Photobiomodulation laser therapy in pemphigus vulgaris oral lesions: A randomized, double-blind, controlled study.

OBJECTIVE: Systemic corticosteroids are the mainstay treatment for PV oral lesions; the aim of this study is to evaluate the efficacy of PBMT with a 645 nm diode laser as a supportive topical therapy in patients with PV induced erosive-ulcerative oral lesions. MATERIALS AND METHODS: This double-blind placebo-controlled study divided patients into two groups: A, patients receiving laser therapy (Raffaello 980 Bio, Dental Medical Technologies, Italy with the following parameters: 100 mW power, 645 nm wave length, irradiation area 1 cm2, application time 30 sec/cm2, energy density 3 J/cm2, scanning modality) and B, receiving sham therapy (placebo). All patients were being treated also with a systemic corticosteroid therapy i.e. prednisone 0.5 mg/Kg per day. Size of lesions, VAS and satisfaction were evaluated before the treatment (T0), after 4 weeks (T1) and after 8 weeks as a follow-up (T2). RESULTS: A total of 50 lesions were evaluated. About lesions size, there was a statistical significative difference between the two groups just at T2 (p=0.0193), though VAS significantly decreased both at T1 (p=0.0198) and at T2 (p=0.0087). In general, all patients were satisfied of the treatment received. CONCLUSION: PBMT can be considered a validate supportive therapeutic option, even if further RCTs studies with wide sample sizes and standardized management protocols are suggested.

Low-level laser therapy on the treatment of oral and cutaneous pemphigus vulgaris: case report.

Pemphigus vulgaris is a chronic autoimmune mucocutaneous disease that initially is manifested by painful intraoral erosions and ulcers which spread to other mucosa and the skin, generally more than 5 months after oral lesion manifestation. The treatment consists of prednisone alone or in combination with an immunosuppressive agent, and the clinical response is perceived within 2 to 4 weeks. Low-level laser therapy has been effective in accelerating the healing of injured tissue, thus inducing cell proliferation and increasing ATP, nucleic acid, and collagen synthesis. We reported two cases of pemphigus vulgaris that received systemic treatment associated with low-level laser therapy for oral and cutaneous lesions. We observed prompt analgesic effect in oral lesions and accelerated healing of oral and cutaneous wounds. Therefore, the present report suggests LLLT as a noninvasive technique that should be considered as an adjuvant therapy in oral and skin disorders in patients with PV.