tretinoin and Mouth-Diseases

Since topical retinoic acid was first used for acne in 1959, many additional uses have been described for lesions on the skin, oral mucosa, and ocular surface epithelia. The topical application of retinoic acid has been shown to be effective in the treatment of several disorders of keratinization, keloids and hypertrophic scars, and various infections and inflammatory, pigmentation, and malignant and premalignant disorders. This article briefly reviews the use of topical retinoic acid for selected cutaneous conditions.

Topics: Administration, Topical; Humans; Mouth Diseases; Pigmentation Disorders; Precancerous Conditions; Skin Diseases; Skin Neoplasms; Tretinoin

Twenty-five patients with oral lichen planus confirmed by histologic examination were divided into three groups: 10 patients received topical treatment with tretinoin, 10 received systemic treatment with etretinate, and the five remaining patients, who received no treatment, served as a control group. An immunopathologic study with the use of monoclonal antibodies was carried out before and after the 3-month course of treatment and showed a variation in the distribution and phenotype of inflammatory cells. No difference between the two types of treatment was observed, but treated patients had a shorter evolution of the disease when compared with control patients.

Topics: Adolescent; Adult; Aged; Aged, 80 and over; Antigens, Differentiation, T-Lymphocyte; CD3 Complex; CD4 Antigens; CD4-Positive T-Lymphocytes; CD8 Antigens; Etretinate; Female; HLA-DR Antigens; Humans; Leukocyte Count; Lichen Planus; Male; Middle Aged; Mouth Diseases; Receptors, Antigen, T-Cell; T-Lymphocytes, Regulatory; Tretinoin

Mucosal dysplasia in the head and neck region is recognized to be a precancerous lesion. Between January 1983 and December 1987, a pilot study was conducted at the Manitoba Cancer Treatment and Research Foundation to determine the effects of beta-carotene and cis-retinoic acid on mucosal dysplasias. Eighteen patients were treated with a "cross-over" regimen. The overall response to treatment was 61%, with 33.3% complete responses. Patients who smoked had a significantly better response than nonsmokers. The response rate for 9 of 11 smokers was 81.2%, and 2 of 7 nonsmokers or 28.6% responded to this protocol. The beneficial effect of these drugs should be established by prospective, randomized trial in high risk populations.

Topics: Adult; Aged; Aged, 80 and over; beta Carotene; Carotenoids; Drug Evaluation; Erythroplasia; Female; Humans; Leukoplakia, Oral; Lichen Planus; Male; Middle Aged; Mouth Diseases; Mouth Mucosa; Pilot Projects; Precancerous Conditions; Prospective Studies; Smoking; Tretinoin; Vitamin A

Twenty patients with oral lichen planus (OLP) were divided into two groups. The first group (8 reticulated OLP, 2 hyperkeratotic OLP) was treated with topical tretinoin. The second group (4 reticulated OLP, 6 eroding OLP) was treated with oral etretinate. All patients were regularly followed in order to observe over a period of five years the evolution of the lesions under treatment, the side-effects and recurrences when the treatment was discontinued.

Topics: Adult; Aged; Aged, 80 and over; Etretinate; Female; Humans; Lichen Planus; Male; Middle Aged; Mouth Diseases; Recurrence; Tretinoin

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

A double-blind study of twenty-eight patients with severe oral lichen planus treated with etretinate (75 mg daily) or a placebo for 2 months, showed that the oral retinoid had a marked beneficial effect. Nine non-responders who had received only placebo then entered an open cross-over study and they responded well to etretinate. Etretinate thus provided effective symptomatic relief for severe oral lichen planus, but side-effects were common, and six patients stopped treatment because of them.

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

Experiences in the treatment of lichen planus mucosae (including the erosive type) are reported. Good therapeutical results could be obtained in all patients. Leukoplakic patches showed a partial involution and in some cases erosive alterations healed completely. After interruption of medication a relapse was observed in most cases. Concerning side effects, some patients complained in particular of minor dryness of both labial and nasal mucosa and of diffuse hair effluvium.

