• Journal of Oral Medicine and Pain
• /
• v.35 no.4
• /
• pp.259-264
• /
• 2010

The majority of chronic gingival ulcerative lesions are known to be due to autoimmune disease such as oral lichen planus, benign mucous membrane pemphigoid or pemphigus vulgaris. Topical or systemic corticosteroids are mainly used and adjuvant drugs like immunosuppressant, anti-inflammatory drugs, antimalarials or antimetabolites can also be prescribed. Because systemic corticosteroids causes various side effects, such as gastrointestinal disturbance, osteoporosis, diabetes or adrenal suppression. So, topical steroid therapy is main treatment for chronic gingival ulcerative lesion confined to small area. However, there's also limitation of topical corticosteroids. The effect of the corticosteroids decreases due to salivary flow and the movement of the tongue, lips, or buccal mucosa. When the lesions are widely distributed or positioned deeply in oral cavity, it is hard to apply the medication on patients' own. Moreover, it can be applied to unaffected mucosa. Although occlusive steroid therapy using stent was reported to minimize taking steroid and overcome the faults of applying topical steroids, it has been used less frequently in the clinical field. Therefore, this report is going to find out the usefulness and the way to utilize clinically through the case which acted satisfactorily by performing topical steroid therapy using stent on chronic ulcerative gingival lesions.

• Childhood Kidney Diseases
• /
• v.13 no.2
• /
• pp.207-214
• /
• 2009

Purpose : To evaluate the cause of asymptomatic bacteriuria (AB) or aseptic pyuria (AP) on physiologic phimosis and to evaluate the effect of topical steroid therapy and preputial hygiene on the resolution of AB and AP. Methods : Ninety uncircumcised boys (age 1-72 month, median 16 month) with AB or AP were examined for physiologic phimosis and allocated by the preputial retractibility into the non-retractile group (n=59) or the retractile group (n=31). Topical steroid therapy [topical application of hydrocortisone (0.1%) cream with physiotherapy] were prescribed (three times a day) and the method of preputial hygiene (gentle retraction of prepuce and water cleansing) was instructed to the non-retractile group. After 2-4 weeks, the preputial retractibility was reevaluated and urine examination was repeated. To the retractile group, only the method of preputial hygiene was instructed and urine examination was repeated two weeks later. Results : Among 90 boys with AB and AP, 65.6% (59/90) had the nonretractile prepuces and nonperformed preputial hygiene. In the nonretractile group, the prepuces became retractile in 81.4% (48/59) after topical steroid therapy. Among boys (n=48) whose prepuces became retractile after topical steroid therapy, AB or AP resolved in 77.1%, decreased in 18.7% and persisted in 4.2%, which were significantly different to 18.2%, 2.37%, 54.5% in boys (n=11) whose prepuces were persistently nonretractile (P=0.0114). In the retractile group (n=31), 65.2% was compliant to preputial hygiene. In boys (n=23) who were compliant to preputial hygiene, AB or AP resolved in 65.2%, decreased in 26.0% and persisted in 8.2%, which were significantly different to 12.5%, 50%, 37.5% in boys (n=8) who were not compliant (P=0.0457). Conclusion : Physiologic phimosis was an important cause of AB or AP. Simple topical steroid therapy on the nonretractile prepuces and good preputial hygiene could improve AB or AP.

