isotretinoin and Mouth-Diseases

Lupoid perioral dermatitis is classified as a special form of perioral dermatitis with dense aggregations of red-brown papules which display a lupoid infiltrate on diascopy. There are various treatment options ranging from total avoidance of all topical substances to different topical treatment. Cases resistant to therapy require systemic treatment, which, however, is off-label use. In our case we were able to achieve a significant improvement with systemic therapy with isotretinoin over a period of 6 months.

Topics: Dermatologic Agents; Facial Dermatoses; Female; Humans; Isotretinoin; Lupus Erythematosus, Systemic; Middle Aged; Mouth Diseases; Treatment Outcome

In a double-blind study, 20 patients with oral lichen planus were treated twice daily with 0.1% isotretinoin gel or the vehicle alone for two months. Subsequently, patients who used the placebo received the active preparation for another two months. Patients treated with the active medication displayed significantly greater improvement than patients receiving the placebo. Patients who were treated initially with the placebo showed statistically significant improvement after receiving the topical isotretinoin treatment for two months. Side effects from using the gel were primarily a transient burning sensation or irritation on initial application.

Topics: Administration, Topical; Adult; Aged; Clinical Trials as Topic; Double-Blind Method; Female; Humans; Isotretinoin; Lichen Planus; Male; Middle Aged; Mouth Diseases; Tretinoin

Topics: Administration, Topical; Cell Count; Humans; Isotretinoin; Langerhans Cells; Lichen Planus; Mouth Diseases; Mouth Mucosa; Random Allocation; Tretinoin

Six patients with symptomatic oral erosive lichen planus were treated with systemic isotretinoin (10 to 60 mg daily) for 8 weeks. Five (83%) showed subjective and objective improvement at completion of therapy, but the improvement was slight. Relapse occurred in four patients within 2 months after the drug was stopped; one was lost to follow-up. Because of the minimal improvement and adverse side effects, no patient wished to be re-treated with isotretinoin.

Topics: Adult; Aged; Female; Follow-Up Studies; Humans; Isotretinoin; Lichen Planus; Male; Middle Aged; Mouth Diseases; Recurrence; Tretinoin

Lichen planus of the skin and mucous membranes may be disabling. Severe pruritus or bullous lesions may be incapacitating when they occur while erosive oral lesions may be extremely painful. Various treatment modalities have been attempted including corticosteroids (parenteral, intralesional, and topical) and photochemotherapy. Recent successful therapeutic trials of topical retinoic acid and oral etretinate have been completed. Two patients with cutaneous and severe erosive oral lichen planus unresponsive to conventional therapies responded to a trial of oral isotretinoin with prompt and successful remission of cutaneous and oral lesions. This suggests that systemic isotretinoin may have a unique position in the treatment of mucous membrane lichen planus that is refractory to conventional therapies.

Topics: Administration, Oral; Female; Humans; Isomerism; Isotretinoin; Lichen Planus; Middle Aged; Mouth Diseases; Mouth Mucosa; Prednisone; Tretinoin