amphotericin-b and Lichen-Planus--Oral

Topics: Aged; Amphotericin B; Antibodies, Monoclonal; Antibodies, Monoclonal, Humanized; Antifungal Agents; Biopsy; Candidiasis; Diagnosis, Differential; Female; Humans; Lichen Planus, Oral; Psoriasis

Oral hairy leukoplakia (OHL) is an EBV-associated condition of the oral mucosa, which is often painless. It is found predominantly in HIV-positive patients and is considered a clinical indicator of immunosuppression. OHL has rarely been described in HIV-negative patients, being found most often in association with iatrogenic immunosuppression. OHL induced by topical steroids remains extremely rare.. An 81-year-old HIV-negative woman, treated for 3 months with topical steroids for oral lichen planus, developed an asymptomatic white, corrugated, non-removable plaque with vertical folds on the lateral edge of the tongue. Associated oral candidiasis was noted. Based upon histological findings and in situ hybridisation showing numerous EBV-infected epithelial cells, a diagnosis of oral hairy leucoplakia was made.. To our knowledge, we report herein only the second recorded case of OHL induced strictly by topical steroids. Self-medication and poor adherence to dosage recommendations were noted in the patient's medical history. Physicians must be aware of the rare but nevertheless possible adverse events associated with topical steroid use, particularly when such medication is prescribed over a long period for inflammatory diseases of the oral mucosa.

Topics: Administration, Topical; Aged, 80 and over; Amphotericin B; Anti-Inflammatory Agents; Antifungal Agents; Betamethasone Valerate; Candidiasis, Oral; Clobetasol; Epithelial Cells; Female; Herpesvirus 4, Human; HIV Seronegativity; Humans; Leukoplakia, Hairy; Lichen Planus, Oral; Self Medication; Tongue

Oral candidiasis is an important side effect of topical corticotherapy. The purpose of this study was to assess oral mucosa colonization by five Candida species during topical corticotherapy and to investigate Candida spp. pathogenicity and in vitro susceptibility to fluconazole and amphotericin B.. Oral swabbing samples from 11 erosive oral lichen planus (OLP) patients were collected before (day 0) and at days 7 and 30 of topical corticotherapy. Conventional methods for identification and quantification of Candida species, quantitative PCR (qPCR), pathogenicity tests and in vitro susceptibility to fluconazole and amphotericin B assays were performed.. Candida albicans was the most prevalent species in the oral mucosa after corticotherapy. Increased number of colony-forming units (CFU) and Candidaalbicans DNA copies were observed at day 30 of corticotherapy, despite no clinical evidence of candidiasis in any patient. Colony-forming units’ count of Candida species was less sensitive than qPCR, but both methods positively correlated. No resistance to fluconazole or amphotericin B was observed.. Topical corticoid used for oral erosive lichen planus treatment was associated with increase in Candida spp., in particular, C. albicans, in the oral cavity, independent of clinical manifestation of the disease.

Topics: Administration, Topical; Adult; Aged; Amphotericin B; Antifungal Agents; Candida; Candida albicans; Candida glabrata; Candida tropicalis; Candidiasis, Oral; Clobetasol; Colony Count, Microbial; Drug Resistance, Fungal; Female; Fluconazole; Follow-Up Studies; Glucocorticoids; Humans; Lichen Planus, Oral; Male; Middle Aged; Mouth; Peptide Hydrolases; Phospholipases

Oral lichen planus is a mucosal inflammatory disease whose pathogenesis is unclear. The chronic inflammation leads to development of a squamous cell carcinoma in 1-2% of the patients; we present an exemplary case.

Topics: Administration, Oral; Amphotericin B; Antifungal Agents; Carcinoma, Squamous Cell; Humans; Lichen Planus, Oral; Male; Middle Aged; Nystatin; Skin Neoplasms; Treatment Outcome