****** DATA-MÉDICOS *********

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LAS AFTAS / THE APHTHAE

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***** DERMAGIC-EXPRESS No 11****

****** 01 NOVIEMBRE 1.998 ******* 

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1.) EDITORIAL ESPAÑOL:

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Hola amigos de la red, DERMAGIC en esta ocasión hace una revisión de aftas la cual fue requerida por el DR. Oscar Mario Torchisnky de Buenos Aires Argentina. Sin duda tema interesante, y de terapéutica muy discutida y controversial. Espero que les guste. El tema fue buscado en las bases de datos bajo el término afta y aftosa, seleccioné estas 32 REFERENCIAS que cubren parte de este amplio campo.

Dr Marco Tulio Mérida, es tu terreno,,,saludos...

Hasta una nueva oportunidad amigos del CYBER...

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DERMAGIC/EXPRESS(11)

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A F T A S, R E V I S I O N 

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REFERENCIA 1: aftas y factor de estimulación colónica

REFERENCIA 2: aftas y talidomida

REFERENCIA 3: aftas y neutropenia

REFERENCIA 4: Mikulicz aphthae

REFERENCIA 5: aftas y thymopoetin pentapeptide

REFERENCIA 6: aftas y tetraciclinas

REFERENCIA 7: estomatitis aftosa características clinicas.

REFERENCIA 8: dexametasona y azathioprina en aftas

REFERENCIA 9: aftas y testosterona

REFERENCIA 10: aftas y Behcet's syndrome

REFERENCIA 11: aftas, histologia e inmunofluorescencia

REFERENCIA 12: aftas y colchicina

REFERENCIA 13: aftas y Behcet's syndrome patogenesis

REFERENCIA 14: aftas y privación de gluten en la dieta

REFERENCIA 15: aftas y Behcet's syndrome

REFERENCIA 16: aftas y deficiencia de zinc y de la inmunidad celular

REFERENCIA 17: aftas y virus

REFERENCIA 18: aftas y talidomida

REFERENCIA 19: aftas y estatus hematológico

REFERENCIA 20: aftas y HIV

REFERENCIA 21: aftas y talidomida

REFERENCIA 22: aftas patomorfología estado ulceroso

REFERENCIA 23: aftas y diclofenac e hyaluronan tópico

REFERENCIA 24: aftas y acido fólico

REFERENCIA 25: aftas y deficiencias hematológicas

REFERENCIA 26: aftas, medicación

REFERENCIA 27: aftas, ansiedad, y cortisol en saliva

REFERENCIA 28: aftas, etiopatogenia y conceptos terapéuticos

REFERENCIA 29: aftas, actualización

REFERENCIA 30: aftas y aspirina

REFERENCIA 31 aftas y enfermedad inflamatoria intestinal

REFERENCIA 32: aftas y dermatosis IGA lineal

REFERENCIA 33: aftas y pentoxifilina

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1.) TI - Thalidomide-resistant HIV-associated aphthae successfully treated with granulocyte colony-stimulating factor.

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SO - J Am Acad Dermatol 1995 Aug;33(2 Pt 2):380-2

AU - Manders SM; Kostman JR; Mendez L; Russin VL

AD - Department of Medicine, University of Medicine and Dentistry of New Jersey, Robert Wood Johnson Medical School at Camden, USA.

MJ - Granulocyte Colony-Stimulating Factor [therapeutic use]; HIV Infections [complications]; Stomatitis, Aphthous [drug therapy]; Thalidomide [therapeutic use]

MN - Adult; Stomatitis, Aphthous [virology]

MT - Case Report; Human

PT - JOURNAL ARTICLE

AB - Thalidomide has been advocated as the treatment of choice for recalcitrant aphthae. We describe the case of patient with HIV infection and extensive aphthae whose condition failed to respond to corticosteroids, cyclosporine, and thalidomide. The patient's course was complicated by colonic aphthae. Rapid and sustained resolution was achieved through treatment with granulocyte colony-stimulating factor, a previously unreported therapeutic option.

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2.) TI - Treatment of aphthae with thalidomide.

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SO - J Am Acad Dermatol 1989 Jun;20(6):1060-3

AU - Grinspan D; Blanco GF; Aguero S

AD - Dermatology Unit, Guemes Institute, Buenos Aires, Argentina.

MJ - Stomatitis, Aphthous [drug therapy]; Thalidomide [therapeutic use]

MN - Adolescence; Adult; Aged, 80 and over; Aged; Child, Preschool; Child; Drug Evaluation; Infant; Middle Age; Thalidomide [administration & dosage] [adverse effects]

MT - Case Report; Female; Human; Male

PT - JOURNAL ARTICLE

AB - We report our experience in the treatment of major and minor aphthae with thalidomide. With doses of 100 to 300 mg daily for 3 months, a cure was obtained in 34% of cases, and marked improvement was evident in the rest. The follow-up period varied from 1 to 8 years. Two patients experienced dysesthesias, which disappeared when the medication was stopped. Thalidomide cannot be prescribed to women of childbearing potential because of its teratogenic potential.

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3.) TI - [Aphthae and neutropenia in children: apropos of a case of paroxysmal giant aphthae]

TT - [Aphtes et neutropenie chez l'enfant: a propos d'une observation d'aphtes geants paroxystiques.]

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SO - Ann Dermatol Venereol 1984;111(5):479-82

AU - Guillet G; Courouge AM; Le Sommer M; Taieb A; Massicot P; Maleville J

MJ - Agranulocytosis [complications]; Neutropenia [complications]; Stomatitis, Aphthous [etiology]

MN - Child, Preschool; Chronic Disease; Periodicity; Recurrence; Remission, Spontaneous; Time Factors

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4.) TI - Stereologic analysis of leukocyte infiltration in oral ulcers of developing Mikulicz aphthae.

