慢性增生性念珠菌病:0.18%异维A酸疗效的初步研究。
Chronic hyperplastic candidosis: a pilot study of the efficacy of 0.18% isotretinoin.
作者信息
Scardina Giuseppe A, Ruggieri Alessia, Messina Pietro
机构信息
Department of Oral Sciences, University of Palermo, Italy.
出版信息
J Oral Sci. 2009 Sep;51(3):407-10. doi: 10.2334/josnusd.51.407.
Management of oral candidiasis depends on an accurate diagnosis, identification and elimination of predisposing factors, and, often, use of antifungal agents. Chronic hyperplastic candidosis (CHC) is considered a premalignant lesion of the oral mucosa, occurring as speckled or homogeneous white lesions. If the lesions are untreated, a minor proportion may become dysplastic and progress to carcinoma. The traditional treatment of this lesion is based on the use of antifungal agents. The aim of this study was to examine the efficacy of 0.18% isotretinoin for treatment of nystatin-resistant candidiasis. Isotretinoin was administered topically twice a day for one month to six patients affected by nystatin-resistant CHC. In all six patients, daily antimycotic topical therapy with nystatin for 30 days had failed to resolve the candidal stomatitis. After one month of isotretinoin treatment, five of the six patients were negative for Candida, whereas in untreated control patients the situation was unchanged. Only one patient with suspected sicca syndrome was found to have oral Candida 15 days after the last administration of isotretinoin. None of the patients had any complaints about the medication. These findings suggest that 0.18% isotretinoin applied twice a day for one month is able to suppress nystatin-resistant candidiasis.
口腔念珠菌病的治疗取决于准确的诊断、识别和消除诱发因素,并且通常需要使用抗真菌药物。慢性增生性念珠菌病(CHC)被认为是口腔黏膜的一种癌前病变,表现为斑点状或均质型白色损害。如果这些损害不进行治疗,一小部分可能会发展为发育异常并进展为癌症。这种病变的传统治疗方法是使用抗真菌药物。本研究的目的是检验0.18%异维A酸治疗对制霉菌素耐药的念珠菌病的疗效。对6例患对制霉菌素耐药的CHC的患者,局部应用异维A酸,每天2次,持续1个月。在所有6例患者中,每天用制霉菌素进行30天的抗真菌局部治疗未能治愈念珠菌性口炎。异维A酸治疗1个月后,6例患者中有5例念珠菌检测呈阴性,而未治疗的对照患者情况未改变。在最后一次应用异维A酸15天后,仅1例疑似干燥综合征的患者口腔中发现念珠菌。所有患者对该药物均无任何不适主诉。这些发现表明,每天2次应用0.18%异维A酸,持续1个月能够抑制对制霉菌素耐药的念珠菌病。