Oral Manifestations of Immunologically Mediated Diseases

Johnson, Lisa A.; Perschbacher, Kristina; Leong, Iona; Bradley, Grace

doi:10.1016/j.cxom.2017.04.009

Cited by 4 publications

(3 citation statements)

References 20 publications

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“…Topical corticosteroid is the drug of choice for OLP [ 11 , 19 ]. It can also be given systemically when the lesion is widespread [ 11 ].…”

Section: Discussionmentioning

confidence: 99%

“…The Guidelines for the Management of Oral Lichen Planus by the British Society for Oral Medicine, as well as a report from the World Workshop on Oral Medicine 2007, still consider corticosteroid as the first-line therapy, especially for symptomatic atrophic/ulcerative/erosive types [ 12 , 20 ]. Indeed, medium- to high-potency corticosteroid (Orabase or mouthwash) can be administered with some considerations, such as the severity and location of the lesion [ 12 , 19 ], older age, and comorbid conditions [ 21 ]. Long-term corticosteroid consumptions will promote hyper-glycemia, leads to increased difficulty with glycemic control, and can cause fatty liver; thus, it must be carefully administered in diabetic patients and people with liver enzyme disorders [ 21 , 22 ].…”

Section: Discussionmentioning

confidence: 99%

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Efficacy of Systemic Acyclovir as Adjuvant Therapy for Oral Lichen Planus

2021

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Patient: Male, 73-year-old Final Diagnosis: Oral lichen planus (OLP) Symptoms: Painful tongue • taste impairment Medication: Acyclovir • antiseptic • corticosteroids • folic acid • vitamin B12 Clinical Procedure: DASS test • medications • OHIP test • serological examinations Specialty: Dentistry • General and Internal Medicine • Pathology Objective: Unusual setting of medical care Background: Oral lichen planus (OLP) is a chronic inflammatory disease involving the oral mucosa, associated with the T-cell activity that mediates an autoimmune condition, with various predisposing factors, such as herpes simplex virus (HSV). The first-line treatment is topical corticosteroids. However, additional therapy can be given according to the underlying factors. This report assessed the efficacy of oral acyclovir as adjuvant therapy in the management of OLP. Case Report: A 73-year-old man came to our unit reporting he had recurring sores on the tongue for the past 10 years. The tongue was painful and there was taste impairment. Intraoral examination showed erosion and erythematous areas surrounded by white net-like plaques on the tongue and buccal mucosa, as well as depapillation on 2/3 dorsal anterior of the tongue. The diagnosis of reticular and erosive OLP was determined based on clinical features. The patient was prescribed topical corticosteroids, multivitamins, and mouthwash containing chlorine dioxide. Supporting examinations were performed to rule out systemic predisposing factors. The patient was referred for anti-HSV-1 IgG testing, and it was reactive (34.8 U/mL). Thus, oral acyclovir was prescribed. After 2 weeks of antiviral treatment, the tongue pain and altered taste were resolved, and the clinical features showed significant improvement. Conclusions: Management of OLP requires a comprehensive approach. OLP symptoms can be relieved if treatment is not only limited to reducing the inflammation but also seeks to remedy other comorbidities, in this case, administration of an antiviral agent to resolve the HSV-1 involvement.

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“…Topical corticosteroid is the drug of choice for OLP [ 11 , 19 ]. It can also be given systemically when the lesion is widespread [ 11 ].…”

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Efficacy of Systemic Acyclovir as Adjuvant Therapy for Oral Lichen Planus

2021

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“…Neurotransmitters can also serve as immunomodulators (Pacheco et al, 2010). Numerous studies have confirmed the crucial role of immune responses in the pathogenesis of oral ulcers (Slebioda et al, 2014;Johnson et al, 2017). Tryptophan metabolism, oxidative stress, and inflammation have also been associated with various conditions, including neurological disorders and inflammatory bowel disease (Roager and Licht, 2018).…”

Section: Discussionmentioning

confidence: 99%