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SO - Oral Surg Oral Med Oral Pathol 1983 Dec;56(6):629-40

AU - Schroeder HE; Muller-Glauser W; Sallay K

MJ - Leukocytes [cytology]; Mikulicz' Disease [pathology]; Stomatitis, Aphthous [pathology]

MN - Behcet's Syndrome [pathology]; Leukocyte Count; Stomatitis, Aphthous [immunology]; Stomatitis, Herpetic [pathology]; Ulcer [pathology]

MT - Human

PT - JOURNAL ARTICLE

AB - Biopsy specimens of 1- to 7-day-old oral ulcers from patients with minor (Mikulicz), herpetiform, and Behcet's aphthae and of nonulcerated oral mucosa of aphthous patients were subjected to a quantitative, stereologic, electron microscopic analysis of the connective tissue infiltrate residing both at the center of and lateral to the ulcers. The data representing volume fractions and the numerical density of cellular and other infiltrate components demonstrated that (1) the infiltrate under the epithelium lateral to the ulcer is different from that at the ulcer's center, (2) at both sites, composition of the gross infiltrate does not change with age of the ulcer, (3) a large population of leukocytes (about 18% in the lateral and 23% in the central region) belong to the monocyte/macrophage series, (4) blast-forming T-lymphocytes are consistently present, blast-forming B-lymphocytes and plasma cells are very rare, and (5) mast cells are several times more numerous than in normal mucosa. In a comparison of the infiltrates of Mikulicz aphthae with those of herpetiform and Behcet's ulcers, it appears that the pathogenesis of the various oral ulcerations may well be diverse.

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5.) TI - [Therapy of recurrent oral aphthae with thymopoetin pentapeptide]

TT - [Therapie der rezidivierenden oralen Aphthen mit Thymopoetin-Pentapeptid.]

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SO - Hautarzt 1983 Sep;34(9):463-4

AU - Djawari D; Haneke E

MJ - Peptide Fragments [therapeutic use]; Stomatitis, Aphthous [drug therapy]; Thymopoietins [therapeutic use]; Thymus Hormones [therapeutic use]

MN - Adolescence; Adult; Middle Age; Recurrence; Stomatitis, Aphthous [immunology]

MT - Female; Human; Male

MC - English Abstract

PT - JOURNAL ARTICLE

AB - Five patients suffering from recurrent oral aphthae and one patient with Behcet's disease were treated with thymopoetin pentapeptide injections for 6 weeks. Although some immune parameters showed a tendency toward normalization no clinical improvement was observed.

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6.) TI - Effect of tetracyclines on collagenase activity in patients with recurrent aphthous ulcers.

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SO - J Oral Pathol Med 1994 Jul;23(6):269-72

AU - Hayrinen-Immonen R; Sorsa T; Pettila J; Konttinen YT; Teronen O; Malmstrom M

AD - Department of Oral and Maxillofacial Surgery, University of Helsinki, Finland.

MJ - Chlortetracycline [therapeutic use]; Collagenases [antagonists & inhibitors]; Stomatitis, Aphthous [drug therapy] [enzymology]

MN - Adolescence; Adult; Child; Chlortetracycline [administration & dosage]; Collagenases [metabolism]; Doxycycline [pharmacology]; Electrophoresis, Polyacrylamide Gel; Fibroblasts [enzymology]; Middle Age; Mouthwashes [therapeutic use]; Neutrophils [enzymology]; Recurrence; Saliva [enzymology]

MT - Female; Human; Male; Support, Non-U.S. Gov't

PT - CLINICAL TRIAL; JOURNAL ARTICLE

AB - Human neutrophil-type (MMP-8) and fibroblast-type (MMP-1) interstitial collagenase, and their inhibition by tetracyclines in saliva from patients with recurrent aphthous ulcers (RAU) or aphthae, were studied by means of sodium dodecyl sulfate polyacrylamide gel electrophoresis (SDS-PAGE) and enzymological analyses. In the salivary specimens obtained from patients with aphthae, collagenase was found in endogenously active form and was predominantly of MMP-8 type. Topical rinsing treatment with chlortetracycline (Aureomycin) alleviated the discomfort caused by the lesions but did not reduce salivary collagenase amounts; however in vitro, doxycycline inhibited salivary collagenase totally.

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7.) TI - Recurrent aphthous stomatitis. A study of the clinical characteristics of lesions in 93 cases.

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SO - J Oral Pathol Med 1991 Sep;20(8):395-7

AU - Bagan JV; Sanchis JM; Milian MA; Penarrocha M; Silvestre FJ

AD - Department of Oral Medicine, Valencia University, School of Dentistry, Spain.

MJ - Stomatitis, Aphthous [pathology]

MN - Adult; Age Factors; Periodicity; Recurrence; Regression Analysis; Stomatitis, Aphthous [classification] [physiopathology]; Time Factors

MT - Female; Human; Male

PT - JOURNAL ARTICLE

AB - We studied the clinical characteristics of 93 patients with recurrent aphthous stomatitis (RAS); 66 corresponded to minor aphthae (MiRAS), 20 to major aphthae (MaRAS), and 7 to herpes-like ulcerations (HU). MiRAS was seen to present the lowest rate of recurrences, as well as the shortest duration and the fewest lesions per episode. In turn, MaRAS presented the longest duration per recurrence, along with a number of lesions and recurrences that was lower than in HU but greater than in cases of MiRAS. Finally, HU developed the greatest number of lesions and recurrences. When we classified RAS according to the rate of episodes, no statistically significant differences were observed among the three types in terms of patient age, number and duration of lesions, or evolution time of the oral disorder.

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8.) TI - Combination immunosuppressant and topical steroid therapy for treatment of recurrent major aphthae. A case report.

