clínicas de Porto Alegre, Porto Alegre, RS, Brazil.
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Research on the Removal of Levamisole Residues in Bovine, Ovine, Caprine, Porcine and Poultry Tissues. SEPARATIONS 2022. [DOI: 10.3390/separations9090261] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
In this paper, we set the waiting time for the elimination of levamisole residues at a safe level from tissues (muscles and organs) from animals treated with levamisole 10%—oral solution. We studied the depletion of levamisole residues by high performance liquid chromatography with a mass spectrometer (limit of quantification 2 μg/kg) in the tissues of bovine, ovine, caprine, porcine and poultry (chickens and pigeons) after administration of levamisole (10 mg levamisole/kg body weight for cattle, sheep, goats, pigs and 20 mg levamisole/kg body weight for birds). We found that in cattle, sheep and goats at 7 days after treatment, the residues of levamisole in the liver and at 14 days and in the other tissues were below the established limit value. In pigs at 7 days, residues from all tissues were below the set limit value. Residue depletion in chickens treated with levamisole was rapid, such that 3 days after treatment, the residues in all tissues were below the set limit. Residue depletion was slower in turkeys than in chickens.
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Effect of a Single and Triple Dose of Levamisole on Hematological Parameters in Controlled Inflammation Model. Animals (Basel) 2022; 12:ani12162110. [PMID: 36009703 PMCID: PMC9404755 DOI: 10.3390/ani12162110] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2022] [Revised: 08/10/2022] [Accepted: 08/14/2022] [Indexed: 11/17/2022] Open
Abstract
This study aimed to evaluate the impact of single and triple administration of levamisole on the dynamics of hematological parameters during experimental pleuritis. The experiment was performed on female Buffalo rats. Rats were randomly assigned to two equal groups that received 1 and 3 doses of levamisole every 2, 24 and 48 h, respectively. Following the experiment, blood samples for the measurement of hematological parameters were collected. The study group receiving three doses of levamisole observed a significant reduction of red blood cell count at 48 h post administration and an increase in mean corpuscular volume compared to the control inflammation group. The administration of a single dose of levamisole results in a significant increase in hematocrit at 72 h, an increase in white blood cell count at 24 h and 72 h, and an increase in neutrophil count at 72 h compared to the control inflammation group. Administration of a single and triple dose of levamisole showed statistically significant modification of some hematological parameters and thus modulates the inflammatory process. In the lungs, this results in a reduction in leukocyte infiltrations around the bronchi and blood vessels.
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Manfredini M, Pedroni G, Bigi L, Apponi R, Murri Dello Diago A, Dattola A, Farnetani F, Pellacani G. Acquired White Oral Lesions with Specific Patterns: Oral Lichen Planus and Lupus Erythematosus. Dermatol Pract Concept 2021; 11:e2021074. [PMID: 34123565 DOI: 10.5826/dpc.1103a74] [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] [Accepted: 02/08/2021] [Indexed: 12/15/2022] Open
Abstract
Background Diagnosis of oral white lesions might be challenging. These lesions represent a wide spectrum of diseases with different etiology and prognosis. Oral white lesions can be categorized into two major groups, congenital and acquired, according to their development, and in four subgroups: lesions which can be scraped off or not and lesions with special pattern or not. Objectives The aim of this manuscript is to review, from diagnosis to treatment, the current knowledge on oral white lesions with specific pattern. Methods A review on oral white lesions with specific pattern was conducted on PubMed and Scopus from inception to January 2021. Results Among acquired lesions with specific pattern two clinical entities are mostly represented: Oral lichenoid reactions and Lupus erythematosus. The etiology of both diseases is still not known but their pathogenesis is mainly immunological. At present the mucoscopic features of those disease have been described only in few case reports or case series. Immunomodulatory therapies are often the agents of choice for their treatment. Conclusions The collaboration of dermatologists and dentists as a team is important for early diagnoses and effective treatments. Mucoscopy is a promising technique which may reveal important features for the differentiation of OLP and LE oral white lesions.
