Response to levamisole and low-dose prednisolone in 41 patients with chronic oral ulcers: a 3-year open clinical trial and follow-up study

ABSTRACT

Objective. The purpose of this open clinical trial and follow-up study was to evaluate the short-term and long-term clinical efficacy of levamisole used with low-dose prednisolone in 30 patientes with oral lichen planus, 6 patients with erythema multiforme, 3 patients with mucous membrane pemphigoid, and 2 patients with early pemphigus vulgaris. Study design. All patients were given 150 mg/day of levamisole and 15 mg/day of prednisolone for 3 consecutive days each week, along with topically applied dexamethasone orobase (dexaltin). Results. Twenty-three patients showed dramatic remission of signs symptoms within 2 weeks; 18 patients experimenced partial remission. Forty patients reported significant pain relief, and almost none showed evidence of oral ulcerative lesions after 4 to 8 weeks of treatment. In contrat, 1 patient with oral lichen planus with allergy to levamisole reported a partial response from prednisolone alone. All 29 patients with oral lichen planus remained free from symptoms for more than 6 months. All 6 patients with erythema multiforme, all 3 patients with mucous membrane pemphigoid, and bot patients with pemphigus vulgaris also remained free from symptoms for 3 to 3 years. There were few side effects from the teatment; there applied dexaltin in the treatment of diffuse atrophic or ulcerative gingivitis. Conclusions. The addition of levamisole to prednisolone may produce improved results in the management of orosive lichen planus, erythema multiforme, mucous membrane pemphigoid, and early pemphigus vulgaris