他克莫司治疗局部类固醇无效的口腔扁平苔藓的有效性和安全性

IF 0.4 Q4 DENTISTRY, ORAL SURGERY & MEDICINE

Journal of Oral and Maxillofacial Surgery Medicine and Pathology Pub Date : 2023-12-07 DOI:10.1016/j.ajoms.2023.11.013

Junichirou Inada , Masaki Minabe , Yuria Akira , Yurie Akiyama , Kazuhiko Hashimoto , Takeshi Nomura , Michiyoshi Kouno

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引用次数: 0

摘要

目的局部类固醇疗法是治疗口腔扁平苔藓（OLP）的一线疗法；然而，类固醇耐药病例也时有发生。局部他克莫司疗法是治疗类固醇无效的有效选择。在这项研究中，我们回顾性地调查了局部他克莫司治疗局部类固醇无效的OLP的有效性和安全性。材料和方法纳入了2017年1月至2022年12月期间就诊并接受局部他克莫司治疗的21例OLP患者。我们对患者的临床类型、组织病理学特征、疗效和副作用进行了评估。疗效通过网状红斑/角化病、红斑和溃疡评分（REUs）和数值评定量表（NRS）评分进行评估，并在局部类固醇激素和他克莫司之间进行比较。结果当我们评估患者的临床特征时，红斑型占多数（90.5%），组织病理学上，上皮变薄突出（76.2%）。类固醇治疗后，REUs 没有明显下降（p = 0.227，变化率评分；+0.7%）；然而，他克莫司转换不仅对 REUs 有明显影响，而且对 NRS 评分也有明显影响（p = 0.0000639，变化率评分；-73.5%）。观察到的副作用包括口腔念珠菌病（5 例）和刺激（1 例）；但没有患者出现癌症。

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Efficacy and safety of tacrolimus for local steroid-ineffective oral lichen planus

Objective

Local steroid therapy is the first-line treatment for oral lichen planus (OLP); however, steroid-resistant cases are often observed. Local tacrolimus therapy is a good candidate as an effective treatment option for steroid-ineffectiveness. In this study, we retrospectively investigated the efficacy and safety of local tacrolimus for local steroid-ineffective OLP.

Materials and methods

Twenty one patients with OLP who visited our clinic between January 2017 and December 2022 and received local tacrolimus therapy were included. We evaluated the clinical type, histopathological features, therapeutic efficacy, and side effects. Therapeutic efficacy was assessed by Reticulation/keratosis, Erythema, and Ulceration scores (REUs) and Numerical Rating Scale (NRS) scores and compared between local steroid and tacrolimus.

Results

When we evaluated the clinical characteristics of the patients, red type was predominant (90.5%), and histologically, epithelium thinning was prominent (76.2%). No significant reduction of REUs was observed after steroid treatment (p = 0.227, rate of change score; +0.7%); however, tacrolimus-switching showed a significant effect not only on REUs but also NRS scores (p = 0.0000639, rate of change score; −73.5%). Oral candidiasis (five cases) and irritation (one case) were observed as side effects; however, no patients showed canceration.