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SO - Oral Surg Oral Med Oral Pathol 1990 Jan;69(1):42-4

AU - Brown RS; Bottomley WK

AD - Department of Oral Diagnostic Sciences, University of Texas Health Science Center, Houston.

MJ - Autoimmune Diseases [drug therapy]; Azathioprine [therapeutic use]; Dexamethasone [therapeutic use]; Stomatitis, Aphthous [drug therapy]; Tongue Diseases [drug therapy]

MN - Adult; Ibuprofen [therapeutic use]

MT - Case Report; Female; Human

PT - JOURNAL ARTICLE

AB - A 32-year-old woman with a 3-month history of severe major aphthous stomatitis covering the anterior dorsal third of the tongue was treated successfully with topical dexamethasone mouthrinse and oral azathioprine tablets. The lesion was resolved within 90 days without side effects.

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9.) TI - Treatment of recurrent premenstrual orogenital aphthae with implants of low doses of testosterone.

SO - BMJ 1989 Sep 30;299(6703):834

AU - Misra R; Anderson DC

AD - Department of Medicine (Endocrinology), University of Manchester, Hope Hospital, Salford.

MJ - Genital Diseases, Female [drug therapy]; Stomatitis, Aphthous [drug therapy]; Testosterone [administration & dosage]

MN - Adult; Drug Implants; Luteal Phase; Recurrence; Testosterone [therapeutic use]

MT - Case Report; Female; Human; Support, Non-U.S. Gov't

PT - JOURNAL ARTICLE

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10.) TI - Complex aphthosis: a forme fruste of Behcet's syndrome?

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SO - J Am Acad Dermatol 1985 Jul;13(1):80-4

AU - Jorizzo JL; Taylor RS; Schmalstieg FC; Solomon AR Jr; Daniels JC; Rudloff HE; Cavallo T

MJ - Behcet's Syndrome [complications]; Stomatitis, Aphthous [etiology]

MN - Adult; Antigen-Antibody Complex [analysis]; Behcet's Syndrome [diagnosis] [immunology]; Neutrophils [immunology]; Stomatitis, Aphthous [immunology]

MT - Female; Human; Male; Support, U.S. Gov't, P.H.S.

PT - JOURNAL ARTICLE

AB - The evaluation of the rare patient who presents with oral and genital aphthae or almost constant, multiple (greater than 3) oral aphthae, but no systemic signs or symptoms (i.e., complex aphthosis), is difficult because no laboratory test is available to exclude Behcet's syndrome. Six patients with complex aphthosis were evaluated. In addition, patients with simple aphthosis, those with seronegative arthritis, and normal controls were assessed for circulating immune complexes (CIC) by in vitro and in vivo assays and for neutrophil migration by subagarose methods, since these tests have given significant results in patients with Behcet's syndrome. Patient 1, with complex aphthosis, had Raji cell evidence for CIC (51.2 mg aggregated human gamma globulin Eq/ml), C1q, and C3 in dermal blood vessels 4 hours post intradermal histamine injection and had a Sweet's syndrome-like vasculitis 24 hours post histamine injection. In addition, her serum enhanced the migration of patient neutrophils (3.6 +/- 0.6 to 4.6 +/- 0.5; N = 6, p less than or equal to 0.01). All other test and control patients had negative or normal CIC and neutrophil migration determinations. Sixteen-month clinical follow-up has confirmed that Patient 1, but not Patients 2 to 6, has developed overt manifestations of Behcet's syndrome.

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11.) TT - [Aphthen: Histologische, immunfluoreszenz-und immunelektronenmikroskopische Studie zur Pathogenes.]

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SO - Hautarzt 1981 Jul;32(7):364-9

AU - Luderschmidt C; Wolff HH; Scherer R

MJ - Stomatitis, Aphthous [pathology]

MN - Behcet's Syndrome [complications]; Fluorescent Antibody Technique; Microscopy, Electron; Stomatitis, Aphthous [complications] [etiology] [immunology]

MT - Human; Support, Non-U.S. Gov't

MC - English Abstract

PT - JOURNAL ARTICLE

AB - The present study was done to elucidate the pathogenesis of aphthae in recurrent oral ulcers and Behcet's disease. Histologically, early stages of aphthae showed a predominantly neutrophil infiltrate and leukocytoclasia in the vessel walls, as well as extravasates of erythrocytes. In later stages, also histiocytes and lymphocytes appeared. By direct immunofluorescence technique, 30 of 34 patients showed perivascular precipitates of C3 and Clq, eight patients in addition, IgM and IgG. Remarkably, band-like fine granular precipitates of C3 were present in the basement membrane zone. By immunoelectronmicroscopy, C3 was demonstrated in fine subendothelial granules of the vessel walls and of the epithelial basement membrane below the lamina densa. There were no fundamental differences between the aphthae of recurrent oral ulcers and Behcet's disease. Our findings indicate, that an immunecomplex vasculitis is involved in the pathogenesis of aphthosis.

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12.) TI - Prevention of recurrent aphthous stomatitis with colchicine: an open trial.

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SO - J Am Acad Dermatol 1994 Sep;31(3 Pt 1):459-61

AU - Katz J; Langevitz P; Shemer J; Barak S; Livneh A

AD - Department of Dentistry, Sheba Medical Center, Tel-Hashomer, Israel.

MJ - Colchicine [therapeutic use]; Stomatitis, Aphthous [prevention & control]

MN - Adolescence; Adult; Colchicine [adverse effects]; Pilot Projects; Prospective Studies; Recurrence; Stomatitis, Aphthous [pathology]

MT - Female; Human; Male

PT - CLINICAL TRIAL; JOURNAL ARTICLE

AB - BACKGROUND: Recurrent aphthous stomatitis (RAS) is a common disorder with hitherto unsatisfactory drug therapy. OBJECTIVE: Our purpose was to evaluate the prophylactic effect of colchicine in the treatment of RAS. METHODS: An open, prospective, 4-month study was conducted in 20 patients with RAS who served as their own controls. During the first 2 months of the study no medications were given and in the last 2 months colchicine, 1.5 mg/day, was prescribed. RESULTS: The mean number of aphthae per week and the subjective daily pain scores were reduced by 71% and 77%, respectively, during colchicine treatment as compared with the previous period (p 0.001 for both). No serious side effects of colchicine were noted. CONCLUSION: These findings suggest a role for continuous colchicine therapy in the prevention of RAS.