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Affiliation(s)
- Marco Manfredini
- Dermatology Unit, Department of Surgical, Medical, Dental & Morphological Sciences with Interest in Transplant, Oncological & Regenerative Medicine, University of Modena & Reggio Emilia, Modena, Italy
| | - Gioia Pedroni
- Dermatology Unit, Department of Surgical, Medical, Dental & Morphological Sciences with Interest in Transplant, Oncological & Regenerative Medicine, University of Modena & Reggio Emilia, Modena, Italy
| | - Laura Bigi
- Dermatology Unit, Department of Surgical, Medical, Dental & Morphological Sciences with Interest in Transplant, Oncological & Regenerative Medicine, University of Modena & Reggio Emilia, Modena, Italy
| | - Roberto Apponi
- Dental Unit, Department of Surgical, Medical, Dental & Morphological Sciences with Interest in Transplant, Oncological & Regenerative Medicine, University of Modena & Reggio Emilia, Modena, Italy
| | - Alberto Murri Dello Diago
- Dental Unit, Department of Surgical, Medical, Dental & Morphological Sciences with Interest in Transplant, Oncological & Regenerative Medicine, University of Modena & Reggio Emilia, Modena, Italy
| | - Annunziata Dattola
- Dermatology Clinic, Department of Systems Medicine, Tor Vergata University, Rome, Italy
| | - Francesca Farnetani
- Dermatology Unit, Department of Surgical, Medical, Dental & Morphological Sciences with Interest in Transplant, Oncological & Regenerative Medicine, University of Modena & Reggio Emilia, Modena, Italy
| | - Giovanni Pellacani
- Dermatology Clinic, Department of Clinical, Internal, Anesthesiological and Cardiovascular Sciences, Sapienza University of Rome, Rome, Italy
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Roostaei Firozabad A, Meybodi ZA, Mousavinasab SR, Sahebnasagh A, Jelodar MG, Karimzadeh I, Habtemariam S, Saghafi F. Efficacy and safety of Levamisole treatment in clinical presentations of non-hospitalized patients with COVID-19: a double-blind, randomized, controlled trial. BMC Infect Dis 2021; 21:297. [PMID: 33761870 PMCID: PMC7988635 DOI: 10.1186/s12879-021-05983-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2020] [Accepted: 03/10/2021] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Levamisole has shown clinical benefits in the management of COVID-19 via its immunomodulatory effect. However, the exact role of Levamisole effect in clinical status of COVID-19 patients is unknown. We aimed to evaluate the efficacy of Levamisole on clinical status of patients with COVID-19 during their course of the disease. METHODS This prospective, double-blind, randomized controlled clinical trial was performed in adult patients with mild to moderate COVID-19 (room-air oxygen saturation > 94%) from late April 2020 to mid-August 2020. Patients were randomly assigned to receive a 3-day course of Levamisole or placebo in combination with routine standard of care. RESULTS With 25 patients in each arm, 50 patients with COVID-19 were enrolled in the study. Most of the study participants were men (60%). On days 3 and 14, patients in Levamisole group had significantly better cough status distribution when compared to the placebo group (P-value = 0.034 and 0.005, respectively). Moreover, there was significant differences between the two groups in dyspnea at follow-up intervals of 7 (P-value = 0.015) and 14 (P-value = 0.010) days after receiving the interventions. However, no significant difference in fever status was observed on days 1, 3, 7, and 14 in both groups (P-value > 0.05). CONCLUSION The results of the current study suggest that Levamisole may improve most of clinical status of patients with COVID-19. The patients receiving Levamisole had significantly better chance of clinical status including cough and dyspnea on day 14 when compared to the placebo. However, the effect-size of this finding has uncertain clinical importance. TRIAL REGISTRATION The trial was registered as IRCT20190810044500N7 (19/09/2020).
