Topical Triamcinolone Acetonide Research Articles

Effect of minoxidil combined with triamcinolone acetonide on alopecia areata by microneedle injection.

Alopecia areata (AA) is often characterized by sudden onset of patchy hair loss. Topical corticosteroid injection is the most common treatment. This study retrospectively observed the clinical efficacy of microneedle minoxidil combined with triamcinolone acetonide in the treatment of AA. A total of 230 patients with AA were selected. The experimental group (n=120) received physician training and home microneedle treatment with minoxidil combined with triamcinolone acetonide once a week. Topical minoxidil and triamcinolone acetonide were used twice daily at other times. The control group (n=110) was treated with minoxidil combined with triamcinolone acetonide, twice a day. Cure rate, response rate, SALT, dermatological Quality of Life Index (DLQI), visual analogue (VAS), and cost were assessed at weeks 4 and 12. Treated group SALT score(Severity of Alopecia Tool)remarkable lower than control group after treated 4 and 12weeks. After 12weeks treatment, DLQI score of the treated group (1.8±1.67) were significantly lower than those of the control group (2.45±1.88) (p<0.05). VAS score and adverse reaction between two group showed no significant different (p=0.823, p=0.484 respectively). The total cost was 53.93±15.85 in the treatment group and 53.26±11.51 in the control group. There was no significant difference between the two groups (p=0.72). In the treated group, the complete response rate (CR: 78.33%) and total effective rate (CR+PR: 95%) were significantly higher than those in the control group (CR: 40.91% and CR+PR: 51.82%), with statistically significant differences (p<0.001). Microneedle introduction of minoxidil and triamcinolone acetonide in the treatment of AA is a safe, effective, economical, and convenient method, with few adverse reactions, and has a good application prospect.

Effect of topical steroid on soft tissue swelling following anterior cervical discectomy and fusion.

Anterior cervical discectomy and fusion is the most commonly used surgical approach for treating cervical spine conditions, but it can often lead to postoperative swallowing difficulties. To retrospectively assess the effects of topical triamcinolone acetonide in the anterior cervical surgery on swallowing function. In this study, a retrospective design was used to select patients aged 18 years and older who were diagnosed with cervical spondylosis and required anterior cervical discectomy and fusion. Among them, the patients in the experimental group used triamcinolone acetonide topically in front of the plate during surgery, and the control group was the patients who did not use triamcinolone acetonide. The sex, age, operation time, operation segment, and preoperative soft tissue area were compared between the two groups. There were no significant differences in gender, age, operation time, and segment between the two groups. For the preoperative soft tissue area, triamcinolone acetonide was significantly lower than in the control group (P < 0.05). The retrospective results of this study support that topical triamcinolone acetonide as a treatment in anterior cervical surgery can significantly reduce soft tissue swelling, and no effect was found on the operation time, postoperative blood loss, and segment. These findings provide an important basis for clinical care teams to make treatment decisions and confirm the effectiveness of triamcinolone acetonide in improving swallowing function. However, there was a possibility of information collection and selection bias due to the limitations of retrospective studies. To confirm and further advance the use of this treatment, more rigorous prospective randomized controlled trials are recommended to validate these preliminary results.

Photobiomodulation versus corticosteroid in the management of erosive oral lichen planus: a randomized controlled clinical trial

BackgroundOral lichen planus (OLP) is a chronic illness of immune origin that is typically treated with corticosteroids as a gold standard therapy. Photobiomodulation (PBM) may represent an alternative remedy that has the potential to treat a variety of pathological conditions by alleviating pain, reducing inflammation, and promoting tissue healing without the drawbacks of steroid therapies. Thus, the aim of the current study was to compare the effect of photobiomodulation to topical 0.1% triamcinolone acetonide on erosive oral lichen planus.MethodsThis randomized controlled clinical trial involved 44 patients complaining of erosive oral lichen planus. Patients were assigned to one of two groups: control group (n = 22) received 0.1% topical triamcinolone acetonide three times daily with miconazole oral gel once daily for 4 weeks, and photobiomodulation group (n = 22) received laser therapy by 980 nm diode laser utilizing output power 300 mW twice weekly for 5 weeks (a total of 10 sessions). The evaluation of patients was performed at baseline, 6 weeks, and 12 weeks postoperatively in terms of pain, clinical scores, and biochemical evaluation of salivary malondialdehyde levels. All recorded data were analyzed using Mann–Whitney test to compare the two studied groups regarding pain, lesion size, and salivary levels of malondialdehyde. Friedman test, followed by post hoc test, was used for comparison of the data within the same group along the 3 periods at baseline, 6 weeks, and 12 weeks.ResultsBoth groups showed significant improvement in pain and clinical scores, with no statistical difference between them. Moreover, there was a significant improvement in salivary malondialdehyde levels for both groups, with no significant difference between them.ConclusionsPhotobiomodulation could be a promising therapeutic modality for management of erosive oral lichen planus without the side effects of steroid therapy. The salivary malondialdehyde level could be used as a biomarker to evaluate the disease severity and its response to the treatment.Trial registrationThe study has been registered at ClinicalTrials.gov (NCT05951361) (19/07/2023).

