Relative efficacy of fluocinolone acetonide compared with triamcinolone acetonide in treatment of oral lichen planus

Twenty patients with oral lichen planus and topically treated with fluocinolone acetonide in orabase 0.1% (FAO) were compared with 20 treated with triamcinolone acetonide in orabase 0.1% (TAO). During 4 wk of treatment the lesions in 13 of 19 patients could be effectively cured with FAO whereas only 8 of 19 patients were cured with TAO. These differences were statistically significant. There were no differences in blood pressure, plasma cortisol or number of circulating lymphocytes after treatment with FAO, but the number of eosinophils was reduced in every case after treatment for 6 months. There was no permanent adrenal cortical suppression after treatment for 6 months. Acute pseudomembranous candidiasis during the treatment was common but could be cured with antifungal drug in every case. This study shows that FAO in a majority of cases is an effective treatment of oral lichen planus without any serious clinical side effects apart from treatable candidiasis.     

Efficacy of topical mesalazine compared with clobetasol propionate in treatment of symptomatic oral lichen planus

OBJECTIVE: To compare topically applied mesalazine (5-aminosalicylic acid) to topically applied clobetasol propionate in the treatment of patients suffering from symptomatic oral lichen planus. DESIGN: Randomized controlled longitudinal investigation. PATIENTS AND METHODS: Twenty-five out-patients suffering from oral lichen planus and referred to the Department of Oral Pathology and Oral Medicine of the University of Milan, Italy, during the period January to August 1997. Patients were randomly allocated (Group A and Group B) to treatment with mesalazine 5% or clobetasol propionate 0.05%. The drugs were topically applied twice daily for 4 weeks. Discomfort and pain were evaluated by the patient before and after treatment using a Visual Analogue Scale from zero (no pain) to 10 (extreme pain). Results were statistically evaluated by a Mann-Whitney U test. RESULTS: The two pharmacological regimens obtained partial and complete absence of symptoms. In particular, the mesalazine tested group disclosed 57% complete absence of symptoms, 21.3% partial response and 9% no response. No statistically relevant difference has been detected between the two regimens. CONCLUSIONS: The results of this preliminary study, if confirmed by further investigations, suggest that mesalazine might be considered an alternative to clobetasol propionate for treatment of symptomatic oral lichen planus.     

Efficacy of topical retinoic acid compared with topical fluocinolone acetonide in the treatment of oral lichen planus

The purpose of this study was to compare the efficacy of retinoic acid in an oral base 0.05% with fluocinolone acetonide in an oral base 0.1% in the treatment of atrophic and erosive oral lichen planus. Thirty-three patients with histologically proven oral lichen planus were asked to participate in the study. Lesions were scored ranging from 0 (no lesion) to 5 (large erosion) according to the severity. Patients were randomly assigned to receive either topical fluocinolone acetonide or topical retinoic acid. They were instructed to apply the medication on dried lesions four times a day. The lesions were evaluated after 2 and 4 weeks of treatment. The sign scores were analyzed by the Wilcoxon rank sum test. Eighteen patients receiving topical fluocinolone acetonide improved from the average score of 3.0 to 1.5 after 4 weeks of treatment, whereas 15 patients receiving topical retinoic acid showed little change (average score, 2.9 and 2.4, respectively). The changes were statistically significantly different between the two groups (p = 0.01). The results suggest that 0.1% fluocinolone acetonide reduced the severity of atrophic and erosive oral lichen planus better than 0.05% retinoic acid.     

Efficacy of fluocinolone acetonide gel in the treatment of oral lichen planus

OBJECTIVE: The purpose of this study was to compare the efficacy of fluocinolone acetonide gel 0.1% in 2 base forms (numbers 1 and 2) with fluocinolone acetonide in an oral base 0.1%. STUDY DESIGN: Forty-eight patients with histologically confirmed oral lichen planus were enrolled in the study. Lesions were scored ranging from 0 (no lesion) to 5 (large erosion) according to the severity. Patients were randomly given fluocinolone acetonide in an oral base, fluocinolone acetonide gel no. 1 or no. 2. They were asked to apply the medication on dried lesions 4 times a day. The lesions were evaluated after 2 and 4 weeks of treatment. The severity scores were analyzed by the Kruskal-Wallis k-sample test. RESULTS: Patients who received fluocinolone acetonide in an oral base and those who received fluocinolone acetonide gel no. 1 and no. 2 improved from the average score of 3.0, 3.0, and 2.9 to 1.5, 1.5, and 1.6, respectively. There were no statistically significant differences in score changes noted in the 3 groups. The results indicate that fluocinolone acetonide gel no. 1 and no. 2 and fluocinolone acetonide in an oral base provide similar efficacy in the treatment of oral lichen planus. CONCLUSION: Fluocinolone acetonide gel 0.1% is a safe and effective alternative therapy to fluocinolone acetonide in an oral base 0.1% in the treatment of oral lichen planus.     

