An open clinical trial of a new mouth-PUVA variant in the treatment of oral lichenoid lesions

Kuusilehto, Asko; Lehtinen, Risto; Happonen, Risto‐Pekka; Heikinheimo, Kristiina; Lehtimäki, Kimmo; Jansén, Christer T.

doi:10.1016/s1079-2104(97)90266-3

Cited by 24 publications

(12 citation statements)

References 14 publications

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“…The basic design of this trial is also questionable, because in the confined space of the oral cavity it is unlikely that the successful treatment of one side would have no effect on the other (Yoke and Machin, 1998). To avoid PUVA undesirable effects, topical application of 0.01% trioxsalen has been proposed in a very preliminary trial (Kuusiletho et al, 1997). One matter of concern is that PUVA therapy has been shown to have oncogenic potential (Lindelof et al, 1991); its use in the treatment of a pre-malignant condition like OLP could theoretically increase the risk of oral cancer.…”

Section: Psoralen and Ultraviolet A (Puva)mentioning

confidence: 99%

The management of oral lichen planus

1999

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OBJECTIVE: To review the current literature regarding the medical treatment of oral lichen planus (OLP). DATA SOURCES: PubMed on‐line Medline data searches were carried out for the years 1966–1998 to identify reports on therapy of OLP. METHODS OF STUDY SELECTION: Single case reports or open trials were included if they covered new therapeutic approaches or suggested significant modifications of known treatment modalities. Review papers were limited to those dealing with the topic. DATA EXTRACTION AND SYNTHESIS: Every paper was critically examined. Because of the great heterogeneity of the response criteria, many data could not be directly compared. Stronger weight was given to therapies that have proven to be effective under placebo‐controlled research protocols. Attention was also drawn to potential and effective adverse effects of every drug used. CONCLUSIONS: Among the various medications advocated for the treatment of OLP, several lack conclusive findings from adequately controlled trials. Mainly high‐potency topical corticosteroids in an adhesive medium appear at present the safest and most efficacious. Adjuvant agents as antimycotics may be useful in topical steroid treatment. Systemic corticosteroids may be occasionally indicated for severe recalcitrant erosive OLP or for diffuse mucocutaneous involvement. Topical cyclo‐sporine should be considered in steroid‐unresponsive cases considering that its efficacy in OLP could be related to a systemic effect and its high cost. Classical PUVA therapy seems to have too many side effects; topical application of psoralen is promising but still experimental. Topically and systemically delivered retinoids combined with topical corticosteroids could improve the efficacy of these agents whereas complete remission is difficult to achieve with retinoids alone and they frequently cause adverse effects. Finally, there are only few data concerning the long‐term effect of the medical treatments upon the course of OLP and we do not know if therapy influences the malignant evolution of OLP.

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Section: Psoralen and Ultraviolet A (Puva)mentioning

confidence: 99%

The management of oral lichen planus

1999

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“…Traditional treatment consists of various drugs, including antifungal ointments, retinoids 22,2 , and local and systemic corticosteroids; for example, fluocinonide 18,6,20,3,30,27,1,5 , cyclosporine 13,31,10,26 , mouth psoralen + UVA radiation treatment 16 , tacrolimus 14,21,24 , pimecrolimus 7 , oral metronidazole 4 , interferon-a cream 23 , hydroxychloroquine 8 , heparin 12 and fenretinide 28 . Surgery and cryosurgery are seldom performed.The use of laser treatment in the oral cavity has gained acceptance, including treatment of oral premalignant lesions, for example leukoplakia 11 .…”

mentioning

confidence: 99%

CO2 laser evaporation of oral lichen planus

Hem

Egges

Wal

et al. 2008

International Journal of Oral and Maxillofacial Surgery

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“…Topical photochemotherapy with psoralens and ultraviolet A (PUVA) is e®ective but can cause many side-e®ects and has the potential of carcinogenicity. 15 Despite many treatment options, since there exist high rates of treatment failure, there is still a need of searching for e®ective treatment modalities. PDT is a minimally invasive treatment that uses photosensitizers, such as ALA, methyl ester of ALA (MAL) or methylene blue (MB), activated by light at a speci¯c wavelength to destroy the targeted cells and tissue.…”

Section: Discussionmentioning

confidence: 99%

Treatment of cutaneous lichen planus with ALA-mediated topical photodynamic therapy

Fan

Zhang

Wang

et al. 2015

J. Innov. Opt. Health Sci.

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Purpose: To evaluate the e®ectiveness of topical 5-aminolevulinic acid (ALA)-mediated photodynamic therapy (PDT) for the treatment of cutaneous lichen planus (LP). Methods: A total of 17 symptomatic LP lesions in 7 Chinese patients were assessed. ALA cream (10%) was applied topically to LP lesions for 3 h. The lesions were irradiated with a 635 nm diode laser at the dose level of 100 J/cm 2 . The treatment was repeated at two-week intervals. Clinical assessment was conducted before each treatment. Follow-up was performed once a month for up to six months. Results: Lesions showed signi¯cant improvement after one to four courses of treatments. Complete response was achieved in 13 lesions (¯ve patients) and partial remission in four lesions (two patients). The complete response rate was 71%. There was no signi¯cant side e®ects except the feeling of pain that most patients could tolerate. Follow-up of¯ve patients who achieved complete response showed no signs of recurrence. Conclusion: Topical ALA PDT is e®ective in the treatment of cutaneous LP.

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An open clinical trial of a new mouth-PUVA variant in the treatment of oral lichenoid lesions

Cited by 24 publications

References 14 publications

The management of oral lichen planus

The management of oral lichen planus

CO2 laser evaporation of oral lichen planus

Treatment of cutaneous lichen planus with ALA-mediated topical photodynamic therapy

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