A comparative study of fractional CO2 laser with topical triamcinolone acetonide versus intralesional triamcinolone acetonide in the treatment of alopecia areata.

Alopecia areata (AA) is a non-scarring alopecia of chronic autoimmune etiology with heterogenous severity against the anagen hair follicle over the scalp, beard, or any part of the body and is associated with a significant psychological morbidity in the mental status of the patients leading the patients to seek treatment for cosmetic reasons. The management of AA is very unpredictable and is associated with various cosmetic adverse effects. This study aimed at comparing the efficacy and safety of a novel procedure of laser-assisted drug delivery system of steroids with the first-line procedure of intralesional steroids (ILS) for the treatment of patchy AA. To assess and compare the efficacy and safety of fractional CO2 laser in combination with topical triamcinolone acetonide aqueous solution and intralesional triamcinolone acetonide as a monotherapy and in the treatment of AA. A total of 60 patchy AA patients were included in this study. Patients were randomized into two equal groups: Group A and Group B with 30 patients in each group using a computer-generated block randomization. Patients in Group A received fractional CO2 laser with topical triamcinolone acetonide aqueous solution and Group B received ILS. Both groups received treatment for five settings with each setting a gap of 3 weeks. The efficacy and safety of treatment modalities in both groups were assessed using global photograph assessment (GPA)-scale, lesional area density score percentage of improvement (LAD score improvement %), visual discomfort scale (VDS), visual analogue scale, and documentation of adverse effects in each setting. Efficacy of treatment modality-assessed using means score of GPA-scale and LAD score improvement % suggests quicker results to patients in Group B in initial settings but drastic improvement happens to patients in Group A in subsequent settings. At the end of 5th setting, GPA-scale and LAD score improvement % suggest maximum efficacy in patients in Group A and they are statistically significant (P-value < 0.001). The mean VDS in both groups suggests maximum discomfort in Group A, yet the patient satisfaction at the end of 5th setting was maximum with patients in Group A and they are statistically significant (P-value < 0.001). Cosmetic notable adverse effect of atrophy of skin was documented in 30% of patients in Group B. This study showed that fractional CO2 laser with topical triamcinolone acetonide is a better treatment modality than the intralesional triamcinolone acetonide for the treatment of AA with respect to efficacy, safety, and adverse events.

Oral Acitretin Plus Topical Triamcinolone vs Topical Triamcinolone Monotherapy in Patients With Symptomatic Oral Lichen Planus