曲安奈德口腔软膏治疗糜烂型口腔扁平苔藓临床疗效观察

纳入60例经病理检查确诊的双侧颊黏膜为糜烂型扁平苔藓患者,以患者的一侧病损为试验组,患处涂抹曲安奈德口腔软膏,另一侧为对照组（不予任何治疗）。分别于初诊、第1、2、3、4周记录患者疼痛程度和糜烂面积的变化。用药后1、2、3、4周试验组患者的疼痛程度和糜烂面积明显改善（P ＜0．05）,且优于同时间点的对照组（P ＜0．001）。2组均未见有不良反应。结果表明应用曲安奈德口腔软膏能有效治疗糜烂型口腔扁平苔藓。     

曲安奈德口腔软膏治疗充血糜烂型口腔扁平苔藓的疗效及安全性观察

目的:观察曲安奈德口腔软膏治疗充血糜烂型口腔扁平苔藓(EOLP)的疗效及安全性.方法:选择62例经临床确诊的EOLP患者,随机分为2组.实验组29例采用局涂曲安奈德口腔软膏、口服硫酸羟氯喹、口含西吡氯铵含片,对照组33例采用口服硫酸羟氯喹、口含西吡氯铵含片治疗.分别于初诊、第2、4周记录患者病损面积和疼痛程度的变化,并观察初诊和4周后的安全性指标.结果:实验组在2周能加速口腔扁平苔藓的充血糜烂面的愈合(P＜0.05),降低患者的疼痛指数(P＜0.05),但4周后与对照组无统计学差异(P＞0.05).实验组4例唾液真菌感染阳性(P＜0.05),其他安全指标与对照组无统计学差异(P＞0.05).结论:曲安奈德口腔软膏配合硫酸氢喹、西吡氯铵治疗EOLP,具有良好的疗效和安全性,但要防范局部真菌感染.     

曲安奈德与雷公藤多甙联合治疗OLP的疗效评价

目的：评价曲安奈德与雷公藤多甙联合应用治疗口腔扁平苔藓（OLP）的疗效。方法：将76例OLP患者随机分为3组,分别采用“局部注射曲安奈德＋口服雷公藤多甙片”、“单纯局部注射曲安奈德”、“单纯口服雷公藤多甙片”的方法治疗4周,分别在治疗结束后即刻和半年后复查,比较各种治疗方法的疗效。结果：统计学分析显示,联合应用曲安奈德和雷公藤多甙组的疗效最佳。结论：曲安奈德与雷公藤多甙联合治疗OLP具有较好的短期疗效和长期临床疗效。     

曲安奈德与卡介苗多糖核酸联合治疗糜烂型OLP疗效观察

目的观察曲安奈德联合卡介苗多糖核酸治疗糜烂型口腔扁平苔藓(OLP)的临床疗效。方法将48例OLP患者随机分为治疗组和对照组,每组24例。治疗组行病变区局部注射曲安奈德,每周1次,4周为一个疗程,同时进行卡介苗多糖核酸肌肉注射,隔日1次,4周为一个疗程;对照组单用曲安奈德行局部注射治疗,一个疗程后观察两组临床疗效。结果治疗组总有效率87.50%,对照组总有效率79.17%,两组间比较无明显差异(P>0.05)。治疗后6个月治疗组和对照组的复发率分别为7.69%和30.0%,组间比较有明显差异(P<0.05)。治疗后1年治疗组和对照组的复发率分别为38.46%和60.0%,组间比较无明显差异(P>0.05)。结论卡介苗多糖核酸联合曲安奈德注射治疗糜烂型OLP,可在一定程度上降低复发率,提高临床疗效。     

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.     

曲安奈德与卡介苗多糖核酸联合治疗老年OLP短期疗效观察

目的：观察曲安奈德联合卡介苗多糖核酸治疗老年人口腔扁平苔藓（OLP）的临床疗效。方法：将老年OLP患者56例随机分成2组,治疗组28例,行病变区局部注射曲安奈德,每周1次,4次为一个疗程,同时进行卡介苗多糖核酸注射液肌内注射,隔日1次,共18次;对照组28例,单用曲安奈德行局部注射治疗。观察两组临床疗效。结果：治疗组治愈率57.2%,总有效率92%,对照组治愈率50%,总有效率78.6%,两组间无明显差异（P〉0.05）。治疗后3～6个月时两组的复发率分别为6.25%和35.7%,组间有明显差异（P〈0.05）。结论：卡介苗多糖核酸联合曲安奈德注射治疗老年OLP,可降低复发率,提高临床疗效。     

Efficacy of mometasone furoate microemulsion in the treatment of erosive-ulcerative oral lichen planus: pilot study.

