口腔扁平苔藓的治疗综述

Khava Abdusalamova, Farzan Solimani, Margitta Worm
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引用次数: 0

摘要

粘膜扁平苔藓(MLP)是一种慢性、复发性、炎症性T细胞疾病,可影响粘膜,与皮肤扁平苔藓(CLP)和扁平苔藓(LPP)一起,属于扁平苔藓(LP)疾病的变体。MLP可影响口腔粘膜(口腔扁平苔藓,OLP)和生殖器粘膜。OLP患者有不同程度的严重程度。特别是,受糜烂/溃疡形式影响的患者通常构成治疗挑战,因为1)目前没有美国食品和药物管理局(FDA)/欧洲药品管理局(EMA)批准的药物,2)该疾病通常具有治疗耐药性。最近发表的关于免疫发病机制的研究描述了干扰素-γ诱导炎症的主要作用,但该疾病的许多方面仍然未知。因此,目前可用的主要是对症治疗。除了局部糖皮质激素外,局部和全身形式的类维生素a和全身糖皮质激素是公认的一线治疗方法。广泛的二线和三线治疗表明,没有标准治疗仍然没有标准治疗。在新的治疗方法中,Janus激酶抑制剂和单克隆抗体值得重视,因为它们可以在未来扩大OLP的治疗范围。然而,未来需要前瞻性的安慰剂对照研究。替代和补充治疗,如草药疗法,光疗,富血小板血浆(PRP)和注射富血小板纤维蛋白(i-PRF)也在文献中描述。在这篇文章中,我们讨论了目前治疗这种难治性疾病的选择。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
[Treatment of oral lichen planus-a review].

Mucosal lichen planus (MLP) is a chronic, recurrent, inflammatory T‑cell disorder that can affect mucous membranes and, together with cutaneous lichen planus (CLP) and lichen planopilaris (LPP), belongs to the variants of lichen planus (LP) diseases. MLP can affect both the oral mucosa (oral lichen planus, OLP) and the genital mucosa. Patients with OLP can have varying degrees of severity. In particular, patients affected by an erosive/ulcerative form usually pose a therapeutic challenge because 1) there are currently no US Food and Drug Administration(FDA)/European Medicines Agency (EMA)-approved drugs and 2) the disease is often treatment resistant. Recently published studies on immunopathogenesis describe a predominant role of interferon-γ-induced inflammation, but many aspects of the disease are still unknown. Accordingly, primarily symptomatic therapies are currently available. In addition to topical glucocorticoids, retinoids in topical and systemic form and systemic glucocorticoids are established first-line therapies. A wide range of second- and third-line therapies show that no standard treatment that there is still o standard treatment. Among the new therapies, Janus kinase inhibitors and monoclonal antibodies should be emphasized, as they could expand the therapeutic spectrum for OLP in the future. However, prospective, placebo-controlled studies are needed for this in the future. Alternative and complementary treatments such as herbal therapies, phototherapy, platelet-rich plasma (PRP) and injectable platelet-rich fibrin (i-PRF) are also described in the literature. In this article, we discuss the current therapeutic options for this difficult-to-treat disease.

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