Symptomatic oral lichen planus (OLP) can be challenging to treat. To compare the efficacy of oral acitretin plus topical triamcinolone acetonide (TAC), 0.1%, with TAC monotherapy in patients with symptomatic OLP. This monocentric, investigator-initiated, placebo-controlled, investigator- and patient-blinded randomized clinical trial was conducted from December 2018 to June 2020 at the Postgraduate Institute of Medical Education and Research, a tertiary referral center in Chandigarh, India. Sixty-four patients 18 years or older with symptomatic OLP were recruited by consecutive sampling. Data were analyzed from July to December 2020. The patients were randomized to receive either a combination of oral acitretin (25-35 mg/d) and TAC (treatment group) or TAC in combination with placebo (placebo group) for 28 weeks, with an additional 8 weeks of treatment-free follow-up after the end of treatment (36 weeks of total study duration). The disease severity and treatment response were assessed using Oral Disease Severity Score (ODSS), Oral Health Impact Profile 14 (OHIP-14), and visual analog scale (VAS). The primary aim was to assess the number of patients achieving ODSS-75 (75% reduction in ODSS compared with baseline) in both groups at 28 weeks and at the end of 36 weeks. Among 64 patients, 31 in the treatment group and 30 in the placebo group completed the study (mean [SD] age, 50.6 [15.2] years vs 49.2 [14.4] years; male-female ratio, 13:19 vs 16:16). Baseline ODSS, visual analog scale, and Oral Health Impact Profile 14 scores were comparable in both groups. In the intention-to-treat analysis, there was a statistically significant higher number of patients achieving 75% or higher reduction in ODSS in the treatment group compared with the placebo group at the end of 28 weeks (28 [88%] vs 15 [47%], a 41 [95% CI, 20-61] percentage point difference between groups; P < .001; Cramér V = 0.47) and 36 weeks (27 [84%] vs 13 [41%], a 43 [95% CI, 23-67] percentage point difference between groups; P < .001; Cramér V = 0.47). Relapses during the posttreatment follow-up of 8 weeks were low among patients in both treatment and placebo groups (1 [3%] vs 2 [6%], a 3 [95% CI, -13 to 7] percentage point difference between groups; P > .99; Cramér V = 0.07). In this randomized clinical trial, the combination of oral acitretin and TAC was more effective than TAC monotherapy in patients with symptomatic OLP. Clinical Trial Registry of India Identifier: CTRI/2018/11/016448.

Evaluation of clinical, histology, TNF-α, and collagen expressions on oral ulcer in rats after treatment with areca nut and chrysanthemum oral gel

Background: Areca nut (Areca catechu Linn.) is the seed of the fruit of the oriental palm that is commonly used among Southeast Asian communities. Chrysanthemum (Dendrathema grandiflora) is a flowering plant originating from East Asia and dominantly grows in China. Both of these plants have strong antioxidant activities. To investigate the mechanism of their wound healing activities, we prepared areca nut and chrysanthemum polyethylene oral gel and performed several in vivo assays using Sprague–Dawley rats. Methods: Sprague–Dawley rats were divided into six groups: Negative control group (rats with base gel treatment), positive control group (rats treated with triamcinolone acetonide), F1 (treatment with 20% areca nut:80% chrysanthemum), F2 (treatment with 50% areca nut:50% chrysanthemum), F3 (treatment with 80% areca nut:20% chrysanthemum), and normal group (without ulcer and treatment). Traumatic ulcers were performed on the buccal mucosa of all experimental animals that received topical oral gel and triamcinolone acetonide twice a day for seven days. The clinical and histological characteristics were analyzed and scored. Results: During the six days, the ulcerated area receded linearly over time and was completely cicatrized in F2, F3, and the positive control group (Dependent t-test, p&lt;0.05). There were significant increases in body weight in F2 and positive control groups. There were no significant differences between groups in histology examination (Kruskal Wallis test, p&lt;0.05). The moderate score of TNF-α levels was seen in F2 and positive control groups (ANOVA/Tukey test, p&lt;0.05). In the collagenases assay, a high concentration of areca nut (F3) induced the abundance of collagen during the ulcer healing process. Conclusions: The combination of areca nut and chrysanthemum extract in the oral gel can optimize the healing of traumatic oral ulcers in Sprague-Dawley rats through the increase of TNF-α and collagen deposition.

Fractional carbon dioxide laser alone and as an assisted drug delivery for treatment of alopecia areata: a clinical, dermoscopic and immunohistochemical study

Alopecia areata (AA) is a common cause of hair loss with no available universally successful treatment. Thus, new innovative treatments are urgently needed. This research aimed to evaluate the effectiveness of fractional carbon dioxide laser (FCL) alone or combined with triamcinolone acetonide (TA) solution, platelet-rich plasma (PRP), or vitamin D3 solution in treating AA. Sixty-four AA patients with 185 lesions were recruited and divided into four treatment groups. All patients received FCL either alone (group A, n = 19) or followed by topical TA (group B, n = 16) or PRP (group C, n = 15), or vitamin D3 solution (group D, n = 14). The response was assessed using Alopecia Areata Severity Index (AASI), MacDonald Hull and Norris grading, and trichoscopy. Histopathological features and immunohistochemical decorin expression were studied. All groups showed significant improvement in AASI compared to the baseline, with insignificant differences between them. Post-treatment, trichoscopic features of disease activity significantly decreased in all groups. Compared to control biopsies, both anagen follicles and decorin expression were significantly decreased in all pretreatment specimens. After treatment, all groups showed significantly increased anagen follicles and decorin expression compared to the baseline. Accordingly, FCL is an effective treatment for AA alone or combined with TA, PRP, or vitamin D3 solution. In AA, Decorin expression was downregulated, while enhanced expression following successful treatment occurred. This suggests the role of decorin in AA pathogenesis. However, further research is still recommended to clarify the exact role of decorin in AA pathogenesis and to investigate the therapeutic benefits of decorin-based therapy.

