In conclusion, the lack of significative difference in salivary opiorphin levels between iBMS and controls does not favor a direct local role for opiorphin in the etiopathogeny of iBMS. However, higher blood opiorphin levels may reflect a systemic dysregulation in iBMS. Trial registration NCT02686359 https://clinicaltrials.gov/ct2/show/NCT02686359.

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Background: Chronic erosive oral lichen planus (CEOLP) is a painful disease. Topical steroids constitute the mainstay of treatment. Given the reports of a slightly greater risk of squamous-cell carcinoma, rapamycin may be a good candidate for recalcitrant CEOLP, as it has both immunosuppressive and antitumour properties. Objectives: To investigate the therapeutic effect and evaluate the blood absorption of topical rapamycin in patients with CEOLP. Patients and Methods: We carried out an open prospective study: 7 women with CEOLP applied topical rapamycin (1 mg/ml) on oral erosive lesions twice a day for 3 months. Four patients also had erosive vulvar lesions and applied the same solution on both mucosae. We monitored blood sirolimus levels 15 days after the initiation of treatment. Complete remission was defined by the disappearance of oral erosions and partial remission when the surface of oral erosions was 50% less than the surface of the initial erosion. Results: At 3 months, 4 women had complete remission and 2 women had partial remission. One patient stopped treatment due to local discomfort. Only 1 woman had blood sirolimus levels that were detectable. Conclusion: Topical rapamycin may be effective in some cases of refractory CEOLP, with negligible absorption into blood and minimal side effects.

Background: Melkersson-Rosenthal syndrome (MRS) is a rare disease whose full-blown form is characterized by orofacial swelling, facial palsy and lingua plicata. Objective: To investigate the complement system as well as its role in patients with MRS. Methods: Seven patients presenting at this hospital between November 2002 and May 2003 and meeting the diagnostic criteria according to Hornstein were evaluated retrospectively. The investigations included clinical signs, an analysis of the complement system including levels of CH50, C3, C4, C1 inhibitor (INH) functions and C1-INH antigen detection. Results: Two female patients showed isolated low levels of functional C1-INH as determined by duplicate tests. Both patients took estrogen-progestin contraceptives. Conclusion: Since deficiency in plasma protease C1-INH is known to lead to recurrent angioedema, we hypothesize that low levels of functional C1-INH may have contributed to the orofacial swelling in the 2 patients.