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F Lozada-Nur

Publications and source records attributed to F Lozada-Nur.

At least 37 records · Page 2Linked to original sources
PubMed1995

Heat shock (stress) proteins and gamma delta T lymphocytes in oral lichen planus.

OBJECTIVE: Heat shock proteins (Hsps), a highly conserved class of protective cellular proteins that are produced under various conditions of environmental challenge, have been implicated as the antigenic stimulus in autoimmune diseases. Because lichen planus (LP) appears to be an autoimmune or hyperimmune condition (mediated by T cells), Hsps may have a role in the pathogenesis of this disease. We believe that if keratinocyte Hsps are antigenic targets of a cellular immune response, upregulation of these proteins should be demonstrable in tissue sections. STUDY DESIGN: Immunohistochemistry was used to evaluate expression of several families of Hsps in oral lichen planus tissues. The number and distribution of gamma delta T cells, a subset of T lymphocytes with an immune surveillance function that may contribute to autoimmunity, were also evaluated. Monoclonal antibodies to Hsps 27, 60, 70, 90, gamma delta receptor, and CD3 (pan-T lymphocyte marker) were incubated with frozen sections of LP (n = 22) and normal oral mucosa (n = 17) followed by an avidin-biotin-peroxidase labeling method. Antibodies to bacterial Hsps (GroEL and DnaK) were used as negative controls, and antibody to constitutive eukaryotic Hsp (Hsc70) was used as a positive control. RESULTS: In six cases of LP, basal keratinocytes stained intensely for Hsp27, whereas controls showed only slight staining. Otherwise LP and normal tissues showed comparable positive staining of upper level keratinocytes with anti-Hsp27. Subjective increases in antibody staining were noted for Hsp60 in LP, which was due in part to staining of infiltrating lymphocytes and in part to keratinocyte expression. Normal tissues showed weak basal cell antibody staining for Hsp60. Hsp70 staining was observed at a less intense level in LP than in controls. Except for more intense basement membrane staining with anti-Hsp90 antibody in gingiva and palate, no differences in the occurrence of this protein were found. Absolute numbers of gamma delta T cells were increased in LP when compared with those in control specimens (n = 10 vs n = 1, respectively, per high-power field). However, gamma delta T cells represented less than 1% of the CD3+ lymphocytes. CONCLUSIONS: It was concluded that normal oral mucosa expresses Hsps 27, 60, 70, and 90 and contains few gamma delta T cells. Although the expression of Hsps was altered in LP, the differences demonstrated were slight and were therefore inconclusive. The Hsps expressed in LP could have contributed to the persistence or chronicity of the disease, or they could have simply reflected cellular injury.

Antibodies, Monoclonal↗
PubMed1994

Oral hairy leukoplakia in nonimmunosuppressed patients. Report of four cases.

Hairy leukoplakia was first described in association with HIV infection. Today hairy leukoplakia has come to represent a sign of immunosuppression and not just of HIV infection. Although molecular mechanisms have not been fully elucidated, Epstein-Barr virus appears to play a significant role in its etiopathogenesis. We present four cases that illustrate that HL may be seen in non-HIV and nonimmunocompromised patients. The use of high potency topical steroids for the treatment of oral vesiculoerosive diseases seems to have been a contributing factor in two of these cases.

Administration, Topical↗
PubMed1994

Double-blind clinical trial of 0.05% clobetasol propionate (corrected from proprionate) ointment in orabase and 0.05% fluocinonide ointment in orabase in the treatment of patients with oral vesiculoerosive diseases.

Because of their chronic nature treatment of oral vesiculoerosive diseases remains a challenge to the oral medicine specialist. Even though oral vesiculoerosive diseases respond well to systemic steroids, adverse side effects sometimes limit their use. Potent topical steroids are becoming increasingly useful to treat these chronic conditions with good control. The purpose of this double-blind clinical trial was to compare clobetasol propionate and fluocinonide ointment in orabase as treatments for controlling oral vesiculoerosive diseases. Sixty patients were asked to participate (43 women and 17 men). Data are reported for 55 patients. Each patient was seen at baseline and at days 7, 14, 21, and 28. Variables evaluated were pain, erythema, atrophy, and size of lesion. Overall, both medications had a beneficial effect in the control of symptoms and signs of oral vesiculoerosive diseases with minimal side effects. Clobetasol propionate was better than fluocinonide as measured by more rapid control of pain (within 7 days). Candidiasis was observed in 13 patients at the end of treatment (most of them carriers of Candida). Therefore normal carriers should be identified and treatment with antifungal therapy instituted before the patient begins using topical steroids.

