Nonsteroidal Topical Immunomodulators in Allergology and Dermatology

Jovanović, Marina; Golušin, Zoran

doi:10.1155/2016/5185303

Cited by 16 publications

(19 citation statements)

References 90 publications

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“…In the subgroup treated with topical tacrolimus 0.03% in orabase erythema showed significant improvement in the first 3 months, 9 of the 13 patients (69.23%) experiencing complete resolution. Pain and functional impairment were also significantly diminished in the first 3 improvement over the next 9 months, with 8 patients (61.53%) describing complete pain relief. Complete epithelization of the erosive lesions was noted in 11 of the 13 patients at 9 months (84.61%), even though relapse occurred after 3 months in 7 patients (53.84%).…”

Section: Figure 2 Distribution Of Erosive Olp Cases According To Age Group and Gendermentioning

confidence: 97%

Topical Calcineurin Inhibitor Tacrolimus in Orabase: an Alternative Treatment for Erosive Oral Lichen Planus

Toader¹,

Mocanu²,

Toader³

et al. 2020

Rev. Chim.

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Tacrolimus, a macrolide with immunosuppressive properties through the inhibition of T-lymphocyte activation, was approved as a second line topical treatment for atopic dermatitis, but has been largely used with beneficial effects in other dermatological conditions that involve a disregulation of the cellular immune response. Oral lichen planus is a T-cell�mediated autoimmune disease in which autocytotoxic CD8+ T cells trigger apoptosis of oral epithelial cells. Our study aimed to analyze the clinical efficacy of tacrolimus 0.03% and 0.1% in orabase as monotherapy on oral erosive lesions of lichen planus, in a group of 20 patients consulted in the Dermatology Clinic of the University C.F. Hospital Iasi during a period of five years. Our results show total or partial remission of oral erosive lesions in most patients at 3 months follow-up. However, after treatment discontinuation relapses are common, which is why intermittent use of topical tacrolimus is needed for longer periods to prevent recurrences. Further large scale studies are necessary to establish efficacy and safety profile of prolonged use of tacrolimus on mucosal membranes, as well as the most appropriate vehicle and concentration.

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Section: Figure 2 Distribution Of Erosive Olp Cases According To Age Group and Gendermentioning

confidence: 97%

Topical Calcineurin Inhibitor Tacrolimus in Orabase: an Alternative Treatment for Erosive Oral Lichen Planus

Toader¹,

Mocanu²,

Toader³

et al. 2020

Rev. Chim.

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“…Głównie jest to SCC, sporadycznie rak brodawkowaty i erytroplazja Queyrata (SCC in situ) [47]. W niektórych badaniach wskazuje się również na prawdopodobne zwiększenie częstości współistnienia zmian melanocytowych u pacjentów z LS w postaci genitalnej [11,[48][49][50]. Uważa się jednak, że w przebiegu LS w postaci pozagenitalnej zmiany skórne nie mają potencjału nowotworzenia [29,30].…”

Section: Ryzyko Nowotworzenia W Liszaju Twardzinowymunclassified

“…Doniesienia o przypadkach potencjalnej złośliwej przemiany zmian skórnych w postaci pozagenitalnej LS są nieliczne [51,52]. melanocytic lesions coexisting with genital LS [11,[48][49][50]. However, the extragenital LS lesions are believed not to have carcinogenic potential [29,30].…”

