Response to levamisole and low-dose prednisolone in 41 patients with chronic oral ulcers: a 3-year open clinical trial and follow-up study.

Abstract

OBJECTIVE:

The purpose of this open clinical trial and follow-up study was to evaluate the short-term and long-term clinical efficacy of levamisole used with low-dose prednisolone in 30 patients with oral lichen planus, 6 patients with erythema multiforme, 3 patients with mucous membrane pemphigoid, and 2 patients with early pemphigus vulgaris.

STUDY DESIGN:

All patients were given 150 mg/day of levamisole and 15 mg/day of prednisolone for 3 consecutive days each week, along with topically applied dexamethasone orobase (dexaltin).

RESULTS:

Twenty-three patients showed dramatic remission of signs and symptoms within 2 weeks; 18 patients experienced partial remission. Forty patients reported significant pain relief, and almost none showed evidence of oral ulcerative lesions after 4 to 8 weeks of treatment. In contrast, 1 patient with oral lichen planus with allergy to levamisole reported a partial response from prednisolone alone. All 29 patients with oral lichen planus remained free from symptoms for more than 6 months. All 6 patients with erythema multiforme, all 3 patients with mucous membrane pemphigoid, and both patients with pemphigus vulgaris also remained free from symptoms for 2 to 3 years. There were few side effects from the treatment; there was minor skin rash from levamisole in 1 case of oral lichen planus. We also designed a flexible plastic carrier for topically applied dexaltin in the treatment of diffuse atrophic or ulcerative gingivitis.

CONCLUSIONS:

The addition of levamisole to prednisolone may produce improved results in the management of erosive lichen planus, erythema multiforme, mucous membrane pemphigoid, and early pemphigus vulgaris.

• Authors: S Y Lu, W J Chen, H L Eng
• Journal: Oral surgery, oral medicine, oral pathology, oral radiology, and endodontics (Oral Surg Oral Med Oral Pathol Oral Radiol Endod) Vol. 86 Issue 4 Pg. 438-45 (Oct 1998) ISSN: 1079-2104 [Print] United States
• PMID: 9798228 (Publication Type: Clinical Trial, Journal Article)

Chemical References

• Adjuvants, Immunologic
• Anti-Inflammatory Agents
• Drug Combinations
• Levamisole
• Prednisolone

Topics

• Adjuvants, Immunologic (therapeutic use)
• Adult
• Aged
• Anti-Inflammatory Agents (therapeutic use)
• Chronic Disease
• Drug Combinations
• Erythema Multiforme (complications, drug therapy)
• Female
• Follow-Up Studies
• Humans
• Levamisole (therapeutic use)
• Lichen Planus, Oral (complications, drug therapy)
• Male
• Middle Aged
• Oral Ulcer (drug therapy, etiology)
• Pemphigoid, Benign Mucous Membrane (complications, drug therapy)
• Pemphigus (complications, drug therapy)
• Prednisolone (administration & dosage, therapeutic use)
• Treatment Outcome