Efficacy and tolerability of low-level diode laser therapy as an adjunctive in the treatment of oral pemphigus vulgaris, a randomized controlled trial

Abstract

Background

Pemphigus is a group of relatively chronic autoimmune disorders characterized by the formation of intraepithelial bullae in the skin and mucous membrane. Low-energy laser radiation has been found to have a stimulating effect on cells and is used to stimulate wound healing and treat ulcers.

Objective

This study aimed to assess the therapeutic efficacy of low-level laser therapy (LLLT) on oral pemphigus vulgaris patients.

Methods

Twenty-two patients diagnosed with oral pemphigus vulgaris were randomly assigned into two equal groups. The first group received low-level diode laser therapy 3 times weekly for 4 weeks in addition to their systemic therapy while the second group received systemic therapy only. Tools of assessment used were wound and pain assessment, Pemphigus Oral Lesions Intensity Score (POLIS) and tissue level of (TNF alpha) as by ELISA. All measures were done before and after 4 weeks of treatment.

Results

Results showed significant differences in ulcer length % change and VAS score (p < 0.001), favoring the combined group with lower scales. Both groups showed significant decreases in POLIS scores after 4 weeks (p = 0.006 in Laser group and 0.003 in the other group) although there was no significant difference) between them (p = 0.101). Although TNFα levels decreased in each group, there was no statistically significant difference in percent change between them. Patient satisfaction scores were similar between groups, while physician global assessment scores were significantly different. Patients in the study group were more satisfied.

Conclusion

Low level laser therapy can be considered an additive safe and effective therapy in treating oral pemphigus.