Aged↗
PubMed1993

Oral Kaposi's sarcoma: a 10-year retrospective histopathologic study.

Microscopic diagnosis of early Kaposi's sarcoma continues to be a challenge to the pathologist, as does the identification of bacillary angiomatosis (BA) which may have a similar appearance. 120 oral Kaposi's sarcoma (KS) biopsies submitted to the UCSF oral pathology service from 1981-1991 were reviewed in order to describe the clinical-pathologic spectrum of these lesions and to search for unrecognized cases of BA. Also, histopathologic features of oral KS were compared to 30 oral pyogenic granulomas, and immunohistochemical stains for endothelium-associated CD34 antigen were done. The diagnosis of KS was confirmed in all biopsies and no cases of BA were found. Histologically, the KS specimens exhibited numerous features that separated them from pyogenic granulomas, and could themselves be divided into two clinical-pathologic subtypes: small, well-delineated macular lesions (31), which were characterized by inconspicuous patches of spindle cells containing ill-defined vascular spaces; and larger, infiltrative nodular lesions (89), which were characterized by spindle cells lining vascular slits and bizarre-shaped vessels. Extravasated RBCs were evident in almost all KS lesions; hemosiderin deposits and hyaline globules were seen in half of each of the small and large lesions. Nuclear atypia was minimal and mitotic activity was slight. Lymphocytes in small lesions added to the difficulty of microscopic interpretation of these incipient lesions. CD34 was expressed on all spindle cells lining vascular spaces in larger lesions and on spindle cells of small, subtle lesions. We conclude that within the spectrum of lesions that are diagnosed as oral KS, two clinical-pathologic types can be identified: macular small spindle-cell lesions and nodular infiltrative vascular lesions.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1992

Clinical response to levamisole in thirty-nine patients with erythema multiforme. An open prospective study.

Patients with erythema multiforme (EM) often have chronic or recurring oral lesions that cause intense pain and interfere with a variety of functions including eating and speech. Previous studies suggest that levamisole restores to normal the function of phagocytes and T lymphocytes, and activates the inflammatory response. In our previous double-blind study 8 of 13 patients with EM had a decrease in severity and frequency of attacks. The purpose of this open prospective study was to evaluate short-term and long-term clinical efficacy of levamisole in patients with mucocutaneous EM. Thirty-nine patients with mucocutaneous EM seen in the Oral Medicine Clinic, School of Dentistry, University of California-San Francisco, comprised our study group. Levamisole was used alone in 17 patients or in combination with prednisone in 22 patients and was given as a single dose of 150 mg/day for 3 consecutive days. Thirty-one patients showed a complete response from levamisole (alone in 13 and in combination with prednisone in 18). Four showed a partial response of signs and symptoms, and four others had no benefits from levamisole whether alone or in combination. The most common side effects from levamisole were skin rash, tiredness, weakness, myalgia, taste change, and insomnia.

Adolescent↗
PubMed1992

Retrospective findings of the clinical benefits of podophyllum resin 25% sol on hairy leukoplakia. Clinical results in nine patients.

Hairy leukoplakia was first described as an oral marker of human immunodeficiency virus infection in 1984. The clinical significance of this lesion in an otherwise healthy, high-risk symptom-free person is that it can be an early manifestation of human immunodeficiency virus infection. Because of its benign nature and the lack of clinical evidence that treatment of the lesion improves the prognosis of human immunodeficiency virus-infected patients, systemic therapy with antiviral drugs does not seem warranted at this time. Topical retinoids (Retin-A sol) and systemic antivirals such as acyclovir have been previously tried; however, lesions tend to recur a few days after treatment is discontinued. Nine patients with oral hairy leukoplakia seen at the Oral Medicine Clinic, University of California San Francisco were offered treatment with podophyllum resin 25% sol. All patients had a complete remission of their condition within 1 week (5 patients) or after the second application a week later (4 patients). Side effects were transient and reversible. These remissions of oral hairy leukoplakia lasted from 2 to 28 weeks, which suggests that podophyllum may be a relatively safe and cost-effective treatment of this otherwise symptom-free lesion.