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Affiliation(s)
- Amirreza Roostaei Firozabad
- Pharmaceutical Sciences Research Center, Student Research Committee, School of Pharmacy, Shahid Sadoughi University of Medical Sciences and Health Services, Yazd, Iran
| | - Zohreh Akhoundi Meybodi
- Infectious disease research center, Shahid Sadoughi hospital, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Seyed Ruhollah Mousavinasab
- Resident of Clinical Pharmacy, Department of Clinical Pharmacy, School of Pharmacy, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Adeleh Sahebnasagh
- Clinical Research Center, Department of Internal Medicine, School of Medicine, North Khorasan University of Medical Sciences, Bojnurd, Iran
| | - Mohsen Gholinataj Jelodar
- Department of Internal Medicine, School of Medicine, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Iman Karimzadeh
- Department of Clinical Pharmacy, School of Pharmacy, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Solomon Habtemariam
- Pharmacognosy Research Laboratories and Herbal Analysis Services UK, University of Greenwich, Central Avenue, Chatham-Maritime, Kent, ME4 4TB UK
| | - Fatemeh Saghafi
- Department of Clinical Pharmacy, Faculty of Pharmacy and Pharmaceutical Sciences Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
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Lu SY, Chang TF, Lin CJ. Treatment effectiveness of levamisole plus prednisolone on oral lichen planus patients with emphasis on levamisole-induced agranulocytosis or pancytopenia. J Formos Med Assoc 2019; 118:1193-1201. [PMID: 30922614 DOI: 10.1016/j.jfma.2019.03.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2019] [Revised: 03/02/2019] [Accepted: 03/06/2019] [Indexed: 10/27/2022] Open
Abstract
BACKGROUND/PURPOSE Physicians' and dentists' knowledge of levamisole-induced agranulocytosis or pancytopenia remains incomplete. This study aimed to evaluate the treatment effectiveness of levamisole plus prednisolone on oral lichen planus (OLP) patients with emphasis on levamisole-induced hematological changes. METHODS Ninety patients with erosive OLP were given 120 mg/day new levamisole (Levazol) and 15 mg/day prednisolone for three consecutive days each week. Three cases with levamisole-induced blood-cytopenias were assessed and treated within one year. RESULTS Most patients reported significant pain relief and showed no evidence of erosive OLP after 4-8 weeks of treatment with few side effects; nevertheless, three female patients developed agranulocytosis or granulocytopenia with concomitant thrombocytopenia or pancytopenia within 2-6 weeks after levamisole (Levazol) treatment. One case with previously unknown double episodes of agranulocytosis revealed her first episode following interruption of levamisole (Decaris) treatment for 4 months. High fever and sore throat were the most common symptoms, but two agranulocytosis cases remained asymptomatic one week before diagnosis, and were treated with levamisole withdrawal and empiric antimicrobial initiation as well as utilization of granulocyte colony-stimulating factors. Neutrophil recovery took about 1 week, but over 4 weeks in one of the cases (an elderly patient) with septic shock. CONCLUSION Agranulocytosis or pancytopenia usually developed within 2 months after levamisole treatment, but it might be delayed. Agranulocytosis was more likely to occur in females and onset was acute. Levamisole is an effective immunomodulator for OLP patients; however, it should be used with caution and administered with regular blood monitoring.
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Affiliation(s)
- Shin-Yu Lu
- Oral Pathology and Family Dentistry Section, Department of Dentistry, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan.