Section: Ryzyko Nowotworzenia W Liszaju Twardzinowymunclassified

Lichen sclerosus

Jabłonowska¹,

Woźniacka²,

Żebrowska³

2021

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Lichen sclerosus is a chronic skin condition with extragenital and/or genital involvement. The disease may develop in women and men of any age, but most frequently affects postmenopausal women. The aetiology of lichen sclerosus remains unknown. Genetic, infectious, environmental, autoimmune, and hormonal factors are presumed to influence its development. In most cases, lesions are located in the anogenital area. It is associated with sexual morbidity and is associated with an increased risk of cancerogenesis. The first-line treatment of lichen sclerosus includes ultrapotent corticosteroid ointments. Topical calcineurin inhibitors are considered second choice treatment. In recalcitrant cases alternative treatment methods (phototherapy and photochemotherapy, oral retinoids, methotrexate, cyclosporine, photodynamic therapy, adipose-derived stem cells and platelet-rich plasma, surgical management) are used. Because of a possible 3-8% risk of malignant transformation of genital lichen sclerosus to squamous cell carcinoma, early diagnosis is required, and long-term follow-up is recommended.streszczenie Liszaj twardzinowy jest przewlekłą chorobą skóry. Występuje w postaci pozagenitalnej i/lub genitalnej. Choroba jest stwierdzana u kobiet i mężczyzn niezależnie od wieku, ale najczęściej dotyczy kobiet w okresie po menopauzie. Etiologia liszaja twardzinowego jest nieznana. Przypuszcza się, że w jego rozwoju pewną rolę odgrywają czynniki genetyczne, zakaźne, środowiskowe, autoimmunologiczne oraz hormonalne. W większości przypadków zmiany są umiejscowione w okolicy anogenitalnej, co wiąże się z zaburzeniem funkcji seksualnych i możliwością kancerogenezy. W terapii pierwszego wyboru u pacjentów z liszajem twardzinowym stosuje się bardzo silnie działające maści z glikokortykosteroidami. Terapia drugiego wyboru opiera się na miejscowych inhibitorach kalcyneuryny. W przypadkach opornych na leczenie stosowane są alternatywne metody terapeutyczne (fototerapia i fotochemioterapia, doustne retinoidy, metotreksat, cyklosporyna, terapia fotodynamiczna, leczenie komórkami macierzystymi pochodzenia tłuszczowego i osoczem bogatopłytkowym, a także zabiegi chirurgiczne). Ze względu na ryzyko złośliwej przemiany postaci genitalnej liszaja twardzinowego w raka płaskonabłonkowego (3-8% przypadków) konieczne jest wczesne rozpoznanie i długoterminowa obserwacja pacjenta.

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“…This indicates that ZnCl 2 contributes, at least in part, to suppressing inflammation in chronic epipharyngitis. The anti-inflammatory effect of Zn has also been reported in the treatment of chronic inflammatory skin diseases, such as acne or eczema, using topical ZnSO 4 , with the therapeutic effect resulting from the inhibition of inflammatory cytokine production, including IL-1 [10]. As well, Zn gluconate lozenges have been reported to improve the symptoms of the common cold [11].…”

Section: Putative Mechanisms Of Eatmentioning

confidence: 99%

Possible Mechanisms Underlying Epipharyngeal Abrasive Therapy (EAT) with ZnCl2 Solution for the Treatment of Autoimmune Diseases and Functional Somatic Syndrome

Hasegawa¹,

Inoue²,

Tanaka³

et al. 2017

J Antivir Antiretrovir

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Chronic epipharyngitis is a common latent but serious condition that may contribute to a wide range of diseases in humans, including collagen diseases, glomerulonephritis and autonomic nervous disorders. In a previous study, we presented a putative causal role of chronic epipharyngitis in the development of functional somatic symptoms and syndromes following human papillomavirus vaccination by demonstrating a significant improvement in symptoms following abrasive therapy using ZnCl 2 on the epipharynx. Since this initial study, we have expanded our clinical experience, providing epipharyngeal abrasive therapy to 988 patients with confirmed chronic epipharyngitis associated with a wide variety of clinical symptoms. These symptoms could be classified into three broad categories, namely local inflammation-referred, autoimmune-related, and neuroendocrine symptoms. Symptom alleviation was achieved in the majority of patients with repeated epipharyngeal abrasive therapy.Through an in-depth review of the literature on epipharyngeal abrasive therapy, combined with our clinical experience, we propose three mechanisms underlying the therapeutic effects of epipharyngeal abrasive therapy: the astringent anti-inflammatory effect of ZnCl 2 , a blood-letting effect that promotes removal of epipharyngeal activated lymphocytes and drainage of excess inflammatory fluids containing various antigens, cytokines or noxious substances, and a neuromodulation effect achieved through stimulation of the vagus nerve. These effects can be explained within the context of current understanding of immunology, lymphology and neuroscience.Our hypothesis-driven review provides a theoretical basis for the observed therapeutic effects of epipharyngeal abrasive therapy in ameliorating various diseases, including functional somatic symptoms and syndromes following human papillomavirus vaccination.

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Nonsteroidal Topical Immunomodulators in Allergology and Dermatology

Cited by 16 publications

References 90 publications

Topical Calcineurin Inhibitor Tacrolimus in Orabase: an Alternative Treatment for Erosive Oral Lichen Planus

Topical Calcineurin Inhibitor Tacrolimus in Orabase: an Alternative Treatment for Erosive Oral Lichen Planus

Lichen sclerosus

Possible Mechanisms Underlying Epipharyngeal Abrasive Therapy (EAT) with ZnCl2 Solution for the Treatment of Autoimmune Diseases and Functional Somatic Syndrome

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