A comprehensive review of therapeutic agents used in the treatment of recurrent aphthous ulcer and oral ulcers in Bechet’s syndrome

Abstract

Introduction: Recurrent aphthous ulcer (RAU) is a common oral disease characterized by ulcers with an erythematous halo, affecting 5–25% of the general population. The underlying etiology is not clear, but several factors are believed to be responsible for the pathogenesis of the disease including stress, hormones, genetic factors etc. Behcet'ssyndrome is a multisystem disorder involving vasculitis of small and medium-sized vessels and inflammation of the epithelium, characterized by recurring oral and genital ulcers with eye lesions. Aim:The objectives of this paper were to compare different treatment options available for the patients suffering from RAU and major refractory oral aphthae without any systemic disease or any syndromes except Bechet’s, associated with RAU published in the review of RAU, point out drugs and therapies along with their dosages that may be used in the first line of treatment (topical) and second line of treatment (systemic). Materials and Methods: Pub Med search (full text and abstracts) with drugs belonging to several categories like anesthetics; antibiotics and antiseptics, corticosteroids, anti-inflammatory and antiallergic drugs hemorrheologic agents, zinc substitutes, immunomodulatory agents and chemical cauterizing agents was done. Pub Med search term “Behcet's trial oral” was used and only those publications that described clinical trial with drugs on patients with Behcet’s disease involving oral lesions were selected. Result:Total 62 articles were analyzed to extract the data regarding different therapeutic agents used in the treatment of Recurrent aphthous ulcer and oral ulcers in Bechet’s syndrome. The drugs most commonly used were lidocaine, benzocaine, tetracycline, chlorehexidine amlexenox and dexamethasone topically and prednisolone, levamisole and thalidomide systemically as a single therapy or in combination. The impact of immunomodulators and LASER in comparison with topical drugs also was assessed. C