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口腔扁平苔藓的治疗策略:现状与新见解

Therapeutic strategies for oral lichen planus: State of the art and new insights.

作者信息

Didona Dario, Caposiena Caro Raffaele Dante, Sequeira Santos Antonio Manuel, Solimani Farzan, Hertl Michael

机构信息

Department of Dermatology and Allergology, Philipps-Universität Marburg, Marburg, Germany.

Dermatology Clinic, Hospital Maggiore of Trieste, University of Trieste, Trieste, Italy.

出版信息

Front Med (Lausanne). 2022 Oct 4;9:997190. doi: 10.3389/fmed.2022.997190. eCollection 2022.

Abstract

Oral lichen planus (OLP) is a chronic inflammatory disease of the oral mucosa. Several clinical subtypes of OLP have been reported, including the reticular and erosive one. On the one hand, reticular OLP is usually asymptomatic and is characterized by white streaks surrounded by well-defined erythematous borders. On the other hand, erosive OLP shows ulcerations and erosions surrounded by erythematous mucosa. While reticular OLP is relatively easy to control, erosive OLP is extremely painful and refractory to therapies, limiting the quality of life of the patients. In addition, treating erosive OLP is extremely tricky, and a gold standard treatment has not yet been established. However, several therapeutic approaches have been reported as effective, including systemic corticosteroids, systemic retinoids, and anti-interleukin (IL)-17/anti-IL-23 drugs. Indeed, our group and other several authors reported the effectiveness of anti-IL17, anti-IL12/23, and anti-IL23 agents in refractory OLP, highlighting the urgency of clinical studies on the use of anti-IL agents in OLP patients. In this paper, we reviewed the English- and German-language literature about therapeutic strategies for treating OLP, focusing on new systemic therapies for erosive OLP.

摘要

口腔扁平苔藓(OLP)是一种口腔黏膜的慢性炎症性疾病。已报道了OLP的几种临床亚型,包括网状型和糜烂型。一方面,网状OLP通常无症状,其特征是白色条纹被边界清晰的红斑环绕。另一方面,糜烂型OLP表现为溃疡和糜烂,周围是红斑性黏膜。虽然网状OLP相对容易控制,但糜烂型OLP极为疼痛且治疗难治,限制了患者的生活质量。此外,治疗糜烂型OLP极其棘手,尚未确立金标准治疗方法。然而,已有几种治疗方法被报道有效,包括全身用皮质类固醇、全身用维甲酸和抗白细胞介素(IL)-17/抗IL-23药物。确实,我们小组和其他几位作者报道了抗IL17、抗IL12/23和抗IL23药物在难治性OLP中的有效性,凸显了对OLP患者使用抗IL药物进行临床研究的紧迫性。在本文中,我们回顾了关于治疗OLP的治疗策略的英文和德文文献,重点关注糜烂型OLP的新的全身治疗方法。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/19c7/9578567/d08e6b702d71/fmed-09-997190-g0001.jpg

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