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13.) TI - Pathogenesis of mucocutaneous lesions in Behcet's disease.

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SO - J Dermatol 1994 Jul;21(7):474-80

AU - Inoue C; Itoh R; Kawa Y; Mizoguchi M

AD - Department of Dermatology, St. Marianna Univeristy School of Medicine, Kawasaki, Japan.

MJ - Behcet's Syndrome [etiology]

MN - Adolescence; Adult; Behcet's Syndrome [immunology] [pathology]; Chemotaxis, Leukocyte [immunology]; Complement 3 [analysis]; Erythema Multiforme [pathology]; Erythema Nodosum [pathology]; Folliculitis [pathology]; HLA Antigens [analysis]; IgA [analysis]; IgG [analysis]; IgM [analysis]; Middle Age; Mucous Membrane [pathology]; Neutrophils [pathology]; Skin [pathology]; Stomatitis, Aphthous [pathology]; Ulcer [pathology]

MT - Female; Human; Male

PT - JOURNAL ARTICLE

AB - Behcet's disease (BD) is characterized by recurrent oral aphthae, skin lesions, eye lesions, and genital ulceration. To determine the pathogenesis of BD, we performed histological and immunohistochemical studies of these mucocutaneous lesions, an assay of neutrophil activity, and HLA typing. Dense dermal or subcutaneous infiltrations of polymorphonuclear cells (PMN) without leukocytoclastic vasculitis were found in 28 of 57 lesions. Immunohistochemically, deposits of C3 on the vessels were found in 12 of 31 lesions. Deposits of immunoglobulin were not found except for one of IgM. C3 deposits and PMN infiltrations were significantly related (p 0.05). PMN activity by polarization was enhanced; however, the results did not show a significant relationship with the PMN infiltrations or the C3 deposits. The incidence of HLA-B51 was significantly high in BD, but no significant relationship was found between HLA-B51 and the results of other examinations. These results suggest that the pathogenesis of BD lesions differs from that of collagen diseases and that C3 deposits on the vessels may play an important role in the development of mucocutaneous lesions where PMN have mainly infiltrated.

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14.) TI - Effects of dietary gluten elimination in patients with recurrent minor aphthous stomatitis and no detectable gluten enteropathy.

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SO - Oral Surg Oral Med Oral Pathol 1993 May;75(5):595-8

AU - Hunter IP; Ferguson MM; Scully C; Galloway AR; Main AN; Russell RI

AD - University Department of Oral Medicine and Oral Pathology, Dental Hospital and School, Glasgow, Scotland.

MJ - Gluten; Stomatitis, Aphthous [diet therapy]

MN - Adolescence; Adult; Chi-Square Distribution; Double-Blind Method; Gluten [adverse effects]; Middle Age; Personality Inventory; Placebo Effect; Stomatitis, Aphthous [etiology]; Treatment Failure

MT - Female; Human; Male

PT - CLINICAL TRIAL; JOURNAL ARTICLE; RANDOMIZED CONTROLLED TRIAL

AB - Fifty patients with a history of minor recurrent aphthous stomatitis were entered into a 6-month double-blind controlled trial of a gluten-free diet. After hematologic and biochemical investigations and jejunal biopsy, one half of the group was given a gluten-free diet; the other half served as controls and received a gluten-free diet supplemented by gluten given blind (control diet). Twenty-three patients completed the trial, 11 patients on a gluten-free diet, 12 on the control diet. Four of the 11 on the gluten-free diet and 7 of the 12 on the control diet reported significant benefit in terms of minor recurrent aphthous stomatitis, but there was no statistical difference between the responses. The results fail to support studies that report widespread benefit in aphthae of gluten withdrawal and suggest simply a marked placebo response in the condition.

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15.) TI - A new kind of skin lesion in Behcet's disease: extragenital ulcerations.

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SO - Acta Derm Venereol 1992 Aug;72(4):286

AU - Azizlerli G; Ozarmagan G; Ovul C; Sarica R; Mustafa SO

AD - Department of Dermatology, Istanbul Medical Faculty, Turkey.

MJ - Behcet's Syndrome [pathology]

MN - Adult; Follow-Up Studies; Recurrence; Skin Ulcer [pathology]

MT - Female; Human; Male

PT - JOURNAL ARTICLE

AB - A new skin lesion was encountered in 29 of 970 Behcet's patients. The lesions resembled oral aphthae clinically, were recurrent and left a scar tissue like genital ulcers but were located extragenitally. Skin biopsies could be done in only 4 cases and they all showed vasculitis.

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16.) TI - Recurrent aphthous ulceration with zinc deficiency and cellular immune deficiency.

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SO - Oral Surg Oral Med Oral Pathol 1991 Nov;72(5):559-61

AU - Endre L

AD - Children's Hospital of Buda, Budapest, Hungary.

MJ - Immunologic Deficiency Syndromes [etiology]; Stomatitis, Aphthous [etiology]; Zinc [deficiency]

MN - Child; Immunity, Cellular; Immunoglobulin Isotypes [blood]; Immunologic Deficiency Syndromes [drug therapy]; Lymphocyte Transformation; Recurrence; Stomatitis, Aphthous [drug therapy] [immunology]; Zinc [therapeutic use]

MT - Case Report; Human; Male

PT - JOURNAL ARTICLE

AB - Zinc deficiency (serum zinc level 65 micrograms/dl) and cellular immune deficiency (confirmed by lymphoblastic transformation assay) were found in a 15-year-old boy who had had recurrent aphthous ulceration for 6 years. Despite the previous therapy (orally administered steroid, isoprinosine, interferon, lysozyme, and local treatment), the ulcers recurred monthly. After 3 months of zinc therapy (50 mg zinc sulfate orally three times daily) the aphthae disappeared and did not reappear for 1 year. The lymphoblastic transformation activity and serum zinc levels were also normalized with this treatment.

