Document Detail


Treatment of refractory erosive oral lichen planus with extracorporeal photochemotherapy: 12 cases.
MedLine Citation:
PMID:  17300247     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Case reports have suggested that extracorporeal photochemotherapy (ECP) might be beneficial for the treatment of erosive oral lichen planus (OLP) recalcitrant to conventional immunosuppressive therapies. OBJECTIVES: To evaluate over a long-term period the clinical efficacy and toxicity of ECP in a series of patients with refractory OLP, and to monitor peripheral blood lymphocyte subset counts under treatment. METHODS: Twelve patients with refractory OLP underwent a standardized protocol of ECP. Sessions were performed twice weekly for 3 weeks, and then the treatment schedule was adapted according to clinical benefit. The disease severity was evaluated monthly on a clinical basis. Complete remission was defined as the absence of any erosion and partial remission as a decrease of at least 50% of erosion surface. Blood cell counts with CD4+ and CD8+ lymphocyte subsets were evaluated every 3 months. RESULTS: All patients showed a decrease of the erosive surface; nine (75%) achieved a complete remission and three (25%) a partial remission. Seven of the eight patients followed for more than 3 years had recurrences of erosions when ECP sessions became less frequent or were stopped. After resumption of an initially accelerated regimen of ECP, all again showed partial or complete remission. Blood lymphocyte counts decreased during treatment, without statistically significant changes in CD4+/CD8+ ratio, and increased during relapse. CONCLUSIONS: ECP is an effective alternative therapy in erosive OLP showing resistance to classical treatments. The decrease in blood lymphocyte counts appears to parallel the clinical improvement under treatment.
Authors:
A D Guyot; D Farhi; S Ingen-Housz-Oro; A Bussel; N Parquet; C Rabian; H Bachelez; C Francès
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Publication Detail:
Type:  Clinical Trial; Journal Article    
Journal Detail:
Title:  The British journal of dermatology     Volume:  156     ISSN:  0007-0963     ISO Abbreviation:  Br. J. Dermatol.     Publication Date:  2007 Mar 
Date Detail:
Created Date:  2007-02-15     Completed Date:  2007-06-26     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0004041     Medline TA:  Br J Dermatol     Country:  England    
Other Details:
Languages:  eng     Pagination:  553-6     Citation Subset:  IM    
Affiliation:
Service de Dermatologie 1, AP-HP, Hôpital Saint Louis, Université Paris VII, Paris, France.
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
CD4-Positive T-Lymphocytes / drug effects
CD8-Positive T-Lymphocytes / drug effects
Female
Follow-Up Studies
Humans
Immunophenotyping
Lichen Planus, Oral / drug therapy*,  immunology,  pathology
Lymphocyte Count
Male
Middle Aged
Photopheresis / methods*
Recurrence
Treatment Outcome

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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