Comparison of statins with steroids and botulinum toxin A in the prevention of benign strictures after esophageal endoscopic submucosal dissection: a retrospective cohort study.

Preventing benign strictures following esophageal endoscopic submucosal dissection (ESD) remains difficult, and finding a safe, effective, and simple management method is vital. We previously reported that rosuvastatin significantly reduced the incidence and severity of strictures in a rabbit model of esophageal stricture. Accordingly, in this study, we compared the effects of statins, steroids, and botulinum toxin A (BTX-A) on stricture prevention after ESD involving more than three-fourths of the luminal circumference. Of the 1019 ESD cases treated between January 2015 and December 2020, 246 met the inclusion criteria, with 21 cases excluded due to loss to follow-up, tumor recurrence, death, or need for additional surgery, radiotherapy, and/or chemotherapy. Of the 225 included cases, 145 received no intervention, while the remaining 80 were treated: 16 with oral steroids, 20 with topical triamcinolone acetonide (TA) injection, 21 with topical BTX-A injection, and 23 with statins. The occurrence stricture rate in the statins group (17.4%, 4/23) was significantly lower than in the non-intervention (75.2%, 109/145, P = 0.000), oral steroids (56.3%, 9/16, P = 0.011) and TA injection (50%, 10/20, P = 0.023) groups, but comparable to in the BTX-A injection (38.1%, 8/21, P = 0.124) group. The dysphagia score was lower in the statin than non-intervention group (P = 0.000). Although there was no significant difference in the number of required dilations between groups, the maximum number of dilations in the statins group was only six. Statins may be a potential treatment to prevent esophageal strictures after extensive ESD; however, clinical trials should be conducted to validate this.

Lymphangiectasia Mimicking Lichenoid Contact Reaction

Lymphangiectasia, otherwise known as acquired lymphangioma, is unusual to occur in the oral cavity. Among the frequently recognised forms of congenital and acquired entities, the acquired form of the lymphangiectasia may be caused due to trauma or obstruction to the lymphatic system. Commonly, this condition is asymptomatic; however, the needs of aesthetics and functions warrant treatment. This was a case report of a 55-year-old male patient, who came with a chief complaint of burning sensation in his left cheek region for the past three weeks. Clinically, silver amalgam restoration was evident in relation to the tooth numbers 26,27,36 and 37. Soft tissue examination revealed evidence of greyish radiating striae interspersed with hyperpigmentation on the left buccal sulcus and left lateral border of the tongue. Considering the clinical features, a working diagnosis of lichenoid contact reaction was proposed. Further, an incisional biopsy was performed. Histopathological examination showed thin stratified squamous epithelium with vacuolar spaces, which strongly supported the diagnosis of lymphatic malformation. The patient was symptomatically managed with topical triamcinolone acetonide 0.1% twice daily for two weeks. At two weeks follow-up, the patient was symptom-free and hence the medication was withdrawn. The patient is currently under regular follow-ups.

Bullous Lichen Planus of Oral Mucosa: A Case Report

Oral bullous lichen planus is a rare form of lichen planus LP characterized by vesicles or bullae which frequently occur in the setting of pre-existing LP lesions. Histopathology corroborates the diagnosis which is based on clinical suspicion. Bullous lichen planus does not have a standard therapy. Dapsone acitretin topical and systemic corticosteroids are a few of the efficient options. A case of oral bullous lichen planus in a 36- year old female patient with extra oral lesions on the legs successfully treated with topical Triamcinolone acetonide is described here in this case report.