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17.) TI - Viruses and chronic disorders involving the human oral mucosa.

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SO - Oral Surg Oral Med Oral Pathol 1991 Nov;72(5):537-44

AU - Scully C; Epstein J; Porter S; Cox M

AD - University Department of Oral Medicine, Surgery and Pathology, Bristol Dental School and Hospital, England.

MJ - Mouth Diseases [microbiology]; Mouth Neoplasms [microbiology]; Virus Diseases [microbiology]

MN - Burkitt's Lymphoma [microbiology]; Carcinoma, Papillary [microbiology]; Carcinoma, Squamous Cell [microbiology]; Chronic Disease; Mouth Mucosa [microbiology]; Sarcoma, Kaposi's [microbiology]

MT - Human

PT - JOURNAL ARTICLE; REVIEW (173 references); REVIEW, TUTORIAL

AB - Viruses have been implicated in the etiology of several chronic disorders of the oral mucosa. Most of these associations have been with DNA viruses, particularly certain herpesviruses, which are associated, for example, with some cases of erythema multiforme and with hairy leukoplakia. Papillomaviruses are associated with various papillomatous lesions, focal epithelial hyperplasia, and possibly with some carcinomas. Viruses may possibly be associated with recurrent aphthae, Behcet's syndrome, and some dermatoses. The literature concerning these possible associations is reviewed. However, much more research needs to be done before the full story of viral associations with oral mucosal disorders can be written.

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18.) TI - Crossover study of thalidomide vs placebo in severe recurrent aphthous stomatitis.

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SO - Arch Dermatol 1990 Jul;126(7):923-7

AU - Revuz J; Guillaume JC; Janier M; Hans P; Marchand C; Souteyrand P; Bonnetblanc JM; Claudy A; Dallac S; Klene C; et al

AD - Services de Dermatologie, Centre Hopitalier Universitaire Henri Mondor, Creteil, France.

MJ - Stomatitis, Aphthous [drug therapy]; Thalidomide [therapeutic use]

MN - Adult; Double-Blind Method; Multicenter Studies; Randomized Controlled Trials; Recurrence; Stomatitis, Aphthous [pathology]; Thalidomide [adverse effects]

MT - Female; Human; Male; Support, Non-U.S. Gov't

PT - CLINICAL TRIAL; JOURNAL ARTICLE; MULTICENTER STUDY; RANDOMIZED CONTROLLED TRIAL

AB - A multicentric crossover randomized trial of 100 mg of thalidomide vs placebo each for 2 months was conducted in patients with severe aphthous stomatitis of more than 6 months' duration. Seventy-three patients were included. Complete remission was obtained in 32 patients who received thalidomide and in 6 patients who received placebo. The confidence interval of the difference between the two treatments ranged from 25% to 53%. Most of the patients who did not achieve a complete remission had a dramatic improvement with regard to the number of aphthae when they were receiving thalidomide. Thirteen of 17 patients who had a complete remission while they were receiving thalidomide had a recurrence with placebo, 19 +/- 9 (mean +/- SD) days after stopping this drug. Side effects were significantly more frequent with thalidomide, especially drowsiness and constipation. We concluded that thalidomide in a dosage of 100 mg/d is an effective treatment of severe aphthous stomatitis but is not without some risk.

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19.) TI - Hematologic status in recurrent aphthous stomatitis compared with other oral disease.

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SO - Oral Surg Oral Med Oral Pathol 1988 Jul;66(1):41-4

AU - Porter SR; Scully C; Flint S

AD - University Department of Oral Medicine, Surgery, and Pathology, Bristol Dental Hospital and School, England.

MJ - Mouth Diseases [blood]; Stomatitis, Aphthous [blood]

MN - Adult; Erythrocyte Indices; Erythrocytes [analysis]; Ferritin [blood]; Folic Acid [blood]; Recurrence; Vitamin B 12 [blood]

MT - Comparative Study; Female; Human; Male

PT - JOURNAL ARTICLE

AB - The hematologic status of 144 consecutive patients in the United Kingdom with oral disease (69 with recurrent aphthous stomatitis; 75 with other disorders) was examined in an attempt to resolve the controversy as to whether levels of hemoglobin, blood cell numbers and indices, and blood film are adequate in the screening of patients with aphthae. Though hemoglobin levels and red blood cell indices were normal in patients with recurrent aphthous stomatitis, there was still a small minority of patients with deficiencies of iron (low serum ferritin), folate (low red blood cell levels), or vitamin B12 (low serum levels) that would have remained undetected. Full hematologic screening of patients with recurrent aphthous stomatitis thus reveals latent deficiency states, at least in some parts of the world, and there are good reasons for elucidating the underlying cause and correcting these deficiencies, particularly vitamin B12 deficiency. Therapeutic studies are now required to establish the frequency with which deficiencies actually predispose to recurrent aphthous stomatitis.

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20.) TI - Acquired immune deficiency syndrome (AIDS) in the United States in 1986: etiology, epidemiology, clinical manifestations, and dental implications.

