orabase and Mouth-Diseases

A case of bullous pemphigoid with extra-oral and intraoral lesions in a 60-year-old female is reported. Diagnosis is based on histopathology and direct immunofluorescence, and the treatment regime described included oral prescription of prednisolone and topical application of a mixture of fluocinonide ointment and triamcinolone acetonide in Orabase on the oral lesions.

Topics: Administration, Topical; Anti-Inflammatory Agents; Biopsy; Carboxymethylcellulose Sodium; Drug Therapy, Combination; Female; Fluocinonide; Glucocorticoids; Humans; Middle Aged; Mouth; Mouth Diseases; Ointments; Pemphigoid, Bullous; Prednisolone; Triamcinolone Acetonide

Because of their chronic nature treatment of oral vesiculoerosive diseases remains a challenge to the oral medicine specialist. Even though oral vesiculoerosive diseases respond well to systemic steroids, adverse side effects sometimes limit their use. Potent topical steroids are becoming increasingly useful to treat these chronic conditions with good control. The purpose of this double-blind clinical trial was to compare clobetasol propionate and fluocinonide ointment in orabase as treatments for controlling oral vesiculoerosive diseases. Sixty patients were asked to participate (43 women and 17 men). Data are reported for 55 patients. Each patient was seen at baseline and at days 7, 14, 21, and 28. Variables evaluated were pain, erythema, atrophy, and size of lesion. Overall, both medications had a beneficial effect in the control of symptoms and signs of oral vesiculoerosive diseases with minimal side effects. Clobetasol propionate was better than fluocinonide as measured by more rapid control of pain (within 7 days). Candidiasis was observed in 13 patients at the end of treatment (most of them carriers of Candida). Therefore normal carriers should be identified and treatment with antifungal therapy instituted before the patient begins using topical steroids.

Topics: Aged; Carboxymethylcellulose Sodium; Clobetasol; Double-Blind Method; Erythema Multiforme; Female; Fluocinonide; Humans; Lichen Planus, Oral; Linear Models; Male; Middle Aged; Mouth Diseases; Pemphigoid, Benign Mucous Membrane; Pemphigus

This study assessed the potential of topical Calendula officinalis extract on the healing of oral mucositis induced by 5-fluorouracil (5-FU) in hamsters.. Oral mucositis was induced in 60 male hamsters by 5-FU (60 mg/kg) on days 0, 5, and 10 of the study. The cheek pouch was scratched with a sterile needle on days 1 and 2. On days 12-17, 5% and 10% C. officinalis gel and gel base groups were treated and then compared with a control group. Macroscopic and microscopic scores and weights were evaluated.. Microscopic and macroscopic scores of mucositis were lower in the 5% and 10% C. officinalis gel groups than in the gel base and control groups (P < .05). Weight gain was noted in the treatment groups compared with the gel base and control groups (P < .05).. Calendula officinalis extract accelerated the healing of oral mucositis in hamsters.

Topics: Abscess; Animals; Antimetabolites, Antineoplastic; Calendula; Carboxymethylcellulose Sodium; Cricetinae; Drug Carriers; Erythema; Fluorouracil; Gels; Hyperemia; Injections, Intraperitoneal; Male; Mesocricetus; Mouth Diseases; Mouth Mucosa; Oral Hemorrhage; Oral Ulcer; Phytotherapy; Plant Extracts; Re-Epithelialization; Single-Blind Method; Stomatitis; Time Factors; Weight Gain; Wound Healing

Psoriasis is a chronic immune-mediated disease of unknown etiology that affects the skin and mucous membranes. According to the National Institutes of Health (NIH), approximately five million Americans, 3% of the population, have been diagnosed with psoriasis. Oral manifestations of psoriasis are less well recognized than skin lesions, and treatment for oral lesions is not standardized. This article will review the clinical presentation of skin and mucous membrane psoriasis, along with the therapeutic modalities available to oral health-care providers.