Adult↗
PubMed1991

A prospective study of findings and management in 214 patients with oral lichen planus.

The findings in this prospective study of 214 patients with oral lichen planus were similar to those found in our 1985 evaluation of 570 patients with oral lichen planus. These two groups of patients with oral lichen planus patients constitute the largest series from one clinic. Oral lichen planus was found mainly in women and most commonly on the buccal mucosa. Spontaneous remissions were infrequent (6.5%), as were malignant transformations (2.3%) in a mean follow-up of 7.5 years. The erosive form of oral lichen planus was most common and was almost always associated with pain. Reproducibly successful management of this T-lymphocyte disease was obtained by selective use of systemic and/or topical corticosteroids. Oral lichen planus was not associated with any evident systemic disease, drug, smoking, or genetic predisposition. Although statistically Candida albicans does not appear to occur disproportionately in large samples of patients with oral lichen planus, in some of the Candida-positive patients, antifungal medications appeared to be useful.

Administration, Oral↗
PubMed1991

Open preliminary clinical trial of clobetasol propionate ointment in adhesive paste for treatment of chronic oral vesiculoerosive diseases.

Clobetasol propionate (Temovate), a novel high-potency topical corticosteroid, was used in open trial from 1987 to 1988 on 24 patients with persistent oral vesiculoerosive disease of at least 1 month's duration. Fourteen women and 10 men, ranging in age from 27 to 76 years (mean 48 years), participated. Nine patients had erosive lichen planus, one had benign mucous membrane pemphigoid, three had pemphigus vulgaris, seven had persistent major recurrent aphthous stomatitis, and four had chronic oral erythema multiforme. Fifteen patients had complete remission of signs and symptoms, seven had excellent response of signs and complete remission of symptoms, and two failed to respond. All other topical therapy was suspended before and during the study. All patients responded to two or three applications daily of medication. Side effects were minor and reversible, and included localized candidiasis (three patients), stomatopyrosis (two), and hypogeusia (one). Clobetasol propionate ointment in adhesive paste (Orabase) thus seems to be an effective topical steroid alternative to other less potent topical and systemic drugs for recalcitrant oral vesiculoerosive disease.

Adult↗
PubMed1989

Oral Kaposi's sarcoma in acquired immunodeficiency syndrome. Review of management and report of the efficacy of intralesional vinblastine.

Treatment of palatal Kaposi's sarcoma (KS) with intralesional injection of vinblastine was seen to provide effective palliation. Of the ten patients studied, four had a 25% to 50% response, two 50% to 75% response, and four had 75% to 100% response with one or two intralesional injections of vinblastine. Response to treatment was followed for a mean of 3.6 months, with recurrence of lesions in two of ten patients.

Acquired Immunodeficiency Syndrome↗
PubMed1989

Oral erythema multiforme: clinical observations and treatment of 95 patients.

Erythema multiforme is a chronic, inflammatory mucocutaneous disease that can occur in both genders at any age. Although the cause remains obscure, a wide range of antigens and factors, including herpesvirus and other infections, has been suggested as triggering the disease. In the present study of 95 patients, we found that patients with oral involvement alone tend to predominate over those who have oral and lip, or oral, lip, and skin disease. There were also more women than men. Our study further confirmed that erythema multiforme cannot be characterized solely as a disease that is cyclical and self-limiting. The dramatic response to corticosteroids and to the immunoregulating agent levamisole, as well as the fact that patients with erythema multiforme are otherwise essentially healthy, suggests that erythema multiforme may be caused by a transient autoimmune defect, possibly triggered by multiple factors. Because 19 patients with oral candidiasis responded to antifungal therapy, a possible antigenic role for these organisms is suggested.

