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Biomedical subjects

K Thongprasom

Publications and source records attributed to K Thongprasom.

11 recordsLinked to original sources

Number V Oral lichen planus: clinical features and management.

Oral lichen planus (OLP) is a relatively common chronic inflammatory disorder affecting stratified squamous epithelia. Whereas in the majority of instances, cutaneous lesions of lichen planus (LP) are self-limiting and cause itching, oral lesions in OLP are chronic, rarely undergo spontaneous remission, are potentially premalignant and are often a source of morbidity. Current data suggest that OLP is a T cell-mediated autoimmune disease in which auto-cytotoxic CD8+ T cells trigger apoptosis of oral epithelial cells. The characteristic clinical aspects of OLP may be sufficient to make a correct diagnosis if there are classic skin lesions present. An oral biopsy with histopathologic study is recommended to confirm the clinical diagnosis and mainly to exclude dysplasia and malignancy. The most commonly employed and useful agents for the treatment of lichen planus (LP) are topical corticosteroids but other newer agents are available.

Adrenal Cortex Hormones↗

Adverse oral reactions associated with the COX-2 inhibitor rofecoxib.

Rofecoxib is an inhibitor of the enzyme cyclo-oxygenase 2 (COX-2) used as an analgesic and anti-inflammatory agent especially in rheumatoid arthritis and osteoarthritis. The adverse effects are generally less than with other anti-inflammatory drugs (NSAIDs), and no oral adverse reactions have been reported in the literature. We present three cases of oral lesions caused by rofecoxib. Extensive erosions appeared, which in all cases resolved on withdrawal of the drug.

Aged↗

Clinical evaluation in treatment of oral lichen planus with topical fluocinolone acetonide: a 2-year follow-up.

BACKGROUND: Oral lichen planus (OLP) is a chronic inflammatory disease which is recalcitrant to medical treatment. The purpose of this study was to compare the effectiveness of various forms of the topical steroid fluocinolone acetonide applications in patients with OLP. METHODS: Data of OLP patients were collected retrospectively from the chart record and the 97 OLP patients were divided into three groups. The first group (n = 28) was treated with a 0.1% solution of fluocinolone acetonide (FAS), the second group (n = 22) with 0.1% fluocinolone acetonide in orabase (FAO), and the third group (n = 47) with both FAS and FAO (FAS/FAO) throughout the study. Each group was clinically evaluated as complete remission (CR), partial remission (PR), or no response (NR), following the treatment. Also, the side-effect of oral candidiasis was recorded in each group. RESULTS: Two years of treatment resulted in complete remission of 77.3, 21.4, and 17.0% of patients in the FAO, FAS, and FAS/FAO groups, respectively. There was a statistically significant difference in disease remission (P < 0.05), but not in oral candidiasis appearance (P > 0.05) among various forms of topical steroid application. CONCLUSION: The study concluded that FAO or FAS can produce improved results in the management of OLP by long-term follow-up.

Administration, Topical↗

Hepatitis C virus infection in Thai patients with oral lichen planus.

OBJECTIVE: Many studies focusing on the association between hepatitis C virus (HCV) infection and oral lichen planus (OLP) have been conducted. Diversities of geographical locations could be a major factor influencing the prevalence of HCV. This study was aimed to define whether there was a relationship between the OLP and HCV infection in Thailand. MATERIALS AND METHODS: Serum samples of 60 patients (with OLP) and 60 controls (without OLP), whose age and gender were matched, were respectively screened for anti-HCV by ELISA (third generation), and reverse transcription polymerase chain reaction (RT-PCR) for HCV-RNA. RESULTS: We found five patients (8.33%) with OLP infected with HCV: three patients were positive for both anti-HCV and HCV-RNA; one patient was only positive for anti-HCV; and one patient was only positive for HCV-RNA; whereas all the controls were negative for both anti-HCV and HCV-RNA (P=0.029). Three of five cases of OLP with HCV infection had histories of blood transfusions over 10 years ago. CONCLUSION: The present study reports a small, but statistically significant high prevalence of HCV infection among patients with OLP, although the underlying mechanism still remains unknown.

Adult↗

Folate and vitamin B12 levels in patients with oral lichen planus, stomatitis or glossitis.

Forty-one patients with oral lesions and symptoms were enrolled in the study. Their ages ranged from 16 to 79 years with a mean age of 48.5 years. They were divided into two groups. Group I consisted of 25 patients with oral lichen planus and group II consisted of 16 patients with stomatitis or glossitis. Their complete blood counts, hemoglobin typing, serum and red cell folate, and serum vitamin B12 levels were studied. The results revealed low red cell folate levels in 11 out of 25 patients (44%) in group I and 9 out of 16 patients (56%) in group II. The serum vitamin B12 levels were within normal range in both groups. They were defined as having folate deficiency (n = 10), folate deficient erythropoiesis (n = 3) and folate depletion (n = 7). None of them had anemia nor macrocytes. Therefore, folate levels should be investigated in patients with oral lesions and symptoms especially those with risk factors of age, poor nutrition or systemic diseases. When suspected, daily folic acid supplements should be given.

Adolescent↗

Telomerase activity in oral lichen planus.

The purpose of this study was to determine the expression of telomerase in refractory oral lichen planus. Using a polymerase chain reaction-based telomerase activity assay, we investigated telomerase activity in 20 oral lichen planus specimens (erosive 9, atrophic 11). Telomerase activity was detected in 14 cases (erosive 7, atrophic 7). Furthermore, 13 cases of lichen planus with mild dysplasia proved telomerase-positive in eight specimens and six of seven cases devoid of dysplasia were also positive in the telomerase assay. The data indicate that, in general, telomerase activity might be frequently detectable in OLP. The data also suggest that telomerase activity might not be particularly associated with the premalignant phenotype in OLP.

Adult↗

Relative efficacy of fluocinolone acetonide compared with triamcinolone acetonide in treatment of oral lichen planus.

Twenty patients with oral lichen planus and topically treated with fluocinolone acetonide in orabase 0.1% (FAO) were compared with 20 treated with triamcinolone acetonide in orabase 0.1% (TAO). During 4 wk of treatment the lesions in 13 of 19 patients could be effectively cured with FAO whereas only 8 of 19 patients were cured with TAO. These differences were statistically significant. There were no differences in blood pressure, plasma cortisol or number of circulating lymphocytes after treatment with FAO, but the number of eosinophils was reduced in every case after treatment for 6 months. There was no permanent adrenal cortical suppression after treatment for 6 months. Acute pseudomembranous candidiasis during the treatment was common but could be cured with antifungal drug in every case. This study shows that FAO in a majority of cases is an effective treatment of oral lichen planus without any serious clinical side effects apart from treatable candidiasis.

Administration, Oral↗