Systemic Treatment in Severe Cases of Recurrent Aphthous Stomatitis: An Open Trial

Mimura, Maria Ângela Martins; Hirota, Silvio K.; Sugaya, Norberto Nobuo; Sanches, José Antônio; Migliari, Dante Antônio

doi:10.1590/s1807-59322009000300008

Cited by 51 publications

(41 citation statements)

References 29 publications

(40 reference statements)

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“…Dapsone has been reported to reduce ulcer recurrences in complex aphthosis with a daily dose of 50-125 mg [78,86,88]. The exact mechanism is thought to be due to its antineutrophilic action.…”

Section: Systemic Therapiesmentioning

confidence: 99%

Recurrent Aphthous Stomatitis: Towards Evidence-Based Treatment?

Challacombe

Alsahaf

Tappuni

2015

Curr Oral Health Rep

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Recurrent aphthous stomatitis is one of the most common oral mucosal diseases seen by dental professionals, and yet its aetiology remains unclear, and its management based on less than robust evidence. The literature remains confused because of the lack of clarity in diagnosis and the lack of a standardised ulcer severity scoring system and agreed outcome measures. However, recent literature is encouraging in meeting these aims. There is agreement that recurrent aphthous stomatitis (RAS) is a localized mucosal disease not secondary to systemic disease and therefore distinguishable from over 40 other types of oral ulcers. Disease severity scores have been introduced and outcome measures have become more standardised. RAS appears to be an autoimmune disease directed at epitopes of heat shock proteins whilst most recent work on aetiology has focused on cytokines and genetics. Pro-inflammatory cytokines including TNF-a and IL-6 and IL-17 are raised in RAS and TNF inhibitors can inhibit episodes of ulceration. Many local antiinflammatory agents will help ulcers heal, and local steroids remain the treatment of choice. Some systemic drugs have evidence-based data indicating efficacy at preventing new ulcers including colchicine, prednisolone, thalidomide, pentoxyfilline and dapsone. The field would benefit from further trials combining local and systemic therapy using defined outcome measures.

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Section: Systemic Therapiesmentioning

confidence: 99%

Recurrent Aphthous Stomatitis: Towards Evidence-Based Treatment?

Challacombe

Alsahaf

Tappuni

2015

Curr Oral Health Rep

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“…Em um estudo clínico aberto, sua eficácia no tratamento da estomatite aftóide foi comparada com dapsona, colchinina e pentoxifilina, sendo o fármaco mais efetivo e bem tolerado, com remissão completa do quadro em sete de oito pacientes (MIMURA et al, 2009). Além disso, foi eficaz também no tratamento da estomatite aftosa recorrente em pacientes portadores de Síndrome da Imunodeficiência Adquirida (AIDS).…”

Section: Aplicações Clínicas Da Talidomida Em Seres Humanosunclassified

O Uso Da Talidomida Em Seres Humanos E Animais – Passado, Presente E Futuro

Fornazari

Pachaly

Montiani‐Ferreira

2015

ArqVet

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A talidomida foi desenvolvida na década de 50 do século XX, e foi amplamente utilizada como um sedativo-hipnótico e como fármaco contra enjoos durante a gestação. No final da década de 60 ela foi retirada do mercado devido ao seu catastrófico efeito colateral de teratogenicidade. Contudo, o próprio mecanismo que é basicamente responsável pela sua teratogenicidade é também responsável por uma de suas muitas propriedades farmacológicas potencialmente benéficas e desejáveis, a anti-angiogênese. Felizmente, as pesquisas dos efeitos terapêuticos da droga não se cessaram e em 1998 o fármaco foi aprovado pelo Food and Drug Administration (FDA) para tratamento do eritema nodoso leproso e em 2006 para tratamento de mieloma múltiplo. Hoje, quase 40 anos depois, a mesma temida talidomida ressurge como fármaco de propriedades imunomoduladoras e antiangiogênicas, com potencial para tratamento de doenças inflamatórias, infecciosas e neoplásicas. Na medicina veterinária ainda pouco se sabe sobre os efeitos terapêuticos do fármaco, entretanto, o sucesso terapêutico do fármaco já fora observado em diversas situações clínicas em pessoas e em testes com animais, podendo existir indicação nas doenças homólogas na medicina veterinária. Este artigo traz uma revisão de literatura sobre a talidomida e suas aplicações reais e potenciais em medicina veterinária.

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“…9 For severe RAS, systemic therapies may be considered, such as a tapering dose of corticosteroids for acute episodes and off-label use of pentoxifylline, colchicine, or thalidomide. 3,7,10 Individuals using systemic medications should be appropriately monitored.…”

Section: 6mentioning

confidence: 99%

Recurrent Oral Ulcers

Stoopler

Sollecito

2015

JAMA

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A 44-year-old man with a history of gastroesophageal reflux disease and anxiety presents for evaluation of mouth ulcers recurring for the past 2 years. The painful ulcers resolve within 2 weeks but recur on different mucosal surfaces. He denies new medications, foods, or oral hygiene products and involvement of cutaneous or other mucosal surfaces. He is uncertain whether he has a family history of oral ulcers. He was previously prescribed anesthetic rinses and fluconazole, without benefit. His current medications include omeprazole and lorazepam. Intraoral examination demonstrates an ulcer with a pseudomembrane and erythematous halo on the left lateral surface of the tongue (Figure). Physical examination results are otherwise normal.Quiz at jama.com WHAT WOULD YOU DO NEXT?

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Systemic Treatment in Severe Cases of Recurrent Aphthous Stomatitis: An Open Trial

Cited by 51 publications

References 29 publications

Recurrent Aphthous Stomatitis: Towards Evidence-Based Treatment?

Recurrent Aphthous Stomatitis: Towards Evidence-Based Treatment?

O Uso Da Talidomida Em Seres Humanos E Animais – Passado, Presente E Futuro

Recurrent Oral Ulcers

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