ABSTRACT
OBJECTIVE: The aim of this work is to report the handling of a patient suffering from cicatricial pemphigoid (CP) treated with laser phototherapy (LPT) and systemic steroids. BACKGROUND DATA: CP is a group of rare chronic autoimmune blistering diseases that predominately affect the mucous membranes and occasionally the skin. The gingiva is most commonly involved, followed by the palate and the buccal mucosa. High-dosage systemic steroids are widely used for its treatment. LPT has been shown to improve wound healing and relieve pain. Its efficacy depends on the amount of energy delivered to the tissue, exposure time, and delivery method. MATERIALS AND METHODS: A white 47-y-old man with CP who used systemic steroids for the previous 5 y was examined at our clinic. Extra- and intraoral examination revealed classic signs of the condition. LPT (GaAlAs diode laser, 660 nm wavelength, 30 mW, continuous wave, diameter approximately 3 mm, 60 J/cm(2) per session) was used in association with the steroids. LPT was performed in a punctual contact manner every other day on the oral mucosa. Maintenance of the treatment was carried out weekly because interruption of the LPT resulted in the recurrence of the lesions. At the time that this report was written, the patient had been undergoing twice weekly treatments for 6 months without signs of lesion recurrence. CONCLUSION: Concomitant use of systemic steroids and LPT showed a positive effect on controlling oral CP lesions and on improving both oral health and the quality of life of the patient.
Subject(s)
Low-Level Light Therapy , Pemphigoid, Benign Mucous Membrane/radiotherapy , Combined Modality Therapy , Glucocorticoids/therapeutic use , Humans , Lasers, Semiconductor , Male , Middle Aged , Pemphigoid, Benign Mucous Membrane/drug therapyABSTRACT
OBJECTIVE: The purpose of this study was to investigate the morphological, histochemical, and immunocytochemical changes of the oral mucosa after CO(2) or Er:YAG laser irradiation. BACKGROUND DATA: There have been no comparative reports on CO(2) and Er:YAG laser effects on human oral soft tissues. MATERIALS AND METHODS: Tissue preservation was studied in 40 oral biopsies of young patients obtained by CO(2) and Er:YAG laser surgery. Hematoxylin-eosin and Giemsa stains, PAS/diastase treatment, AE1 and AE2 cytokeratins, MiB1/Ki67, and bcl-2 immunoreactions were performed on the laser cut edges on formalin fixed, paraffin embedded biopsies. RESULTS: CO(2) laser biopsies show blisters, clefts and erosions of the epithelium. Intracellular edema and lengthened nuclei were also seen. The glycogen content results decreased in CO(2) laser biopsies. Good expression for cytokeratins and cell-cycle proliferation markers were found in Er:YAG biopsies, on the contrary the apoptosis marker was better expressed in CO(2) laser biopsies. CONCLUSION: The results suggest that Er:YAG laser may be routinely used in surgery, because of its minimal damage of the epithelial tissue, its low inflammatory reaction, its quicker healing process and its lower risk of scarring.