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SO - J Oral Maxillofac Surg 1986 Dec;44(12):956-64

AU - Anneroth G; Anneroth I; Lynch DP

MJ - Acquired Immunodeficiency Syndrome

MN - Acquired Immunodeficiency Syndrome [epidemiology] [etiology] [pathology]; Adolescence; Adult; Child; Middle Age; Mouth Diseases [etiology]; Risk

MT - Female; Human; Male

PT - JOURNAL ARTICLE; REVIEW (60 references)

AB - The acquired immune deficiency syndrome (AIDS) results from a lymphotropic retrovirus (HTLV-III) infection and is characterized by specific opportunistic infections and malignancies. The virus is transmitted primarily by semen and blood. Infection is limited principally to defined risk groups, i.e., homosexual men and intravenous drug users. Head and neck manifestations include cervical lymphadenopathy and Kaposi's sarcoma. Oral manifestations include Kaposi's sarcoma, candidiasis, hairy leukoplakia, precocious periodontal disease, xerostomia, herpes simplex, recurrent aphthae, erythema multiforme, and venereal warts. Although HTLV-III is present in saliva, there are no reported cases of transmission secondary to dental procedures. Appropriate precautions and techniques are recommended in treating patients at risk for AIDS.

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21.) TI - Significant response of oral aphthosis to thalidomide treatment.

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SO - J Am Acad Dermatol 1985 Jan;12(1 Pt 1):85-90

AU - Grinspan D

MJ - Stomatitis, Aphthous [drug therapy]; Thalidomide [therapeutic use]

MN - Adolescence; Adult; Aged; Child; Middle Age; Stomatitis, Aphthous [pathology]; Thalidomide [administration & dosage] [adverse effects]

MT - Female; Human; Male

PT - JOURNAL ARTICLE

AB - The results are reported of the treatment of forty patients who had aphthous manifestations with the administration of thalidomide in daily doses ranging between 100 and 300 mg, over a period of 1 to 3 months. The study comprised nineteen patients with severe aphthosis, 17 with mild aphthosis, three with bipolar manifestations, and one with Sutton and Sutton's periadenitis mucosa necrotica recurrens. The results obtained were judged as remissions (35%) and marked improvements (40%). It is felt that thalidomide constitutes the most effective therapeutic approach so far available for oral aphthae, not only because it rapidly controls their manifestation but also because it controls recurrences.

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22.) TI - Pathomorphologic features of the ulcerative stage of oral aphthous ulcerations.

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SO - Oral Surg Oral Med Oral Pathol 1984 Sep;58(3):293-305

AU - Schroeder HE; Muller-Glauser W; Sallay K

MJ - Stomatitis, Aphthous [pathology]

MN - Adolescence; Adult; Behcet's Syndrome [immunology] [pathology]; Erythrocytes [pathology]; Immunoenzyme Techniques; Immunoglobulins [analysis]; Microscopy, Electron; Middle Age; Mikulicz' Disease [immunology] [pathology]; Stomatitis, Aphthous [immunology]; Stomatitis, Herpetic [pathology]; Ulcer [pathology]

MT - Female; Human; Male

PT - JOURNAL ARTICLE

AB - Macroscopic, histopathologic, and immunohistochemical features of eight 1- to 7-day-old minor (Mikulicz) aphthae, one herpetiform ulcer, and one ulcer from a patient with Behcet's syndrome were studied. In addition to light and electron microscopy, methods included the peroxidase-antiperoxidase (PAP) technique to disclose binding of IgA, IgG, IgM, Clq, and C3. Observations revealed the presence and distribution of extravasates of erythrocytes at and around the ulcers, extravascular neutrophilic granulocytes undermining the oral epithelium of the ulcer margin, the presence of numerous macrophages loaded with phagolysosomes containing debris of neutrophilic granulocytes, particular pathomorphologic features of a Behcet lesion and a herpetiform lesion, and the occurrence in diseased and normal oral mucosa of particular stratum spinosum cells binding nonselectively all immune components tested in this study, probably by leakage and passive diffusion of serum proteins. The observations fit the concept of immune complex vasculitis being essential in the pathogenesis of oral aphthous ulcerations.

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23.) TI: Sustained relief of oral aphthous ulcer pain from 

topical diclofenac in hyaluronan: a randomized, double-blind clinical trial.

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AU: Saxen-MA; Ambrosius-WT; Rehemtula-al-KF; Russell-AL; Eckert-GJ

AD: Department of Oral Surgery, Medicine and Pathology, Indiana University School of Dentistry, Indianapolis, Ind., USA.

SO: Oral-Surg-Oral-Med-Oral-Pathol-Oral-Radiol-Endod. 1997 Oct; 84(4): 356-61

ISSN: 1079-2104

PY: 1997

LA: ENGLISH

CP: UNITED-STATES

AB: OBJECTIVES: The purpose of this study was to test the hypothesis that topically applied 3% diclofenac in 2.5% hyaluronan reduces aphthous ulcer pain. STUDY DESIGN: A randomized, double-blind, single dose study of 60 healthy adults with aphthous ulcers in three treatment groups--3% diclofenac in 2.5% hyaluronan, 2.5% hyaluronan, 3% viscous lidocaine--was undertaken. Visual analogue scale pain scores were obtained before and after gel application and hourly, for up to 8 hours after gel application. Statistical analysis was performed with repeated measures ANOVA with square root transformation and Bonferroni correction. RESULTS: A 48% overall reduction in pain (p < 0.01) was observed 10 minutes after gel application; however, no significant difference was found between the three topical agents. A 35% to 52% pain reduction (p < 0.01) was reported 2 to 6 hours after the application of diclofenac in hyaluronan, whereas hyaluronan gel alone and viscous lidocaine failed to produce significant VAS reductions. CONCLUSIONS: A dose of 3% diclofenac in 2.5% hyaluronan is an effective and novel treatment for this common, painful disorder.

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24 TI: Aciclovir in herpes simplex gingivostomatitis. Folic acid may be beneficial in aphthous stomatitis [letter]

AU: Dawson-TA

SO: BMJ. 1997 Nov 1; 315(7116): 1162

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25.) [Hematologic deficiencies in patients with recurrent oral aphthae]

Estudio de los deficit hematologicos en los enfermos afectados de aftas orales 

recidivantes.

