Expression of IFN-gamma before and after treatment of oral lichen planus with 0.1% fluocinolone acetonide in orabase.

BACKGROUND: Oral lichen planus (OLP) is a common chronic inflammatory mucosal disease in which T-cell-mediated immune responses are implicated in the pathogenesis. The purpose of this study was to investigate the effect of 0.1% fluocinolone acetonide in orabase (FAO) on the in situ expression of IFN-gamma in patients with OLP. METHODS: Twenty OLP patients were enrolled in this study. Biopsy specimens and serum samples were obtained before and 1-month after the treatment with 0.1% FAO. In situ expression and serum levels of IFN-gamma were determined using immunohistochemistry and ELISA, respectively. RESULTS: The number of IFN-gamma-positive mononuclear cells in OLP lesions before the treatment was significantly higher as compared with that after the treatment. Similarly, the mean number of total mononuclear cells was clearly decreased after the treatment. However, the serum levels of IFN-gamma were not detectable. CONCLUSIONS: Our results suggest that IFN-gamma expression in OLP tissue may involve in the immunopathogenesis and the treatment with 0.1% FAO had an immunomodulating effect on the decrease of IFN-gamma.

The application of acetic acid in the detection of oral squamous cell carcinoma.

BACKGROUND: Oral cancer is the fourth most common cancer in males and the seventh most common cancer in females in Thailand. The survival rates and quality of life of oral cancer patients will significantly be improved if they receive treatment for lesions that are less advanced or premalignant. Early diagnosis is therefore of paramount importance. A number of techniques have been developed to supplement clinical examination for oral malignancy. One interesting screening method is the application of 3% to 5% acetic acid, which has been used for cervical cancer screening. OBJECTIVES: The primary objective of this study was to assess the sensitivity, specificity, and accuracy of using vinegar (5% acetic acid) for the examination of oral cancer. The secondary objective was to investigate the association between clinical examination using acetic acid and expression of the tumor marker, p53. METHODS: The study included 30 participants suspected of having oral squamous cell carcinoma. Five percent acetic acid was applied to the lesions, followed by incisional biopsy. The specimens were microscopically examined for pathological diagnosis and p53 immunohistochemical investigation. RESULTS: The sensitivity, specificity, and accuracy of using acetic acid for oral cancer examination were 83.33%, 84.21%, and 83.64%, respectively. There was a statistically significant association between clinical examination using acetic acid and expression of p53 protein (P = .000). CONCLUSIONS: The results of this study suggest that 5% acetic acid has high sensitivity, specificity, and accuracy in detecting oral squamous cell carcinoma and might be used as an adjunct for oral cancer examination.

A randomized-controlled trial to compare topical cyclosporin with triamcinolone acetonide for the treatment of oral lichen planus.

BACKGROUND: Various treatments have been employed to treat symptomatic oral lichen planus (OLP), but a complete cure is very difficult to achieve because of its recalcitrant nature. Topical cyclosporin therapy of OLP has shown conflicting results in many reports. The purpose of this study was to compare the effectiveness of cyclosporin solution with triamcinolone acetonide 0.1% in orabase in the treatment of Thai patients with OLP. METHODS: Thirteen Thai patients with symptomatic OLP and proven by biopsy were randomly assigned treatment with cyclosporin (six) or triamcinolone acetonide 0.1% (seven). The patients were instructed to apply cyclosporin or triamcinolone acetonide 0.1% three times daily at the marker lesions and affected areas. The assessments were at weeks 0, 2, 4, 8 by clinical scoring and grid measurement of the target lesions. Cyclosporin levels were assessed at weeks 2 and 8 of treatment. Pain and burning sensation were evaluated by linear visual analogue scale (0-10). RESULTS: OLP patients in the triamcinolone acetonide group showed equal cases of clinical complete and partial remission (50%). Whereas, in the cyclosporin group, there was partial remission in only two cases (33.5%) and no response in four cases (66.7%). However, our study showed that there were no statistical differences in pain, burning sensation and clinical response in OLP patients between the two groups (P > 0.01). Moreover, five of six cases in the cyclosporin group developed side-effects such as transient burning sensation, itching, swelling lips, petechial haemorrhages and others. CONCLUSION: Our results indicated that topical cyclosporin did not provide any beneficial effect and was not more effective than triamcinolone acetonide 0.1% in the treatment of Thai patients with symptomatic OLP.