BACKGROUND: Oral lichen planus (OLP) is a frequent immunological chronic disease, having different clinical forms: asymptomatic and symptomatic. Symptomatic OLP has been palliated with topical corticosteroids with different levels of efficacy and safety. The purpose of this pilot phase II clinical trial was to determine the efficacy of mometasone furoate microemulsion upon the symptoms and signs of erosive-ulcerative OLP. METHODS: Forty-nine patients with clinical and histologically confirmed erosive-ulcerative OLP were enrolled in this study (36 women and 13 men). Their average age was 56.4 years (from 28 to 78). The treatment consisted of 0.1% mometasone furoate microemulsion mouthwash three times a day over 30 days. Pain, erythema and ulceration were assessed after 15 and 30 days of treatment. The data was processed and statistically analysed by student's t-test for paired samples. RESULTS: Mometasone caused a statistically significant reduction in pain (3.58 vs. 0.65, P = 0.0000). Treatment significantly reduced the surface area of erythema (155.2 vs. 21.9 mm(2), P = 0.0001) and ulceration (30.7 vs. 7.3 mm(2), P = 0.0000). None of these patients suffered severe adverse effects. CONCLUSIONS: Mometasone furoate microemulsion is a safe and effective therapy in the treatment of symptomatic erosive-ulcerative OLP.     

Short-term clinical evaluation of intralesional triamcinolone acetonide injection for ulcerative oral lichen planus

BACKGROUND: Efforts are made in a continued searching for novel therapies for symptomatic oral lichen planus (OLP). This study aimed to evaluate the efficacy and safety of intralesional triamcinolone acetonide (TA) injection for ulcerative OLP. METHODS: Forty-five patients with clinical and histologically confirmed ulcerative OLP on bilateral buccal mucosa, one for treatment and the other for control, were studied. All participants received 0.5 ml TA (40 mg/ml) on experimental sites. Visual analogue scale score and lesion areas were recorded at the time of injection and 1-week interval. After 2 weeks, if the treated ulceration reduced < 81% in size, a second injection was given. RESULTS: The treated group gave rapid relief of signs and symptoms, while the control group showed minimal decrease. 38 (84.4%) patients demonstrated complete response in ulceration size. No complications were noted with TA injections. CONCLUSIONS: Intralesional TA injection in ulcerative OLP is effective and safe in achieving lesion and pain regression.     

激素局部应用加抗真菌药物治疗口腔扁平苔藓的疗效观察

为探讨治疗口腔扁平苔藓（ＯＬＰ）的较有效途径，本文将８８例ＯＬＰ患者随机分为三组，激素局注射真菌药物组（４０例）以病损区局注酮缩去炎舒松抗真菌物进行治疗，局部注射治疗组（３０例）以病损区局注丙酮缩去炎舒松进行治疗，抗真菌药物组（１８丙）单纯给予抗真菌药物治疗，结果表明，激素局注射加抗真菌药物组疗效优于局部注射治疗组（Ｐ〈０．０５）。而复发率低于后者（Ｐ〈０．０５），说明采用本疗法治疗口腔扁平苔藓能     

白芍总苷联合曲安奈德治疗口腔扁平苔藓的疗效观察

目的 评价白芍总苷联合曲安奈德局部注射治疗口腔扁平苔藓的临床疗效。方法 58例口腔黏膜扁平苔藓患者随机分为治疗组和对照组,分别采用白芍总苷联合曲安奈德局部注射及单独曲安奈德局部注射治疗,同时记录VAS和REU分值,分别在治疗1、3、6个月时评定疗效。结果 1个月时治疗组疗效为82.7%,对照组为79.3%,2组疗效差异无统计学意义（χ2=0.112,P>0.01）,3个月时治疗组疗效为86.2%,对照组为51.7%,2组差异有统计学意义（χ2=15.241,P<0.01）,6个月时治疗组为79.3%,对照组为37.9%,2组差异有统计学意义（χ2=34.621,P<0.01）。结论 白芍总苷联合曲安奈德局部注射治疗口腔扁平苔藓可提高临床疗效,优于单独使用曲安奈德局部注射。     

曲安奈德和帕夫林联合治疗老年糜烂型OLP疗效观察

目的：探讨局部注射曲安奈德配合口服帕夫林治疗老年人糜烂型OLP的疗效。方法：对34例老年糜烂型OLP患者用药治疗前后检测T淋巴细胞亚群的变化及观察临床疗效指标。结果：患者经治疗后临床有效率91.18%,T淋巴细胞亚群检测CD3＋、CD4＋T细胞升高（P〈0.01）,CD8＋T细胞下降（P〈0.01）,CD4＋/CD8＋治疗后上升（P〈0.01）。结论：口腔糜烂型OLP经治疗后,临床疗效肯定,血中T淋巴细胞亚群状态有明显改善。