| | - Tzu-Fan Chang
- Oral Pathology and Family Dentistry Section, Department of Dentistry, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Chih-Jen Lin
- Oral Pathology and Family Dentistry Section, Department of Dentistry, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
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8
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Brilhante RSN, Caetano EP, Lima RAC, Castelo Branco DSCM, Serpa R, Oliveira JS, Monteiro AJ, Rocha MFG, Cordeiro RA, Sidrim JJC. In vitro antifungal activity of miltefosine and levamisole: their impact on ergosterol biosynthesis and cell permeability of dimorphic fungi. J Appl Microbiol 2015; 119:962-9. [PMID: 26178247 DOI: 10.1111/jam.12891] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2015] [Revised: 06/09/2015] [Accepted: 06/25/2015] [Indexed: 12/26/2022]
Abstract
AIMS This study aimed to evaluate the in vitro activity of miltefosine and levamisole against strains of Coccidioides posadasii in the filamentous phase and strains of Histoplasma capsulatum in filamentous and yeast phases. METHODS AND RESULTS Strains of C. posadasii in the filamentous phase (n = 22) and strains of H. capsulatum in filamentous (n = 40) and yeast phases (n = 13) were, respectively, submitted to broth macrodilution and broth microdilution methods, as described by the Clinical and Laboratory Standards Institute, to determine the minimum inhibitory concentration (MIC) and the minimum fungicidal concentration (MFC) of miltefosine and levamisole. The effect of the drugs on cell membrane permeability under osmotic stress conditions and total ergosterol production were also assessed, along with quantification of extravasated molecules. The results show the inhibitory effect of levamisole and miltefosine against C. posadasii and H. capsulatum and the effect of these drugs on ergosterol synthesis and the permeability of the plasma membrane using subinhibitory concentrations against strains subjected to osmotic stress. Levamisole was also able to cause the release of nucleic acids. CONCLUSIONS Miltefosine and levamisole are capable of inhibiting the in vitro growth of C. posadasii and H. capsulatum, probably by altering the permeability of the cellular membrane. SIGNIFICANCE AND IMPACT OF THE STUDY This work presents alternatives for the treatment of histoplasmosis and coccidioidomycosis, raising the possibility of the use of miltefosine and levamisole as adjuvants in antifungal therapy, providing perspectives for the design of in vivo studies.
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Affiliation(s)
- R S N Brilhante
- Specialized Medical Mycology Center, Postgraduate Program in Medical Microbiology, Federal University of Ceará, Fortaleza, CE, Brazil.,Postgraduate Program in Medical Sciences, Federal University of Ceará, Fortaleza, CE, Brazil
| | - E P Caetano
- Specialized Medical Mycology Center, Postgraduate Program in Medical Microbiology, Federal University of Ceará, Fortaleza, CE, Brazil
| | - R A C Lima
- Specialized Medical Mycology Center, Postgraduate Program in Medical Microbiology, Federal University of Ceará, Fortaleza, CE, Brazil
| | - D S C M Castelo Branco
- Specialized Medical Mycology Center, Postgraduate Program in Medical Microbiology, Federal University of Ceará, Fortaleza, CE, Brazil
| | - R Serpa
- Specialized Medical Mycology Center, Postgraduate Program in Medical Microbiology, Federal University of Ceará, Fortaleza, CE, Brazil
| | - J S Oliveira
- Specialized Medical Mycology Center, Postgraduate Program in Medical Microbiology, Federal University of Ceará, Fortaleza, CE, Brazil
| | - A J Monteiro
- Department of Statistics and Applied Mathematics, Federal University of Ceará, Fortaleza, CE, Brazil
| | - M F G Rocha
- Specialized Medical Mycology Center, Postgraduate Program in Medical Microbiology, Federal University of Ceará, Fortaleza, CE, Brazil.,Postgraduate Program in Veterinary Sciences, State University of Ceará, Fortaleza, CE, Brazil
| | - R A Cordeiro
- Specialized Medical Mycology Center, Postgraduate Program in Medical Microbiology, Federal University of Ceará, Fortaleza, CE, Brazil.,Postgraduate Program in Medical Sciences, Federal University of Ceará, Fortaleza, CE, Brazil
| | - J J C Sidrim
- Specialized Medical Mycology Center, Postgraduate Program in Medical Microbiology, Federal University of Ceará, Fortaleza, CE, Brazil.,Postgraduate Program in Medical Sciences, Federal University of Ceará, Fortaleza, CE, Brazil
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Sharma S, Ali FM, Saraf K, Mudhol A. Anti-helminthic drugs in recurrent apthous stomatitis: A short review. J Pharm Bioallied Sci 2014; 6:65-8. [PMID: 24741272 PMCID: PMC3983748 DOI: 10.4103/0975-7406.129169] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2013] [Revised: 06/12/2013] [Accepted: 01/22/2014] [Indexed: 11/05/2022] Open
Abstract
Recurrent aphthous stomatitis (RAS) is a common mucosal condition producing painful ulcerations in the oral cavity and considerable clinical morbidity. The etiology remains obscure, though local trauma, psychologic stress, hematinic deficiencies and immune dysregulation have been implicated. Though the primary goals of therapy are symptomatic relief of pain, the clinicians are aiming toward reducing the frequency, duration, number of ulcerations and increasing ulcer free periods with systemic drug therapy if topical medications appear ineffective. Levamisole, an antihelminthic drug has been tried with promising results in patients with severe RAS providing long-term benefits.
