Nakano Medical Clinic, Miyazaki, Japan.
J Dermatol. 2013 Jun;40(6):471-4. doi: 10.1111/1346-8138.12152. Epub 2013 Apr 27.
Plasma cell cheilitis is a chronic inflammatory disease that presents with erythema, erosions, ulcers and occasional nodules within the mucosa, including the lips. It is histopathologically characterized by dense plasma cell infiltration in the lamina propria of the mucous membranes. Several treatments for plasma cell cheilitis have been reported, including topical steroids, topical antibiotics or topical tacrolimus. However, 308-nm monochromatic excimer light (MEL) has never been reported as a treatment option, while it was reported to be very effective in treating erosive oral lichen planus. We report a 62-year-old man who had chronic plasma cell cheilitis on the lower lip, which was refractory to topical and systemic corticosteroid. The lesion and severe pain were significantly improved by the treatment with nine sessions of 308-nm MEL twice per week with a total dose of 1120 mJ/cm(2). However, the lesion gradually worsened after treatment frequency was reduced to once per month. Subsequent tacrolimus 0.03% ointment cleared the lesion completely in a month and no recurrence was observed a year later. Refractory plasma cell cheilitis and concomitant severe pain quickly responded to 308-nm MEL when administrated twice per week. Because the long interval between each MEL treatment seemed ineffective to improve the lesion, appropriate frequency and adequate total dose of MEL treatment may be necessary for a successful treatment.
浆细胞性唇炎是一种慢性炎症性疾病，表现为红斑、糜烂、溃疡和偶尔黏膜内结节，包括唇部。其组织病理学特征为黏膜固有层密集的浆细胞浸润。已有多种浆细胞性唇炎的治疗方法被报道，包括局部皮质类固醇、局部抗生素或局部他克莫司。然而，308nm 单频准分子光（MEL）从未被报道作为一种治疗选择，尽管它被报道在治疗糜烂性口腔扁平苔藓方面非常有效。我们报告了一位 62 岁男性，其下唇患有慢性浆细胞性唇炎，对局部和全身皮质类固醇均无反应。经过 9 次每周两次的 308nm MEL 治疗，总剂量为 1120mJ/cm²，病变和严重疼痛得到显著改善。然而，治疗频率降低至每月一次后，病变逐渐加重。随后，他克莫司 0.03%软膏在一个月内完全清除了病变，一年后未观察到复发。当每周两次给予 308nm MEL 治疗时，难治性浆细胞性唇炎和同时存在的严重疼痛迅速得到缓解。由于每次 MEL 治疗之间的间隔似乎对改善病变无效，因此 MEL 治疗的适当频率和足够的总剂量可能是成功治疗的必要条件。