• Journal of Oral Medicine and Pain
• /
• v.26 no.2
• /
• pp.121-126
• /
• 2001

Mucous membrane pemphigoid is uncommom disease in oral cavity and synonymous with cicatricial pemphigoid. This disease is caused by autoimmune reaction that autoantibody reacts antigen located in basement membrane and epithelium is separated from underlying connective tissue. It affects female over sixth decade, commonly. Oral mucosa, especially gingiva is common site but conjunctival, nasal, pharyngeal, laryngeal, esophageal, varginal mucosa and skin are involved. Intraoral findings show Nikolsky sign, irregular erythema, erosion, vesicle, and ulceration at mucous membrane. To differentiate from diseases of positive Nikolsky sign, should perform histologic, immunologic test. Histologic features show subbasilar cleft and direct immunologic features show IgG, C3 deposits at basement membrane in linear pattern. Mucous membrane pemphigoid is incurable disease because symptoms are repetitively improved or worsed for several years. Patiens are commonly managed with topical and systemic steroid. To avoid side effects of prolonged steroid therapy and to maintain immunosupressive effects, combination therapy of azathioprine with steroid is effective. This case reports that mucous membrane pemphigoid is diagnosed based on clinical and histologic features, is treated with topical, systemic steroid and azathioprine therapy.

• The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology
• /
• v.36 no.4
• /
• pp.196-205
• /
• 2023

Objectives : We would like to report what symptoms appear in patients experiencing steroid rebound phenomenon and how to manage and treat them at Korean medicine hospital. Methods : A 20-year-old woman who had been using topical and oral steroids for more than 6 weeks presented to the hospital. She hospitalized for 5 weeks and stopped using steroid. The treatment applied was acupuncture, wet dressing therapy and herbal medicine including Yangdokbackho-tang, Sunbangpaedok-tang and Danguieumja. We assessed symptoms through Inflammation Index and Chronicization Index. Results : Right after she stopped using steroid, symptoms of skin got worse gradually. However, after 5 weeks of treatment, all symptoms except itching and dryness disappeared. When symptom was severe, Inflammation Index and Chronicization Index was 12 and 9 points and after the treatment they were 2 and 4 points. Conclusions : This study shows various symptoms in patients with topical steroid addiction and how to manage at Korean medicine hospital.

• Korean Journal of Bronchoesophagology
• /
• v.2 no.2
• /
• pp.227-231
• /
• 1996

Recurrent aphthous stomatitis is one of the most common diseases of ulcerative oral mucosal lesions and its cause remains elusive. The purpose of this study is to evaluate the therapeutic effect of topical steroids for the treatment of recurrent aphthous stomatitis. We performed the study with 50 cases who had visited to our office for the treatment of recurrent aphthous stomatitis during the recent five years. We devided 50 cases into five groups. Group 1 is that triamcinolone of 0.1-0.2mg was injected into the submucosal lesions of ulcerations. Group 2 is that the gargling of 5ml with triamcinolone tablet of 2mg was used three times per day for seven days. Group 3 is that the gargling of 5ml with betamethasone tablet 0.5mg was used three times per day for seven days. Group 4 is that tetracycline gargling was used six times per day for seven days. Group 5 is that normal saline gargling was used six times per day for seven days. The retrospective analysis of results were as follows : Betamethasone gargling was effective in the treatment of minor aphthous stomatitis and the submucosal injection of triamcinolone was effective in the treatment of major aphthous stomatitis, but none of the different therapeutic methods was effective for herpetiform stomatitis. In the evaluation of mean recurrence periods, the triamcinolone gargling and betamethasone gargling showed longer asymptomatic periods than other methods. We concluded that some kinds of topical steroids can be used for the treatment of recurrent aphthous stomatitis but the proper selection of agents according to the type of the disease is important for the treatment.

• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
• /
• v.29 no.2
• /
• pp.79-82
• /
• 2018

Background and Objectives : Laryngeal contact granuloma is benign inflammatory disease induced by excessive mechanical contact of larynx such as endotracheal intubation, voice abuse, laryngeal microsurgery as well as laryngopharygeal reflux. Because it is caused by various risk factors, multiple treatment modalities are required. The purpose of study is to evaluate treatment effect of topical steroid through nasal cavity in contact granuloma. Materials and Method : Fifty-two patients were enrolled in this study with exception of intubation granuloma. Patients were classified with four groups (Proton pump inhibitor (PPI), Nasal steroid spray (SPR), PPI+SPR, Observation) according to treatment modality. Results : Patients who treated with PPI (Odds ratio 2.45, p=0.03) and combination of PPI and SPR (Odds ratio 2.88, p<0.01) had significantly better response than patients who not treated with medical therapy. Conclusion : Combination therapy of nasal steroid spray and PPI is effective for contact granuloma of larynx and considered as a treatment of choice rather than PPI only treatment.