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Affiliation(s)
- Shilpa Sharma
- Department of Oral Medicine and Radiology, SMBT Dental College, Sangamner, Ahmednagar, Maharashtra, India
| | - Fareedi Mukram Ali
- Department of Oral and Maxillofacial Surgery, SMBT Dental College, Sangamner, Ahmednagar, Maharashtra, India
| | - Kedar Saraf
- Department of Oral Medicine and Radiology, SMBT Dental College, Sangamner, Ahmednagar, Maharashtra, India
| | - Anupama Mudhol
- Department of Oral and Maxillofacial Surgery, SMBT Dental College, Sangamner, Ahmednagar, Maharashtra, India
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Lemaignen A, Goulenok T, Kalamarides S, Plat A, Pfau G, Fantin B. [Agranulocytosis and vasculitis in a cocaine addict: levamisole, the hidden culprit]. Rev Med Interne 2013; 35:676-9. [PMID: 24290029 DOI: 10.1016/j.revmed.2013.10.337] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2013] [Accepted: 10/24/2013] [Indexed: 10/26/2022]
Abstract
INTRODUCTION Adulterants are compounds added to street drugs to increase profits for the seller. Levamisole, a veterinary antihelminthic agent, has become the most common adulterant of cocaine. The prevalence of levamisole in samples of cocaine is increasing. Levamisole can lead to neutropenia and to a dramatic vasculopathy and even vasculitis of small and medium-size blood vessels. CASE REPORT We here reported the first French case of levamisole related toxicity, due to cocaine use in a 50-year-old man, revealed by fever and agranulocytosis, high titters of antineutrophil cytoplasmic antibodies (ANCA), anticoagulant and positive Coombs tests. Outcome was slowly favorable with exposition withdrawal. CONCLUSION Clinicians should be aware that agranulocytosis or vasculitis or vasculopathy could be related to levamisole toxicity in individuals who use cocaine.
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Affiliation(s)
- A Lemaignen
- Service de médecine interne, hôpital Beaujon, université Paris Diderot, Sorbonne Paris-Cité, AP-HP, 100, boulevard du Général-Leclerc, 92110 Clichy, France
| | - T Goulenok
- Service de médecine interne, hôpital Beaujon, université Paris Diderot, Sorbonne Paris-Cité, AP-HP, 100, boulevard du Général-Leclerc, 92110 Clichy, France.
| | - S Kalamarides
- Unité de traitement ambulatoire des maladies addictives (UTAMA), hôpital Beaujon, université Paris Diderot, Sorbonne Paris-Cité, AP-HP, 100, boulevard du Général-Leclerc, 92110 Clichy, France
| | - A Plat
- Unité de traitement ambulatoire des maladies addictives (UTAMA), hôpital Beaujon, université Paris Diderot, Sorbonne Paris-Cité, AP-HP, 100, boulevard du Général-Leclerc, 92110 Clichy, France
| | - G Pfau
- Dispositif TREND/SINTES Paris, association Charonne, 75012 Paris, France
| | - B Fantin
- Service de médecine interne, hôpital Beaujon, université Paris Diderot, Sorbonne Paris-Cité, AP-HP, 100, boulevard du Général-Leclerc, 92110 Clichy, France
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Fatemi MJ, Salehi H, Akbari H, Alinejad F, Saberi M, Mousavi SJ, Soltani M, Taghavi S, Payandan H. The effect of levamisole on mortality rate among patients with severe burn injuries. JOURNAL OF RESEARCH IN MEDICAL SCIENCES : THE OFFICIAL JOURNAL OF ISFAHAN UNIVERSITY OF MEDICAL SCIENCES 2013; 18:795-800. [PMID: 24381625 PMCID: PMC3872590] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/28/2013] [Revised: 08/11/2013] [Accepted: 09/02/2013] [Indexed: 11/30/2022]
Abstract
