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16.
Med. clín (Ed. impr.) ; 149(8): 351-362, oct. 2017. graf, tab
Artigo em Espanhol | IBECS | ID: ibc-167662

RESUMO

En la presente revisión sistemática se analizaron 55 artículos estructurados sobre la eficacia terapéutica frente al dolor y a los signos clínicos del liquen plano oral (LPO). La búsqueda bibliográfica se elaboró siguiendo los criterios del sistema PRISMA, seleccionando los ensayos realizados mediante alguno de los siguientes diseños metodológicos: entre fármaco (principio activo) vs. mismo fármaco en diferente excipiente o concentración, fármaco vs. diferente principio activo, fármaco vs. fitoterapia y fármaco vs. tratamiento con fototerapia. Basándonos en los resultados se propone un algoritmo que sirva de guía para establecer el tratamiento del LPO en sus formas clínicas atrófica y erosiva. Se destaca el empleo del propionato de clobetasol al 0,025-0,05% de aplicación tópica como primera alternativa terapéutica. En segundo lugar, el tacrolimús al 0,1% y pimecrolimús al 1% también formulado para su pauta tópica. Y, finalmente, se aborda el empleo de corticosteroide sistémico y la aplicación de láser de diodo (AU)


In this systematic review, 55 structured articles on the therapeutic efficacy against pain and clinical signs of oral lichen planus (OLP) were analysed. The literature search was developed according to the criteria of the PRISMA system, selecting the tests performed using one of the following methodological designs: drug (active ingredient) vs. drug in different excipient or concentration, drug vs. different active principle, drug vs. phytotherapy and drug vs. treatment with phototherapy. Based on the results, an algorithm is proposed to guide the treatment of OLP in its atrophic and erosive clinical forms. The use of clobetasol propionate at 0.025-0.05% of topical application as the first therapeutic alternative is highlighted. Secondly, 0.1% tacrolimus and 1% pimecrolimus also formulated for its topical regimen. And finally, we address the use of systemic corticosteroids and the application of diode lasers (AU)


Assuntos
Humanos , Líquen Plano Bucal/terapia , Clobetasol/uso terapêutico , Triancinolona Acetonida/uso terapêutico , Calcineurina/uso terapêutico , Terapia a Laser , Protocolos Clínicos , Manejo da Dor/métodos , Padrões de Prática Odontológica/tendências , Resultado do Tratamento , Miconazol/uso terapêutico , Dexametasona/uso terapêutico
17.
Med. oral patol. oral cir. bucal (Internet) ; 22(5): e562-e571, sept. 2017. ilus, tab, graf
Artigo em Inglês | IBECS | ID: ibc-166650

RESUMO

Background: Scoring systems have been widely used to evaluate the severity and activity of oral lichen planus (OLP). The aim of the present study was to compare two existing (one modified) scoring systems in the evaluation of OLP severity and correlation with pain. Three differently experienced raters were involved. Material and Methods: Consecutive patients with OLP were assessed for pain using the Visual Analogue Scale and examined at 10 intraoral sites before starting (T0) and three weeks after (T1) steroid therapy (Clobetasol). Three differently experienced raters evaluated photographs using two scoring systems designated White-Erosive-Atrophic (WEA) modified from an older WEA system (WEA-MOD) and Reticular-erythematous-Ulcerative (REU) systems. WEA-MOD Kendall's W and interclass correlation coefficient were calculated and correlation between REU/WEA-MOD and pain was calculated using Spearman coefficient. Results: Most patients showed lesions on buccal mucosa (85-93,5%) and maxillary/mandibular gingivae (31,8- 31,2%), predominantly reticular. At T0, Kendall-W coefficients of 0.89 and 0.74 were obtained for the REU and WEA respectively. At T1, Kendall-W coefficients of 0.83 and 0.58 were obtained for the REU and WEA respectively. Interclass correlation coefficient ranged from 0.87 to 0.90 for REU and from 0.58 to 0.87 for WEA. REU and WEA scores significantly decreased after therapy (p< 0.000) as well as VAS (p< 0.05). REU score showed correlation with VAS. Conclusions: All the raters achieved comparable measures using REU whereas WEA and WEA-MOD seem less reproducible. REU seems to correlate to disease activity and pain (AU)


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Assuntos
Humanos , Clobetasol/farmacocinética , Líquen Plano Bucal/classificação , Lesões Pré-Cancerosas/classificação , Esteroides/farmacocinética , Estudos Prospectivos , Medição da Dor/métodos , Índice de Gravidade de Doença , Líquen Plano Bucal/tratamento farmacológico , Úlceras Orais/patologia
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