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

摘要

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.