Role of Topical Ritodrine Hydrochloride in Experimentally Induced Hypertrophic Scar in Rabbits

Hypertrophic scars are fibroproliferative illnesses caused by improper wound healing, during that, excessive inflammation, angiogenesis, and differentiated human dermal fibroblast (HDF ) function contribute to scarring, whereas hyperpigmentation negatively affects scar quality. Over 100 million patients heal with a scar every year. To investigate the role of the beta 2 adrenergic receptor (β2AR); Ritodrine, in wound scarring, the ability of beta 2 adrenergic receptor agonist (β2ARag) to alter HDF differentiation and function, wound inflammation, angiogenesis, and wound scarring was explored in HDFs, zebrafish, chick chorioallantoic membrane assay (CAM), and a porcine skin wound model, respectively. A study identify a β2AR-mediated mechanism for scar reduction. β2ARag significantly reduced HDF differentiation, via multiple cAMP and/or fibroblast growth factor 2 or basic FGF (FGF2)-dependent mechanisms, in the presence of transforming growth factor betaβ1, reduced contractile function, and inhibited mRNA expression of a number of profibrotic markers. β2ARag also reduced inflammation and angiogenesis in zebrafish and CAMs in vivo, respectively. In Red Duroc pig full-thickness wounds, β2ARag reduced both scar area and hyperpigmentation by almost 50% and significantly improved scar quality. Indeed, mechanisms delineated in vitro and in other in vivo models were evident in the β2ARag-treated porcine scars in vivo. Both macrophage infiltration and angiogenesis were initially decreased, whereas DF function was impaired in the β2ARag-treated porcine wound bed. This data reveal the potential of β2ARag to improve skin scarring. The purpose of this study was to assess the therapeutic effect of topical Ritodrine hydrochloride on hypertrophic scars in rabbits. Thirty-two healthy male albino rabbits that divided in to 4 groups were included in the study (healthy; induced untreated hypertrophic scars; induced hypertrophic scars treated with 0.1% Triamcinolone acetonide (TAC) as a standard drug; and induced hypertrophic scars treated with 0.5% Ritodrine HCL gel twice daily for 21 days. Histopathology of skin sections, transforming growth factor beta1 TGFβ-1 level, and collagen III alpha1 in skin tissue were all used as outcome measures. Compared to the induced hypertrophic scar group; treatment with Ritodrine significantly reduced means of TGF β1 and collagen III (p ≤0.01); significantly reduce mean score of inflammation (p ≤0.001), significantly lowered scar size (P ≤ 0.001), and significantly lower mean scar height (P≤0.001), but no significant decrease in SEI (P&gt;0.05). Therapy of induced hypertrophic scar with topical Ritodrine was successfully effective in rabbits. It reduced the immunological score (TGF-β1, collagen III), inflammation, and scar size in a substantial way. This effect was comparable (except in terms of SEI) to topical Triamcinolone acetonide efficacy

A Clinical Comparative Evaluation of Steroid and Tacrolimus in Oral Lichen Planus: A Pilot Study

Background: There are various pharmacological approaches for Oral Lichen Planus (OLP), but mainstay of therapy always tends to be corticosteroids. Irrespective of innumerable therapies, attaining permanent cure is still far from reach. Considering the limitations of steroids, a relatively novel therapeutic option is provided by immunosuppressants like Tacrolimus. Thus, the aim of this pilot study is to clinically compare and evaluate the effectiveness of Tacrolimus over corticosteroids in OLP patients. Materials And Methods: Four cases of bilateral OLP administered with 0.1% topical Triamcinolone acetonide (S group) and four other cases administered with 0.1% topical Tacrolimus (T group) were selected and their response to the treatment based on changes in symptoms and signs were recorded on follow up visits. Both the groups were followed up for 3 months. Visual Analogue Scale (VAS) was used for recording the burning sensation and Modified Oral Mucositis Scale (MOMI) for measuring the extent of the lesion. Results: Although the post-follow up results were insignificant between 2 groups, T group had more stable reduction in symptoms without flare up with a significant reduction in post follow up VAS and MOMI score. Conclusion: Tacrolimus can be considered as an effective alternative to steroid, and a potential drug of choice for OLP.

