Carbone M, Carrozzo M, Castellano S, Conrotto D, Broccoletti R, Gandolfo S
Department of Oral Medicine and Periodontology, School of Medicine and Dentistry, University of Turin.
Minerva Stomatol. 1998 Oct;47(10):479-87.
We report the preliminary findings from our open study on how to optimize the doses and the response times to systemic corticosteroid therapy for three forms of oral vesiculoerosive diseases (OVED).
All twenty-one patients enrolled in the study were affected with OVED (10 OLP, 6 MMP, 5 EM) and received different doses of prednisone in relation to the type of disease and its severity. Daily mouthwashes with 0.12% chlorhexidine and application of miconazole gel were added to the therapy; its response time to treatment varied individually, the doses were reduced only after 75% of lesions had cleared.
The average response time to treatment was 28 days. Clinical assessment showed that 95% of the patients had improved, whereas 71% had complete remission of oral signs and 48% experienced side effects. The degree of clinical resolution was: 70% complete remission after 26 days of therapy in patients with OLP, 33% complete remission after 38 days in patients with MMP, and 100% complete remission after ten days in patients with EM.
Although a preliminary study, initial results showed different types and times of response to systemic corticosteroid treatment for the three diseases. Our findings strongly suggest that a unified therapeutic protocol for different OVED is not advisable, nor can systemic treatment be considered the first therapeutic approach.
我们报告了一项开放性研究的初步结果,该研究旨在探讨如何优化三种口腔水疱糜烂性疾病(OVED)全身用皮质类固醇疗法的剂量和反应时间。
该研究纳入的21例患者均患有OVED(10例口腔扁平苔藓、6例类天疱疮、5例多形性红斑),并根据疾病类型及其严重程度接受了不同剂量的泼尼松治疗。治疗中添加了每日用0.12%氯己定漱口以及应用咪康唑凝胶;其对治疗的反应时间因人而异,仅在75%的病损消退后才减少剂量。
治疗的平均反应时间为28天。临床评估显示,95%的患者病情有所改善,而71%的患者口腔症状完全缓解,48%的患者出现了副作用。临床缓解程度为:口腔扁平苔藓患者在治疗26天后70%完全缓解,类天疱疮患者在治疗38天后33%完全缓解,多形性红斑患者在治疗10天后100%完全缓解。
尽管这是一项初步研究,但初步结果显示这三种疾病对全身用皮质类固醇治疗的反应类型和时间有所不同。我们的研究结果强烈表明,针对不同的OVED采用统一的治疗方案是不可取的,全身治疗也不能被视为首选治疗方法。