School of Dentistry, Instituto de Biomedicina de Granada, University of Granada, Granada, Spain.
Hospital General de Ciudad Real, Ciudad Real, Spain.
Oral Dis. 2018 May;24(4):573-579. doi: 10.1111/odi.12803. Epub 2018 Feb 13.
To determine corticosteroid treatment effectiveness in patients with oral lichen planus/oral lichenoid lesions (OLP/OLL).
Twenty-one patients with OLP and eighty-one patients with OLL received 0.05% clobetasol propionate (CP) or 0.05% triamcinolone acetonide (TA) in aqueous solution (AS) or orabase (OB), evaluating responses to treatment and follow-up compliance.
Lesions were atrophic (72 of 102; 70.6%), extensive (58 of 100; 58%), producing eating difficulties (62 of 102; 60.8%), and spontaneous pain (30 of 102; 29.4%); 50 patients (49%) received CP-AS. The mean ± SD percentage of follow-ups attended was 43 ± 32%. Symptom remission was achieved in 46% of patients receiving CP-AS, 36.36% of those receiving TA-AS, 20% of those receiving CP-OB, and 25% of those receiving TA-OB. Follow-up compliance was poor in 66.7% of patients. Among 51 patients with continuous symptoms, 64.7% evidenced total remission at treatment completion; among 33 with intermittent symptoms, 73.1% had outbreaks 2-3 times/year and 51.5% controlled outbreaks with <6 corticosteroid applications. Adverse effects were observed in seven patients (6.8%) (moon face, hirsutism, capillary fragility) in induction stage, subsiding with dose; among 15 patients under maintenance treatment for >6 months, one showed hypothalamic-pituitary-adrenal (HPA) axis inhibition but not adrenal insufficiency.
Our treatment proved highly effective and safe. Recall programs are desirable to enhance follow-up compliance.
评估皮质类固醇治疗口腔扁平苔藓/口腔黏膜类天疱疮(OLP/OLL)患者的疗效。
21 例 OLP 患者和 81 例 OLL 患者分别接受 0.05%丙酸氯倍他索(CP)或 0.05%醋酸曲安奈德(TA)水溶液(AS)或口崩片(OB)治疗,评估治疗反应和随访依从性。
病变为萎缩性(102 例中的 72 例;70.6%)、广泛性(100 例中的 58 例;58%)、导致进食困难(102 例中的 62 例;60.8%)和自发性疼痛(102 例中的 30 例;29.4%);50 例(49%)患者接受 CP-AS 治疗。随访出席率的平均值±标准差为 43±32%。接受 CP-AS 治疗的患者中,46%的症状缓解,接受 TA-AS 治疗的患者中 36.36%的症状缓解,接受 CP-OB 治疗的患者中 20%的症状缓解,接受 TA-OB 治疗的患者中 25%的症状缓解。66.7%的患者随访依从性差。在 51 例持续症状的患者中,64.7%在治疗结束时出现完全缓解;在 33 例间歇性症状的患者中,73.1%每年发作 2-3 次,51.5%用 <6 次皮质类固醇即可控制发作。7 例(6.8%)(满月脸、多毛症、毛细血管脆性增加)患者在诱导期出现不良反应,剂量减少后缓解;15 例接受>6 个月维持治疗的患者中,1 例出现下丘脑-垂体-肾上腺(HPA)轴抑制,但无肾上腺功能不全。
我们的治疗方法非常有效且安全。需要召回方案来提高随访依从性。