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Barnadas MA; Remacha A; Condomines J; de Moragas JM

Servicio de Dermatologia, Hospital de la Santa Creu i Sant Pau, Barcelona.

Med Clin (Barc) (SPAIN) Jun 14 1997 109 (3) p85-7 ISSN: 0025-7753

Language: SPANISH Summary Language: ENGLISH

Document Type: 

JOURNAL ARTICLE English Abstract

Journal Announcement: 9711

Subfile: INDEX MEDICUS

BACKGROUND: The prevalence of iron, folic acid and vitamin B12 deficiencies and 

their role in the development of recurrent oral ulcerations is not well known. The 

aim of this study was to determine the prevalence of these deficiencies in our 

patients. PATIENTS AND METHODS: Iron, folic acid and vitamin B12 levels were 

studied in 80 patients with recurrent oral ulcerations (ROU) and the results were 

compared with a control group of 29 patients with different oral diseases. RESULTS: 

In the recurrent oral ulcers patients, deficiencies were detected in 21/80 patients 

(26.2%). In 18 cases they were pure: iron (4), folic acid (10) and vitamin B12 (4). 

In 3 patients, combined deficiencies were detected, being secondary to pernicious 

anaemia in two patients. In the control group, deficiencies were observed in 4/29 

cases (13.7%). In three cases they were isolated (one case suffered from ferropenic 

anaemia and two patients of pernicious anaemia). CONCLUSIONS: Patients with 

recurrent oral ulcerations have more frequently iron, folic acid and vitamin B12 

deficiencies than those with other diseases of oral mucosa. However, there were not 

significant differences when the frequency of deficiency of each one of such 

elements were taken into account separately.

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26. Use of proprietary agents to relieve recurrent aphthous stomatitis.

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Edres MA; Scully C; Gelbier M

Eastman Dental Institute, University of London.

Br Dent J (ENGLAND) Feb 22 1997 182 (4) p144-6 ISSN: 0007-0610

Language: ENGLISH

Document Type: JOURNAL ARTICLE 

Journal Announcement: 9706

Subfile: DENTAL

AIM: To examine the subjective efficacy of proprietary agents for aphthous 

stomatitis. DESIGN: A simple open study. SETTING: Hospital out-patients in the UK 

in 1993. SUBJECTS: 50 consecutive patients with aphthae. OUTCOME: Patients 

assessed agent efficacy as very effective, possibly effective or not effective at 

relieving symptoms. RESULTS: 38 of 54 available agents were used. Difflam Oral 

Rinse (benzydamine hydrochloride) appeared to give most control of pain. Overall, 

Corsodyl mouthwash (chlorhexidine gluconate) gave most beneficial effect. 

CONCLUSIONS: Difflam and Corsodyl appear to give some symptomatic relief to aphthous 

victims.

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27.) Salivary cortisol and anxiety in recurrent aphthous stomatitis.

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McCartan BE; Lamey PJ; Wallace AM

Department of Oral Surgery, Oral Medicine and Oral Pathology, School of Dental 

Science, Trinity College, Dublin, Ireland.

J Oral Pathol Med (DENMARK) Aug 1996 25 (7) p357-9 ISSN: 0904-2512

Language: ENGLISH

Document Type: JOURNAL ARTICLE 

Journal Announcement: 9704

Subfile: INDEX MEDICUS; DENTAL

Anxiety and salivary cortisol were measured in two groups of patients with 

recurrent aphthous ulceration. One group of patients had persistent aphthae (Group 

1) and the others had been relieved of their aphthae following correction of 

detected haematinic deficiency states (Group 2). Anxiety was measured using the 

Hospital Anxiety and Depression scale and radioimmunoassay of salivary cortisol. 

There was a statistically significant increased proportion of borderline or 

clinically anxious patients in Group 1 compared to Group 2 (P < 0.05). Median 

salivary cortisol levels also showed a statistically significant elevation in Group 

1 (P < 0.01). It is concluded that stress may play a role in the aetiology of 

recurrent aphthous stomatitis, particularly in patients who have an underlying 

anxiety trait.

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28.) TI: [Recurrent aphthous stomatitis: current etiopathogenetic and therapeutic concepts]

TO: Stomatite aftosa ricorrente: attuali concetti eziopathogenetici e terapeutici.

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AU: Carrozzo-M; Carbone-M; Gandolfo-S

AD: di Clinica Odontostomatologica, Universita degli Studi-Torino.

SO: Minerva-Stomatol. 1995 Oct; 44(10): 467-75

ISSN: 0926-4970

PY: 1995

LA: ITALIAN; NON-ENGLISH

CP: ITALY

AB: The authors review the literature on aetiopathogenesis and therapeutic management of recurrent aphthous stomatitis. The data regarding the role of genetic, nutritional and microbiological factors in the genesis of recurrent aphthous stomatitis has been particularly examined. Despite significant associations with some antigens HLA have been reported in Southern Europe, there is no clear genetic predisposition in recurrent aphthous stomatitis. Several studies have analyzed the importance of iron, folic acid and vitamin B12 deficiencies, gluten intolerance and sensitivity to certain foods in the triggering of recurrent aphthous stomatitis however the results have been controversial. Recently, it has been suggested that recurrent aphthous stomatitis could be caused by reactivation of varicella-zoster virus and/or cytomegalovirus but these viruses may be reactivated by the immunodysregulation known to underlie recurrent aphthous stomatitis. Moreover, antiviral drugs appear to have only an equivocal effect on recurrent aphthous stomatitis. Recurrent aphthous stomatitis is probably determined by immunological mechanisms although there actually no unifying hypothesis which attempt to integrate the results of the many immunologic studies on recurrent aphotous stomatitis. Moreover, the target antigen and the cause of recurrences of recurrent aphthous stomatitis are still unknown. As far as the management of this disease it is important to recognize recurrent aphthous stomatitis secondary to systemic diseases like Behcet's syndrome, gluten enteropathy and haematinics deficiencies. Subsequently, the symptoms can be reduced with several drugs (mainly topical corticosteroids) but there are no effective therapies preventing recurrences.