Topics: Adult; Aged; Clinical Trials as Topic; Drug Evaluation; Etretinate; Female; Humans; Leukoplakia, Oral; Lichen Planus; Male; Middle Aged; Mouth Diseases; Mouth Mucosa; Recurrence; Time Factors; Tretinoin

The treatment of severe forms of oral lichen planus is still relatively unsatisfactory. In this controlled study, 0.1% tretinoin in an adhesive base was used in 23 patients. Fifteen other control patients were similarly treated with the vehicle alone. In the tretinoin-treated group, 71% of the atrophic-erosive lesions improved while 29% improved from the vehicle (P less than .05). Reticular-plaque lesions improved in 74% from tretinoin and in 15% from the vehicle (P less than .001). Irritation from tretinoin occurs and thorough usage information is mandatory.

Topics: Administration, Topical; Adult; Aged; Cheek; Female; Humans; Lichen Planus; Male; Middle Aged; Mouth Diseases; Mouth Mucosa; Tretinoin; Vitamin A

Vitamin A acid (retinoic acid) is less toxic than vitamin A and seems to be an important advance in dermatology. Its therapeutic effect was investigated in clinical studies involving 405 patients. Biochemical investigations have shown that the administration of vitamin A acid is associated with elevation of serum levels of retinol and carotene and after high dosage symptoms develop identical with hypervitaminosis A. Several possibilities regarding the mode of action of vitamin A acid are discussed.

Topics: Administration, Topical; Animals; Female; Humans; Injections; Mouth Diseases; Mouth Mucosa; Placebos; Pregnancy; Rats; Skin Diseases; Tretinoin; Vitamin A

Topics: Diagnosis, Differential; Female; Humans; Keratolytic Agents; Middle Aged; Mouth Diseases; Palate, Soft; Tongue Diseases; Tretinoin

Topics: Epithelium; Eye Diseases; Humans; Lung Diseases; Mouth Diseases; Tracheal Diseases; Tretinoin; Vitamin A; Vitamin A Deficiency

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

Topics: Adult; Aged; Female; Humans; Lichen Planus; Male; Middle Aged; Mouth Diseases; Tretinoin

Twenty-five patients with chronic oral lichen planus, usually of the atrophic-erosive type, were treated for 2 months with Etretinate 0.6 mg/kg b.w./day, followed for 4 months by Etretinate 0.3 mg/kg/day, or 0.1% Tretinoin in an adhesive base. Complete resolution or improvement was seen in 85% of the lesions after first treatment. The number of patients with oral soreness and pain was significantly reduced (p less than 0.001). During the second treatment, the improvement was maintained or even increased in about 70% of the patients, irrespective of the mode of treatment. Treatment was discontinued in one patient owing to moderately increased serum transaminase levels. The number of drug-related drop-outs was significantly lower than in a previous study utilizing an etretinate dose of about 1 mg/kg/day (p less than 0.05). Other adverse effects were minor and tolerable. Retinoids offer an effective mode of therapy for severe oral lichen planus.

Topics: Adult; Aged; Drug Evaluation; Drug Therapy, Combination; Etretinate; Female; Humans; Lichen Planus; Male; Middle Aged; Mouth Diseases; Recurrence; Tretinoin

Topics: Administration, Topical; Adult; Aged; Female; Humans; Leukoplakia, Oral; Lichen Planus; Male; Middle Aged; Mouth Diseases; Mouth Mucosa; Recurrence; Tretinoin

Topics: Administration, Topical; Mouth Diseases; Mouth Mucosa; Tretinoin

Topics: Adrenal Cortex Hormones; Candidiasis, Oral; Humans; Levamisole; Levodopa; Mouth Diseases; Mycoses; Tretinoin; Virus Diseases; Vitamin A