• Proceedings of the PSK Conference
• /
• 2003.04a
• /
• pp.293.2-294
• /
• 2003

Topical buccal therapy with steroid anti-inflammatory drugs is based on the concept that a high activity of steroids can be produced at the site of administration and, at the same time, the degree of systemic side effects can be minimized or avoided. In this study we developed a new formulation consisting of a mucoadhesive bead for buccal administration of glucocorticoids. (omitted)

• Journal of Oral Medicine and Pain
• /
• v.43 no.1
• /
• pp.16-20
• /
• 2018

Graft-versus-host disease (GVHD) is frequent complications of hematopoietic stem cell transplantation. In the chronic GVHD (cGVHD), the oral cavity is the most commonly affected region. The clinical manifestations include erythema, ulceration, lichenoid-hyperkeratotic change in oral mucosa, dry mouth, and limitation of mouth opening. The initial treatment strategy of oral cGVHD patients is topical corticosteroid therapy in various formulation. However, corticosteroid resistance appears in some patients. We report a case of a 25-year-old male patient with oral cGVHD, who has resistance to topical corticosteroid medication, treated with 0.03% tacrolimus ointment and low-dose doxycycline. The patient showed subjective and objective improvement without side effect.

• Journal of Yeungnam Medical Science
• /
• v.40 no.4
• /
• pp.423-425
• /
• 2023

Porokeratosis ptychotropica is an uncommon form of porokeratosis, which was initially described in 1995. It is clinically characterized by symmetrical reddish to brown-colored hyperkeratotic, verrucous, or psoriasiform plaques on the perianal and gluteal regions. The lesions tend to integrate and expand centrally, with small peripheral satellite lesions. Early skin biopsy and appropriate diagnosis are essential because malignant change occurs in 7.5% of porokeratotic lesions. Conventional treatment options include topical steroid, retinoid, imiquimod, 5-fluorouracil, isotretinoin, excimer laser, photodynamic therapy, intralesional steroid or bleomycin injection, cryotherapy, carbon dioxide (CO₂) laser, and dermatome and excision, but none seem to achieve complete clearance. A 68-year-old woman presented with diffuse hyperkeratotic scaly lichenoid plaques on the buttocks that had persisted for several years. A skin biopsy of the buttocks revealed multiple cornoid lamellae and intense hyperkeratosis. There were some dyskeratotic cells beneath the cornoid lamellae and the granular layer was absent. Porokeratosis ptychotropica was diagnosed based on the characteristic clinical appearance and typical histopathological manifestations. She was treated with a CO₂ laser in one session and topical application of urea and imiquimod cream for 1 month. The lesions slightly improved at the 1-month follow-up. We herein present a rare case of porokeratosis ptychotropica.

• Journal of Oral Medicine and Pain
• /
• v.37 no.3
• /
• pp.155-159
• /
• 2012

Background Oral lichen planus (OLP) is a chronic inflammatory disease characterized by cell-mediated immune responses, but the exact cause is unknown. Sulfasalazine has shown efficacy in the treatment of cutaneous lichen planus. Objective Our purpose was to assess the usefulness of sulfasalazine in treatment of OLP resistant to corticosteroid therapy. This study provides a new option for controlling OLP symptoms. Methods Two patients with the symptomatic reticular form of OLP were treated with 30 mg/5 ml of topical sulfasalazine for 8 to 15 weeks and were evaluated for symptom severity using a numerical analog scale during each week of treatment. The lesion size was measured using a 2 $mm^2$ grid. Results After 2 weeks of application, both patients reported improvements in their symptoms and lesions. Most of the lesions disappeared after 8 weeks of treatment without any side effects. Conclusion Topical sulfasalazine can be a successful treatment option for patients with oral lichen planus resistant to steroid therapy.