Adolescent↗
PubMed1988

Kaposi's sarcoma of the oral cavity: a study of 134 patients with a review of the pathogenesis, epidemiology, clinical aspects, and treatment.

Since our first description and profile of patients with Kaposi's sarcoma (KS) in 1984, the relative rate of KS in patients with the acquired immunodeficiency syndrome has dropped from 34% to 20%. However, the absolute number is increasing. The pathogenesis of KS is still obscure, and its interaction with the human immunodeficiency virus infection remains unclear. Cause of death is usually opportunistic infections in both endemic and epidemic KS. The most common intraoral site is the palate, which is involved in 95% of our cases. The oral cavity may be the only or first site of KS, and therefore, becomes important in the diagnosis. More than 20% of our current patient population had the oral cavity as the initial site of manifestation. Because of functional impairment, bleeding, pain, or cosmetic reasons, treatment is frequently required. There are many modalities used, including chemotherapy, radiation, and laser resection. Radiation appears to be a most effective and practical control measure for oral KS.

Acquired Immunodeficiency Syndrome↗
PubMed1986

Oral mucous membrane pemphigoid. A study of sixty-five patients.

Sixty-five patients with oral mucous membrane pemphigoid were examined, treated, and followed for a mean of 3.5 years. Seventy-two percent were women, and the mean age was 59 years. In most patients multiple oral sites were involved and the gingiva was affected in 94% of the patients. Seven patients had ocular lesions (symblepharon), and seven others had nasal, vaginal, or pharyngeal involvement. Persons with skin lesions (bullous form) were not included in this series. Topical and systemic anti-inflammatory/immunosuppressive medications were successful in controlling signs and symptoms. There were no spontaneous remissions. Candidiasis, tobacco, other diseases, and drugs did not appear to be related to the pemphigoid.

Adult↗
PubMed1986

Oral findings in people with or at high risk for AIDS: a study of 375 homosexual males.

A total of 375 homosexual males were studied to assess the dental findings, life-style, and risk factors during a 4-year period. At baseline, 136 of the patients were diagnosed as having AIDS, 116 were considered at risk for AIDS, and 123 were considered healthy. In a mean follow-up time of 23 months, nine of the patients at risk for AIDS and five of the patients considered healthy were diagnosed as having AIDS. Kaposi's sarcoma was the most common oral neoplasm, and candidiasis was the most frequent oral infection. Hairy leukoplakia was found in 28% of the patients, and periodontal disease was found in 17% of the patients. Carriers of the AIDS virus may not be identified easily and control measures in the dental office must be followed.

Acquired Immunodeficiency Syndrome↗
PubMed1985

Clinical efficacy of prednisone in the treatment of patients with oral inflammatory ulcerative diseases: a study of fifty-five patients.

An objective evaluation of 55 patients with chronic vesiculoerosive oral diseases was made to compare the beneficial and adverse effects of prednisone treatment. Patients were divided into groups of high, intermediate, and low drug dosages, as well as short and long periods of administration. Prednisone benefited 49 patients in spite of the fact that 55% had some adverse side effects. The duration of prednisone administration appeared to have a larger impact on side effects than the daily amount given. The most common side effects were gastrointestinal disturbances, mood alterations, polyuria and insomnia. There were no significant changes in blood pressure, blood sugar level, weight, or white blood cell counts. This study confirmed that systemic prednisone is a useful and beneficial treatment modality for patients with chronic oral inflammatory diseases.

Adolescent↗
PubMed1985

A prospective follow-up study of 570 patients with oral lichen planus: persistence, remission, and malignant association.

Five hundred seventy patients with oral lichen planus were followed for periods ranging from 6 months to more than 10 years (mean, 5.6 years). The mean age was 52 years, and 67% of the patients were women. Erosive lichen planus was the most frequent clinical form, and the buccal mucosa was the most common site. Of the 75% patients treated with corticosteroids, 29% experienced complete remission and 63% had partial remission while maintained on medication. Fewer than 3% experienced spontaneous remission. Malignant transformation occurred in 7 patients (1.2%) in a mean time of 3.4 years after the onset of lichen planus. The onset of lichen planus could not be associated with any evident factors, such as family history, Candida albicans, glucose intolerance, and smoking.

Adolescent↗