Topics: Alefacept; Anti-Inflammatory Agents, Non-Steroidal; Antibodies, Monoclonal; Antibodies, Monoclonal, Humanized; Carboxymethylcellulose Sodium; Diphenhydramine; Etanercept; Glossitis, Benign Migratory; Humans; Immunoglobulin G; Immunosuppressive Agents; Infliximab; Lip Diseases; Methotrexate; Mouth Diseases; Mouth Mucosa; Palliative Care; Psoriasis; Receptors, Tumor Necrosis Factor; Recombinant Fusion Proteins

Bullous diseases of the oral cavity cause painful erosion. They must be distinguished from aphthae and vesicles which may have a similar presentation. Acute, chronic and congenital conditions are recognized. Acute lesions may involve a polymorphous oral erhythema which has an polymorphous erythematous presentation or toxidermia (Stevens-Johnson syndrome, Lyell syndrome, fixed pigmented erythema). Examination of the skin and history taking are the keys to diagnosis. Patients with chronic bullous diseases may have a congenital condition (bullous epidermolysis or lymphangioma) suggested by the age at onset and the clinical presentation. Acquired chronic bullous diseases include lichen planus and autoimmune bullous diseases. Careful examination is essential to identify mucosal or cutaneous involvement and to obtain a biopsy for histological examination. Search for antibodies deposited in the perilesional mucosa is necessary. Chronic erosive gingivitis is a frequent presentation. Most of the patients have cicatricial pemphigoid, lichen planus, and more rarely pemphigus. The pinch sign is highly discriminative to differentiate the cause of this syndrome. Symptomatic treatment of bullous lesions of the oral cavity include adapted diet and correct and early use of antalgesics.

Topics: Acute Disease; Carboxymethylcellulose Sodium; Chronic Disease; Diagnosis, Differential; Erythema Multiforme; Glucocorticoids; Humans; Lichen Planus, Oral; Mouth Diseases; Mouth Mucosa; Pemphigoid, Benign Mucous Membrane; Pemphigus; Skin Diseases, Vesiculobullous

The findings in this prospective study of 214 patients with oral lichen planus were similar to those found in our 1985 evaluation of 570 patients with oral lichen planus. These two groups of patients with oral lichen planus patients constitute the largest series from one clinic. Oral lichen planus was found mainly in women and most commonly on the buccal mucosa. Spontaneous remissions were infrequent (6.5%), as were malignant transformations (2.3%) in a mean follow-up of 7.5 years. The erosive form of oral lichen planus was most common and was almost always associated with pain. Reproducibly successful management of this T-lymphocyte disease was obtained by selective use of systemic and/or topical corticosteroids. Oral lichen planus was not associated with any evident systemic disease, drug, smoking, or genetic predisposition. Although statistically Candida albicans does not appear to occur disproportionately in large samples of patients with oral lichen planus, in some of the Candida-positive patients, antifungal medications appeared to be useful.

Topics: Administration, Oral; Adult; Aged; Aged, 80 and over; Azathioprine; Carboxymethylcellulose Sodium; Female; Fluocinonide; Follow-Up Studies; Humans; Lichen Planus; Male; Middle Aged; Mouth Diseases; Prednisone; Prospective Studies; Treatment Outcome

The aim of this study was to analyse the adhesion of various polymeric formulations and to measure the in vitro release of a local anaesthetic (febuverine hydrochloride) from a hydrophobic gel containing 34% (wt/wt) adhesive hydrocolloids. The bioadhesive polymer system was prepared from a polyethylene gel containing various amounts of sodium carboxymethylcellulose (NaCMC) as the adhesive, and hydrolysed gelatin as the water sensitive material to ensure rapid swelling. Upon hydration, adhesion studies were performed with a tensile tester equipped with a custom-made cell. The controlled release of the active ingredient was studied with a dissolution cell filled with artificial saliva at 37 degrees C. It was found that the relative adhesive bond strength of the formulations was dependent on the NaCMC content, showing a maximum at about 20 wt %. Febuverine hydrochloride release achieved an optimal release rate for formulations with NaCMC in the range of 12-25 wt %.

Topics: Adhesiveness; Biomechanical Phenomena; Carboxymethylcellulose Sodium; Delayed-Action Preparations; Humans; Molecular Weight; Mouth Diseases; Tissue Adhesives

Topics: Carboxymethylcellulose Sodium; Humans; Mouth Diseases; Mouth Mucosa; Pharmaceutical Vehicles