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29.) TI: Recurrent aphthous stomatitis. An update.

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AU: Ship-JA

AD: Department of Oral Medicine, Pathology, Surgery, University of Michigan School of Dentistry, USA.

SO: Oral-Surg-Oral-Med-Oral-Pathol-Oral-Radiol-Endod. 1996 Feb; 81(2): 141-7

ISSN: 1079-2104

PY: 1996

LA: ENGLISH

CP: UNITED-STATES

AB: Recurrent aphthous ulceration or recurrent aphthous stomatitis is the most common oral mucosal disease known to human beings. Despite much clinical and research attention, the causes remain poorly understood, the ulcers are not preventable, and treatment is symptomatic. The most common presentation is minor recurrent aphthous stomatitis: recurrent, round, clearly defined, small, painful ulcers that heal in 10 to 14 days without scarring. Major recurrent aphthous stomatitis lesions are larger (greater than 5 mm), can last for 6 weeks or longer, and frequently scar. The third variety of recurrent aphthous stomatitis is herpetiform ulcers, which present as multiple small clusters of pinpoint lesions that can coalesce to form large irregular ulcers and last 7 to 10 days. Diagnosis of all varieties is usually made after clinical examination. Many local and systemic factors have been associated with these conditions, and there is evidence that there may be a genetic and immunopathogenic basis for recurrent aphthous ulceration. Management of this condition depends on the clinical presentation and symptoms and includes analgesic, antimicrobial, and immunomodulatory drugs. As dental clinicians and researchers become better trained in oral medicine and stomatology, it is anticipated that the pathophysiology, prevention, and treatment of recurrent aphthous ulceration will improve in the future.

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30.) TI: Aspirin-mouthwash relieves pain of oral lesions.

AU: Angirish-A

SO: J-R-Soc-Health. 1996 Apr; 116(2): 105-6

ISSN: 0264-0325

PY: 1996

LA: ENGLISH

CP: ENGLAND

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31.) TI: Prevalence of oral lesions in inflammatory bowel disease.

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AU: Lisciandrano-D; Ranzi-T; Carrassi-A; Sardella-A; Campanini-MC; Velio-P; Bianchi-PA

AD: Istituto di Scienze Mediche, Cattedra di Gastroenterologia, IRCCS Ospedale Maggiore, Italy.

SO: Am-J-Gastroenterol. 1996 Jan; 91(1): 7-10

ISSN: 0002-9270

PY: 1996

LA: ENGLISH

CP: UNITED-STATES

AB: OBJECTIVE: To obtain precise data on the prevalence of oral lesions in inflammatory bowel disease (IBD). METHODS: Oral lesions were carefully sought in a consecutive series of 198 Italian IBD outpatients, 77 with Crohn's disease (CD) and 121 with ulcerative colitis (UC); 89 subjects with functional intestinal motility disorders served as controls. RESULTS: The oral lesions detected were angular cheilitis (in 7.8% of CD patients, 5% of UC patients, and 0% of controls (p < 0.05, patients vs controls), lichen (6.5, 5.8, and 3.3%, respectively, p = not significant), aphthous ulcers (5.2, 5.8, and 5.6%, respectively, p = not significant), candidiasis (5.2, 0.8, and 0%, respectively, p < 0.05, CD patients vs controls), benign tumors (5.2, 0, and 7.8%, respectively, p < 0.05, patients vs controls), leukoplakia (5.2, 11, and 3.3%, respectively, p = not significant), and, less frequently, glossitis and herpes labialis. No specific CD oral lesions were observed in this series. No correlation was found between clinical disease activity and frequency of oral lesions. CONCLUSIONS: Aphthous ulcers are not common in IBD patients. Oral candidiasis is more frequent in CD than UC patients and controls.

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32.) TI: Linear IgA dermatosis: a new cause of fever of unknown origin.

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AU: Blockmans-D; Bossuyt-L; Degreef-H; van-den-Oord-JJ; Knockaert-D; Bobbaers-H

AD: Department of General Internal Medicine, University Hospital Gasthuisberg, Leuven, Belgium.

SO: Neth-J-Med. 1995 Nov; 47(5): 214-8

ISSN: 0300-2977

PY: 1995

LA: ENGLISH

CP: NETHERLANDS

AB: We describe a 60-year-old patient who presented with prolonged fever, weight loss, adenopathies and malaise. Two months later, an aphthous stomatitis and pharyngitis developed, together with ulcerations bilaterally in the groin. Two separate skin biopsies revealed the diagnosis of linear IgA dermatosis. This entity, which is well known to dermatologists but not to internists, should be added to the extensive list of disorders than can provoke the syndrome of fever of unknown origin.

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33.) TI: Recurrent aphthous stomatitis: treatment with pentoxifylline [letter]

AU: Pizarro-A; Herranz-P; Navarro-A; Casado-M

SO: Acta-Derm-Venereol. 1996 Jan; 76(1): 79-80

ISSN: 0001-5555

LA: ENGLISH

AN: 96282005

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DATA-MEDICOS/DERMAGIC-EXPRESS No (11) 01/11/98 DR. JOSE LAPENTA R. DERMATOLOGO 

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Produced by Dr. José Lapenta R. Dermatologist
Venezuela 1.998-2.024

Producido por Dr. José Lapenta R. Dermatólogo Venezuela 1.998-2.0024

Tlf: 0414-2976087 - 04127766810