BACKGROUND Burn injuries are one of the main causes of mortality and morbidity throughout the world and burn patients have higher chances for infection due to their decreased immune resistance. Levamisole, as an immunomodulation agent, stimulates the immune response against infection. MATERIALS AND METHODS This randomized clinical trial was conducted in Motahari Burn Center, Tehran, Iran. Patients who had second- or third-degree burn with involvement of more than 50% of total body surface area (TBSA) were studied. The levamisole group received levamisole tablet, 100 mg per day. Meantime, both the levamisole and control groups received the standard therapy of the Burn Center, based on a standard protocol. Then, the outcome of the patients was evaluated. RESULTS 237 patients entered the study. After excluding 42 patients with inhalation injury, electrical and chemical burns, and the patients who died in the first 72 h, 195 patients remained in the study, including 110 patients in the control group and 85 in the treatment group. The mean age of all patients (between 13 to 64 years) was 33.29 ± 11.39 years (Mean ± SD), and it was 33.86 ± 11.45 years in the control group and 32.57 ± 11.32 years in the treatment group. The mean percentage of TBSA burn was 64.50 ± 14.34 and 68.58 ± 14.55 for the levamisole and control groups, respectively, with the range of 50-100% and 50-95% TBSA. The mortality rate was 68 (61.8%) patients in the control group and 50 (58.8%) patients in the treatment group (P = 0.8). CONCLUSION According to this study, there was no significant relationship between improvement of mortality and levamisole consumption.
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Affiliation(s)
- Mohammad Javad Fatemi
- Department of Plastic and Reconstructive Surgery, Burn Research Center and Hazrat Fatemeh Hospital, Iran University of Medical Sciences, Tehran, Iran,Address for correspondence: Dr. Mohammad Javad Fatemi, Department of Plastic and Reconstructive Surgery, Burn Research Center and Hazrat Fatemeh Hospital, Iran University of Medical Sciences, Tehran, Iran. E-mail:
| | - Hamid Salehi
- Department of Surgery, Burn Research Center and Motahari Hospital, Iran University of Medical Sciences, Tehran, Iran
| | - Hossein Akbari
- Department of Plastic and Reconstructive Surgery, Burn Research Center and Hazrat Fatemeh Hospital, Iran University of Medical Sciences, Tehran, Iran
| | - Faranak Alinejad
- Infectious Disease Specialist, Burn Research Center and Motahari Hospital, Iran University of Medical Sciences, Tehran, Iran
| | - Mohsen Saberi
- Medicine, Quran and Hadith Research Center and Department of Community Medicine, Baqiyatallah University of Medical Sciences, Tehran, Iran
| | - Seyed Jaber Mousavi
- Department of Community Medicine, Burn Research Center, Iran University of Medical Sciences and Mazandaran University of Medical Sciences, Tehran, Iran
| | - Majid Soltani
- General Physician, Burn Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Shahrzad Taghavi
- General Physician, Burn Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Hossein Payandan
- Psychologist, Shahid Lavasani Hospital, Social Security Organization, Tehran, Iran
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Nico MMS, Fernandes JD, Lourenço SV. Oral lichen planus. An Bras Dermatol 2012; 86:633-41; quiz 642-3. [PMID: 21987126 DOI: 10.1590/s0365-05962011000400002] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2010] [Accepted: 10/25/2010] [Indexed: 02/06/2023] Open
Abstract
Oral lichen planus (OLP) is a relatively common mucosal disease that can present isolated or associated with cutaneous lichen planus. Contrarily to its cutaneous counterpart, though, OLP tends to be chronic, relapsing, and difficult to treat. Severe morbidity is related to erosive forms, and more aggressive presentations have been described, such as the "gingivo-vulvar syndrome". This article reviews the current knowledge about the pathogenesis, clinical picture, differential and laboratorial diagnosis, prognosis, and treatment of OLP.
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