Effect of topical cyclosporine rinse on oral lichen planus: a double-blind analysis

Article Abstract:

Oral lichen planus is a condition affecting the mouth and involving multiple areas of lacelike lesions or plaques that may be erosive. Oral lesions are more resistant to therapy and less likely to undergo remission than cutaneous forms of the disorder. Treatment of oral lichen planus is aimed primarily at relieving discomfort. A total of 16 patients with oral lichen planus and accompanying discomfort were studied; eight patients received cyclosporine, while eight received only the vehicle. Cyclosporine or the placebo was administered as a swish-and-spit medication three times a day for eight weeks. All eight patients who received the active drug experienced marked improvement in erosion, inflammation, pain, and the number of lesions. One patient who received the vehicle had moderate improvement and the remainder either were unaffected or experienced flare-ups of their ulcerations. Patients receiving the vehicle were later treated with cyclosporine and had clinical responses equivalent to those of the patients who received cyclosporine. Treatment of oral lichen planus is difficult and discontinuation of therapy frequently results in a relapse. Corticosteroids have been applied topically or injected, and retinoids have also been used to treat oral lichen planus; however, long-term use of these agents is not recommended because of their potential toxicity. The cause of oral lichen planus is unknown; however, treatment response from the agents used successfully indicates a possible role of the immune system. (Consumer Summary produced by Reliance Medical Information, Inc.)

Evaluation, Drug therapy, Cyclosporine, Cyclosporins, Lichen planus

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Topical tretinoin (retinoic acid) treatment for liver spots associated with photodamage

Article Abstract:

A 0.1 percent tretinoin cream applied to the skin may eliminate liver spots in some individuals. Liver spots are pigmented areas on the skin that are believed to be caused by long-term exposure to sunlight. Of 58 individuals with liver spots on their faces and arms, 28 applied the cream to affected areas every night, and 30 applied a cream that did not contain tretinoin. The appearance of their liver spots was assessed visually after two and four weeks of treatment and every month thereafter. A skin biopsy of a liver spot was performed in each individual before and after 10 months of treatment. After 10 months of treatment, significantly more patients in the tretinoin group experienced some lightening of their liver spots, compared with patients in the control group. Analysis of skin biopsies showed individuals using tretinoin had decreased pigmentation in the area of the liver spot.

Health aspects, Tretinoin, Skin Aging

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Markedly diminished epidermal keratinocyte expression of intercellular adhesion molecule-1 (ICAM-1) in Sezary syndrome

Article Abstract:

In mycosis fungoides, a chronic or rapidly progressive form of cutaneous T-cell lymphoma, the malignant T-cells that are involved in the immune process bind to epidermal keratinocytes, the skin cell which synthesizes keratin. A patient with leukemic-stage mycosis fungoides, or Sezary syndrome, had red skin lesions containing malignant T-cells but did not show any sign of outer skin disorder. Due to the inability of the malignant T-cells to produce gamma interferon, the inability of malignant T-cells to enter the outer layer of skin may contribute to the emergence of a more clinically aggressive form of the disease as the tumor cells are no longer confined to the skin. They can then infiltrate the blood, lymph nodes, and visera, as seen in Sezary syndrome.

Analysis, Skin diseases, Skin, Keratinocytes, Leukocytes, White blood cells, column, Sezary syndrome, Skin biopsy

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