Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology, and Endodontology
Oral medicineTreatment of recurrent aphthous stomatitis with clofazimine
Section snippets
Materials and Methods
We carried out a randomized, controlled, and partially blind study in consecutive patients with recurrent aphthous stomatitis who were seen in the Stomatology Outclinic of the Federal University of São Paulo between 2000 and 2003. The protocol was reviewed by the Committee of Ethics in Research of the institution, and each subject in the project signed a detailed informed consent form. The study compared the effects of clofazimine, colchicine, and placebo. This study included 15- to 60-year-old
Results
Regarding race, clinical form, and gender, there were no significant differences among the groups (P = .430; P = .542; and P = .317; respectively). In the total study sample, 70% of the subjects were caucasian. Eighty percent presented with the minor clinical form, 12% presented with the major form, and 8% presented with the herpetiform. Sixty-eight percent of the subjects were men. The average age was 38 years (SD 2.4 years) for the clofazimine group, 34 years (SD 2.6 years) for the colchicine
Discussion
Despite the many therapeutic options available for the management of recurrent aphthous stomatitis, no treatment is specific and definitive. Colchicine, thalidomide, levamisole, and pentoxifylline have been used to treat severe cases, but they are not always effective, long-term adverse effects are a restriction factor, and recurrence occurs once the drug is discontinued.7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17, 18, 19, 20 We decided to use clofazimine in patients with aphthous stomatitis
Conclusions
Clofazimine is effective in the prevention of recurrent aphthous stomatitis and the amelioration of symptoms related to aphthous lesions. It is a well tolerated and relatively safe drug in the doses used in this study. Adverse effects were mild and transient, and there were no changes in the results of the ophthalmologic exams, complete blood cell counts, and liver and renal tests. Clofazimine should be considered as a treatment option for recurrent aphthous stomatitis, and it may be of benefit
References (34)
Recurrent aphthous stomatitisAn update
Oral Surg Oral Med Oral Pathol Oral Radiol Endod
(1996)- et al.
Clinical, historic, and therapeutic features of aphthous stomatitisLiterature review and open clinical trial employing steroids
Oral Surg Oral Med Oral Pathol Oral Radiol Endod
(1992) - et al.
Prevention of recurrent aphthous stomatitis with colchicine: an open trial
J Am Acad Dermatol
(1994) - et al.
Recurrent aphthous stomatitis of the Behçet's type: successful treatment with thalidomide
Oral Surg Oral Med Oral Pathol Oral Radiol Endod
(1987) - et al.
A randomized double-blind trial of levamisole in the therapy of recurrent aphthous stomatitis
Oral Surg Oral Med Oral Pathol Oral Radiol Endod
(1978) - et al.
Oxypentifylline in the management of recurrent aphthous oral ulcers: an open clinical trial
Oral Surg Oral Med Oral Pathol Oral Radiol Endod
(1999) - et al.
Clofazimine: a review of its medical uses and mechanisms of action
J Am Acad Dermatol
(1995) - et al.
Clofazimine-mediated regulation of human polymophonuclear leukocyte migration by pro-oxidative inactivation of both leukoattractants and cellular migratory responsiveness
Int J Immunopharmacol
(1986) - et al.
Clofazimine and B669 inhibit the proliferative responses and Na+,K(+)-adenosine triphosphatase activity of human lymphocytes by a lysophospholipid-dependent mechanism
Biochem Pharmacol
(1993) - et al.
Effects of clofazimine analogues and tumor necrosis factor-alpha individually and in combination on human polymorphonuclear leukocyte functions in vitro
Int J Immunopharmacol
(1993)
Biochemical and hematological side effects of clofazimine in leprosy patients
Pharmacol Res
T-Lymphocyte subset changes in recurrent aphthous stomatitis
Oral Surg Oral Med Oral Pathol Oral Radiol Endod
Alterations of T helper/inducer and T suppressor/inducer cells in patients with recurrent aphthous ulcers
Oral Surg Oral Med Oral Pathol Oral Radiol Endod
The TH1/TH2 immune-type response of the recurrent aphthous ulceration analyzed by cDNA microarray
J Oral Pathol Med
Defining a T-cell epitope within HSP 65 in recurrent aphthous stomatitis
Clin Exp Immunol
Treatment of severe recurrent aphthous stomatitis with colchicine
Arch Otolaryngol Head Neck Surg
The effects of colchicine on neutrophil function in subjects with recurrent aphthous stomatitis
J Eur Acad Dermatol Venereol
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2012, Oral Surgery, Oral Medicine, Oral Pathology and Oral RadiologyCitation Excerpt :In this context, allicin has been reported to inhibit the growth of gram-positive, gram-negative, and acid-fast bacterium, including multidrug-resistant bacterium by its chemical reaction with thiol groups of various enzymes,31 especially the oral bacteria in vitro.32 Moreover, allicin has been shown to be a biological immune response modifier in mice23 and in vitro,14,22 which may modulate the local immune state in treatment of MiRAU, as does clofazimine.33 Although the exact mechanism of action of allicin in the treatment of MiRAU remains unclear, previous evidence from in vitro and animal studies lead to the hypothesis that inhibition of the production of inflammatory mediators and microbial infection, as well as its immunomodulation properties, may be beneficial in accelerating pain relief and ulcer healing.
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