Retinoids and proliferative verrucous leukoplakia (PVL). A preliminary study

ABSTRACT

Objective. A study is made of the efficacy and adverse effects of retinoid therapy applied to the white lesions ofproliferative verrucous leukoplakia (PVL). Material and methods. The results of retinoid therapy were evaluatedin 17 patients diagnosed with PVL. Topical retinoids were used in 5 patients, in the form of two daily applicationsof 0.1% 13-cis-retinoic acid in orabase for an average of 6.17+/-3.13 months. Systemic retinoids were used in 11patients, with the administration of 25 mg/day of acitretin in tablet form for an average of 5.41+/-2.02 months.One patient successively received the topical and systemic retinoid formulations. The course and results wereevaluated on a blind basis by two investigators. The adverse effects of the medication were also assessed. Results.Clinical improvement was recorded for 7 lesions (38.8%) (six involving systemic treatment and one as a resultof topical application). Clinical worsening was recorded in the same proportion (5 lesions with systemic therapyand two with topical treatment), while four lesions (22.4%) showed no changes (one lesion with systemic therapyand three with topical treatment). Adverse effects were documented in all the patients administered the systemicformulation, versus in only one patient administered topical retinoids. The most frequent problems were desquamationand pruritus. Conclusion. Although topical or systemic retinoic acid produces some improvement in aboutone-third of all patients with PVL, further studies are needed to assess the efficacy and safety of these products,in view of the important percentage of individuals who worsen despite therapy, and the frequent appearance of adverse effects (AU)

RESUMEN

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