Evaluation of clinical, histology, TNF-α, and collagen expressions on oral ulcer in rats after treatment with areca nut and chrysanthemum oral gel

Background: Areca nut (Areca catechu Linn.) is the seed of the fruit of the oriental palm that is commonly used among Southeast Asian communities. Chrysanthemum (Dendrathema grandiflora) is a flowering plant originating from East Asia and dominantly grows in China. Both of these plants have strong antioxidant activities. To investigate the mechanism of their wound healing activities, we prepared areca nut and chrysanthemum polyethylene oral gel and performed several in vivo assays using Sprague–Dawley rats. Methods: Sprague–Dawley rats were divided into six groups: Negative control group (rats with base gel treatment), positive control group (rats treated with triamcinolone acetonide), F1 (treatment with 20% areca nut:80% chrysanthemum), F2 (treatment with 50% areca nut:50% chrysanthemum), F3 (treatment with 80% areca nut:20% chrysanthemum), and normal group (without ulcer and treatment). Traumatic ulcers were performed on the buccal mucosa of all experimental animals that received topical oral gel and triamcinolone acetonide twice a day for seven days. The clinical and histological characteristics were analyzed and scored. Results: During the six days, the ulcerated area receded linearly over time and was completely cicatrized in F2, F3, and the positive control group (Dependent t-test, p&lt;0.05). There were significant increases in body weight in F2 and positive control groups. There were no significant differences between groups in histology examination (Kruskal Wallis test, p&lt;0.05). The moderate score of TNF-α levels was seen in F2 and positive control groups (ANOVA/Tukey test, p&lt;0.05). In the collagenases assay, a high concentration of areca nut (F3) induced the abundance of collagen during the ulcer healing process. Conclusions: The combination of areca nut and chrysanthemum extract in the oral gel can optimize the healing of traumatic oral ulcers in Sprague-Dawley rats through the increase of TNF-α and collagen deposition.

Evaluation of clinical, histology, TNF-α, and collagen expressions on oral ulcer in rats after treatment with areca nut and chrysanthemum oral gel

Background: Areca nut (Areca catechu Linn.) is the seed of the fruit of the oriental palm that is commonly used among Southeast Asian communities. Chrysanthemum (Dendrathema grandiflora) is a flowering plant originating from East Asia and dominantly grows in China. Both of these plants have strong antioxidant activities. To investigate the mechanism of their wound healing activities, we prepared areca nut and chrysanthemum polyethylene oral gel and performed several in vivo assays using Sprague–Dawley rats. Methods: Sprague–Dawley rats were divided into five groups: Negative control group (rats with base gel treatment), positive control group (rats treated with triamcinolone acetonide), F1 (treatment with 20% areca nut:80% chrysanthemum), F2 (treatment with 50% areca nut:50% chrysanthemum), and F3 (treatment with 80% areca nut:20% chrysanthemum). Traumatic ulcers were performed on the buccal mucosa of all experimental animals that received topical oral gel and triamcinolone acetonide twice a day for seven days. The clinical and histological characteristics were analyzed and scored. Results: During the six days, the ulcerated area receded linearly over time and was completely cicatrized in F2, F3, and positive control group (Dependent t-test, p&lt;0.05). There were significant increases in body weight in F2 and positive control groups. There were no significant differences between groups in histology examination (Kruskal Wallis test, p&lt;0.05). The moderate score of TNF-α levels was seen in F2 and positive control groups (ANOVA/Tukey test, p&lt;0.05). In the collagenases assay, a high concentration of areca nut (F3) induced the abundance of collagen during the ulcer healing process. Conclusions: The combination of areca nut and chrysanthemum extract in the oral gel can optimize the healing of traumatic oral ulcers in Sprague-Dawley rats through the increase of TNF-α and collagen deposition.

Efficacy of Spirulina 500 mg vs Triamcinolone Acetonide 0.1% for the Treatment of Oral Lichen Planus: A Randomized Clinical Trial

The present study aimed at evaluating the efficacy of spirulina 500 mg in reducing the burning sensation and lesion size in oral lichen planus (OLP). A total of 60 subjects who attended the oral medicine specialty clinic with histopathologically confirmed OLP and having symptoms of burning sensation were recruited for the study. They were randomly divided into two groups: group A (30) subjects were prescribed Spirulina 500 mg twice daily along with only a week application of topical triamcinolone acetonide 0.1% thrice daily; group B subjects were prescribed topical triamcinolone acetonide 0.1% alone thrice daily for 8 weeks. Both the groups were followed up posttreatment monthly for three consecutive months. Data were recorded, and statistical analysis by using ANOVA one-way test, and Chi-square test were performed, which showed statistically significant p-value (<0.005) for the parameters "burning sensation" and "size of the lesion". When compared between groups, group A showed a favorable outcome of the intervention. Spirulina 500 mg supplementation twice daily could be effective adjunct therapy with steroids to treat OLP. This research allowed us to delve into spirulina as one of the treatment modalities for OLP. Further studies are needed as it is a rich source of proteins and vitamins and demonstrates potent anti-inflammatory, immunomodulatory, and antioxidant actions.

