ABSTRACT
Patients with symptomatic oral lichen planus often require therapy to reduce signs and symptoms of the condition. For this purpose, corticosteroids are frequently used. In this study the effect of another immunosuppressive drug, cyclosporin A was evaluated; it was applied as a topical drug four times daily and contained 0.025% cyclosporin A. The study group was composed of nine symptomatic patients in whom the diagnosis of oral lichen planus was confirmed by histopathologic examination including immunofluorescence. All patients had unsuccessfully undergone previous treatment with topical or systemic corticosteroids. The minimum follow-up period in the present study was at least 4 months. Four patients showed partial response to treatment with respect to signs and symptoms. None of the patients had a complete remission. Five patients showed no response or even complained of an increase of signs and symptoms. No adverse side effects of the drug were recorded during follow-up. Although the number of patients has been small, the results of this study indicate that topical application of cyclosporin A (0.025%) in the treatment of recalcitrant oral lichen planus does not offer a distinct advantage over the use of topical corticosteroids.
Subject(s)
Cyclosporine/administration & dosage , Lichen Planus, Oral/drug therapy , Administration, Topical , Adult , Chronic Disease , Cyclosporine/therapeutic use , Female , Humans , Male , Middle Aged , Ointments , Pain MeasurementABSTRACT
Patients with symptomatic oral lichen planus frequently require therapy to reduce signs and symptoms. For this purpose, corticosteroids are often applied topically. In a randomized, double-blind, placebo-controlled study, the efficacy of the topical application of 0.025% fluocinonide was evaluated. Forty consecutive patients with oral lichen planus diagnosed on the basis of histopathologic and immunofluorescence findings participated in this study. All patients were followed for 3 to 17 months. No adverse effects were noted during follow-up period. In the group of 20 patients that received the drug, 4 patients (20%) showed a complete remission, and 12 patients (60%) had a good or partial response to topical treatment. In the placebo-group, these figures were 0 and 6 (30%), respectively. The majority of the placebo-group (70%) did not respond at all with regard to signs (Xt2 = 10.4; p = 0.0013) and symptoms (Xt2 = 6.97, p = 0.008). The results from this study suggest that topical application of fluocinonide in an adhesive base is a safe and effective drug to reduce signs and symptoms in oral lichen planus.
Subject(s)
Fluocinonide/therapeutic use , Lichen Planus/drug therapy , Mouth Diseases/drug therapy , Adolescent , Adult , Aged , Aged, 80 and over , Chi-Square Distribution , Child , Double-Blind Method , Female , Fluocinonide/administration & dosage , Humans , Lichen Planus/classification , Male , Middle Aged , Ointment Bases , Remission Induction , Treatment OutcomeABSTRACT
In the present paper the 21-yr experience of the Department of Oral and Maxillofacial Surgery and Oral Pathology, and the Department of Otorhinolaryngology of the Free University Hospital, Amsterdam, is reported with regard to the possible premalignant character of oral lichen planus. The study consists of two parts: 1) the follow-up of 113 patients with histopathologically proven oral lichen planus, and 2) a search for lichen planus in 727 patients who have been admitted for oral cancer. Three patients with histopathologically proven lichen planus developed a squamous cell carcinoma in an average follow-up period of 7 yr. In the 727 patients with oral cancer, two additional patients with the simultaneous occurrence of oral lichen planus were observed. Our experience gives some but not very strong support to the hypothesis that oral lichen planus is a premalignant condition.
Subject(s)
Carcinoma, Squamous Cell/pathology , Lichen Planus/pathology , Mouth Diseases/pathology , Mouth Neoplasms/pathology , Precancerous Conditions/pathology , Adult , Aged , Cell Transformation, Neoplastic , Female , Humans , Male , Middle AgedABSTRACT
In a multifactorial experiment, dermal sheep collagen was treated in diluted glutaraldehyde solutions, 70% ethyl alcohol, Cialit 1:5000, and distilled water for 1, 3 and 5 min, respectively, in combination with microwave irradiation at different temperature settings. The shrinkage temperature indicating the degree of cross-linking achieved was then determined. Treatment in 0.65% glutaraldehyde with microwave irradiation setting for 60 degrees C resulted in the maximum shrinkage temperature within 1 min, whilst at the lower setting of 50 degrees C, the maximum shrinkage temperature for both glutaraldehyde solutions is only reached after 5 min. Neither microwave irradiation by itself, Cialit or ethyl alcohol induce cross-linking of collagen fibres. These findings are relevant for implant studies.
Subject(s)
Biocompatible Materials , Collagen/radiation effects , Animals , Collagen/chemistry , Cross-Linking Reagents , Glutaral , In Vitro Techniques , Materials Testing , MicrowavesABSTRACT
Lichen planus is a mucocutaneous disease of unknown etiology. There is a great difference between the course of lichen planus of oral mucosa and that of the skin. Some authors consider oral lichen planus a premalignant condition. Whether this is true still remains to be settled. The dentist is advised to discuss a patient with oral lichen planus with the oral and maxillofacial surgeon, both with regard to the establishment of the diagnosis and the possible treatment and follow-up.