Comparative Evaluation of Low-Level Laser Therapy and Topical Triamcinolone Acetonide 0.1% in Recurrent Aphthous Stomatitis Subjects.

BackgroundRecurrent aphthous stomatitis (RAS), sometimes known as canker sores, is an infection of the oral mucous membranes caused by an inflammatory process. Triamcinolone and low-level laser therapy for recurrent aphthous ulcers were studied in this research, which evaluated their clinical efficacy.MethodologyAmong 60 subjects, 54 subjects fulfilled the inclusion criteria with an age range between 16 and 46 years. Subjects were randomly divided into two groups, the control group who received four times daily topical application of triamcinolone acetonide 0.1% and the test group who underwent a single application of low-level laser therapy on three alternate days. Evaluations were done on day 1, day 3, day 5, and day 10. Data obtained on oral-health-related quality of life (OHR-QoL) using the OHR-QoL questionnaire were used as baseline data. Clinical parameters like pain score were assessed using a visual analog scale, ulcer size using UNC-15 probe, and erythema and healing score were evaluated using erythema and healing scale.ResultAccording to the OHR-QoL data, there was no statistically significant difference in the quality of life of test and control subjects. We found that pain and ulcer size reduced considerably (p=0.007) from the first day to the third day (p=0.000), and then dropped significantly again (p=0.000) on days 3-10 (p=0.000). On days 3 and 5, the test group showed significant reductions in pain and erythema (p=0.13), as well as an improvement in ulcer healing when compared to the control group. On days 3 and 5, the size of the ulcers decreased similarly in the control and test groups. On the 10th day, patients in both groups had less discomfort, erythema, and ulcer size, as well as improved healing of the ulcer.ConclusionPain and erythema reduction and ulcer healing improvement were significantly higher in subjects in the test group as compared to those in the control group by day 3. The reduction in ulcer size was comparable to the control group on days 3 and 5, while the complete reduction in ulcer size was seen in both groups by day 10.

Evaluation of clinical, histology, TNF-α, and collagen expressions on oral ulcer in rats after treatment with areca nut and chrysanthemum oral gel

Background: Areca nut (Areca catechu Linn.) is the seed of the fruit of the oriental palm that is commonly used among Southeast Asian communities. Chrysanthemum (Dendrathema grandiflora) is a flowering plant originating from East Asia and dominantly grows in China. Both of these plants have strong antioxidant activities. To investigate the mechanism of their wound healing activities, we prepared areca nut and chrysanthemum polyethylene oral gel and performed several in vivo assays using Sprague–Dawley rats. Methods: Sprague–Dawley rats were divided into five groups: Negative control group (rats with base gel treatment), positive control group (rats treated with triamcinolone acetonide), F1 (treatment with 20% areca nut:80% chrysanthemum), F2 (treatment with 50% areca nut:50% chrysanthemum), and F3 (treatment with 80% areca nut:20% chrysanthemum). Traumatic ulcers were performed on the buccal mucosa of all experimental animals that received topical oral gel and triamcinolone acetonide twice a day for seven days. The clinical and histological characteristics were analyzed and scored. Results: During the six days, the ulcerated area receded linearly over time and was completely cicatrized in F2, F3, and positive control group (Dependent t-test, p&lt;0.05). There were significant increases in body weight in F2 and positive control groups. There were no significant differences between groups in histology examination (Kruskal Wallis test, p&lt;0.05). The moderate score of TNF-α levels was seen in F2 and positive control groups (ANOVA/Tukey test, p&lt;0.05). In the collagenases assay, a high concentration of areca nut (F3) induced the abundance of collagen during the ulcer healing process. Conclusions: The combination of areca nut and chrysanthemum extract in the oral gel can optimize the healing of traumatic oral ulcers in Sprague-Dawley rats through the increase of TNF-α and collagen deposition.

Manejo odontológico na Unidade de Terapia Intensiva no tratamento da necrólise epidérmica tóxica associada a fenitoína: relato de caso

ABSTRACT Stevens-Johnson syndrome (SJS) and Toxic Epidermal Necrolysis (TEN) are adverse reactions, usually medicine-related, in which extensive and painful mucocutaneous lesions are formed. Oral lesions are characterized by the presence of erosions and ulcers. The treatment usually requires intensive care in a hospital setting, where the Dentist is essential in the multidisciplinary team, as he will act in the treatment of oral lesions. In this article, a 26-year-old female patient was reported, who presented TEN-compatible mucocutaneous lesions associated with the drug Phenytoin and required admission to a Teaching Hospital. The treatment consisted of the immediate suspension of the Phenytoin use and systemic therapy with corticosteroids and immunosuppressants. Oral lesions were monitored by the hospital dentistry team. The procedures adopted were: oral hygiene with 0.12% non-alcoholic Chlorhexidine Digluconate solution, hydration of the oral tissue with an essential fatty acid, application of frozen chamomile tea, and prescription of topical Triamcinolone Acetonide. Also, low-level laser therapy sessions (red and infrared) were performed. Oral lesions evolved with significant improvement. In this case, the importance of the Dentist in the multi-professional team is demonstrated. Although there is no protocol, the procedures used in the present case can be an alternative to therapies used in SSJ and TEN oral lesions.

Effects of Apremilast on Induced Hypertrophic Scar of Rabbits.

The present study aimed to assess the effect of Apremilast on experimentally inducedhypertrophic scarsin rabbits. A total of 40 healthy male New Zealand White rabbits between 6 and 12 months of age were assigned to four groups (n=10). Group I consists of apparently healthy control rabbits, in group II, the rabbits with an induced hypertrophic scar received no treatment, except for base gel. In group III, the rabbits with induced hypertrophic scar were treated with triamcinolone acetonide (TAC) 0.1% as standard medication. In group IV, rabbits with induced hypertrophic scars were treated with Apremilast 5%. On the first day,four surgical incisions were madeusing an 8-mm biopsy punch on the ventral surface of the rabbit eardownto cartilage. The TAC and Apremilast were topically administered to thedeveloped scars on day 31. The results included an examination of skin histopathology, thelevel oftransforming growth factorbeta-1 (TGF-β1), andcollagen III in skin tissue. In the treatments, the inflammatory score, scar index, as well as immunological scores of TGFβ1 and collagen III, significantly decreased, compared to the hypertrophic induced scar group(P≤0.001). Moreover, there was a significant reductionin fibroblast count, compared to thegroup of inducedhypertrophic scars (P<0.05). Apremilast was efficacious in the treatment of hypertrophic scars due to its ability to reduce inflammations and fibroblast counts and scar index. Nonetheless, the reduction of immunological scoreswas almost comparableto that of topical TAC.

Evaluation of clinical, histology, TNF-α, and collagen expressions on oral ulcer in rats after treatment with areca nut and chrysanthemum oral gel

Background: Areca nut (Areca catechu Linn.) is the seed of the fruit of the oriental palm that is commonly used among Southeast Asian communities. Chrysanthemum (Dendrathema grandiflora) is a flowering plant originating from East Asia and dominantly grows in China. Both of these plants have strong antioxidant activities. To investigate the mechanism of their wound healing activities, we prepared areca nut and chrysanthemum polyethylene oral gel and performed several in vivo assays using Sprague–Dawley rats. Methods: Sprague–Dawley rats were divided into five groups: Negative control group (rats with base gel treatment), positive control group (rats treated with triamcinolone acetonide), F1 (treatment with 20% areca nut:80% chrysanthemum), F2 (treatment with 50% areca nut:50% chrysanthemum), and F3 (treatment with 80% areca nut:20% chrysanthemum). Traumatic ulcers were performed on the buccal mucosa of all experimental animals that received topical oral gel and triamcinolone acetonide twice a day for seven days. The clinical and histological characteristics were analyzed and scored. Results: During the six days, the ulcerated area receded linearly over time and was completely cicatrized in F2, F3, and positive control group (Dependent t-test, p&lt;0.05). There were significant increases in body weight in F2 and positive control groups. There were no significant differences between groups in histology examination (Kruskal Wallis test, p&lt;0.05). The moderate score of TNF-α levels was seen in F2 and positive control groups (ANOVA/Tukey test, p&lt;0.05). In the collagenases assay, a high concentration of areca nut (F3) induced the abundance of collagen during the ulcer healing process. Conclusions: The combination of areca nut and chrysanthemum extract in the oral gel can optimize the healing of traumatic oral ulcers in Sprague-Dawley rats through the increase of TNF-α and collagen deposition.