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Last year, the American Dental Association (ADA) launched an unprecedented three--year nationwide public awareness campaign to alert all Americans, those with and without risk factors, to the dangers of oral [...]

Oral lichen planus is a condition affecting the mouth and involving multiple areas of lacelike lesions or plaques that may be erosive. Oral lesions are more resistant to therapy and less likely to undergo remission than cutaneous forms of the disorder. Treatment of oral lichen planus is aimed primarily at relieving discomfort. A total of 16 patients with oral lichen planus and accompanying discomfort were studied; eight patients received cyclosporine, while eight received only the vehicle. Cyclosporine or the placebo was administered as a swish-and-spit medication three times a day for eight weeks. All eight patients who received the active drug experienced marked improvement in erosion, inflammation, pain, and the number of lesions. One patient who received the vehicle had moderate improvement and the remainder either were unaffected or experienced flare-ups of their ulcerations. Patients receiving the vehicle were later treated with cyclosporine and had clinical responses equivalent to those of the patients who received cyclosporine. Treatment of oral lichen planus is difficult and discontinuation of therapy frequently results in a relapse. Corticosteroids have been applied topically or injected, and retinoids have also been used to treat oral lichen planus; however, long-term use of these agents is not recommended because of their potential toxicity. The cause of oral lichen planus is unknown; however, treatment response from the agents used successfully indicates a possible role of the immune system. (Consumer Summary produced by Reliance Medical Information, Inc.)

Objective: To assess the efficacy and tolerability of etanercept to treat psoriatic arthritis. Materials and methods: A total of 1122 patients who had active psoriatic arthritis were enrolled in a Phase 4, non-randomized, open-label, single-arm, 24-week study. These patients had clinically stable, plaque psoriasis involving ≥10% body surface area and joint disease (either ≥two swollen and ≥two tender/painful joints for ≥3 months, or ≥one joint with sacroiliitis or spondylitis). They received etanercept therapy 50 mg subcutaneously once weekly for 24 weeks. Results: After 24 weeks of treatment, 865 patients (77.1%; 95% CI: 74.64-79.55%) achieved a 'mild or better' score on the physician global assessment of psoriasis and were improved from baseline. Mean improvement in body surface area involvement was 16.9 percentage points (15.89-17.91). Patient global assessment of psoriasis, joint pain, and joint disease scores were improved by means of 2.2 (2.15-2.34), 2.7 (2.53-2.84), and 1.5 (1.39-1.55), respectively. Thirty-five patients (3.1%) experienced at least one serious adverse event. No patient died during the study. Conclusions: These results support the effectiveness and tolerability of etanercept treatment in patients with psoriatic arthritis being treated at dermatology clinics. [ABSTRACT FROM AUTHOR]

Objective: To describe the skin and joint disease of patients with psoriatic arthritis being treated in dermatology clinics. Methods: A total of 1122 patients who had active psoriatic arthritis were enrolled in a Phase 4, non‐randomized, open‐label, single‐arm, 24‐week study. They were treated at 108 community and 17 academic dermatology centers. These patients experienced clinically stable, plaque psoriasis involving ⩾̸10% body surface area and joint disease (either ⩾̸ two swollen and ⩾̸ two tender/painful joints for ⩾̸3 months, or ⩾̸ one joint with sacroiliitis or spondylitis). Results: In general, patient demographics and disease characteristics did not appear to differ between academic and community dermatology sites. Based on patient‐reported assessments, patients rated the severity of their baseline joint symptoms lower than the severity of their skin disease. Baseline skin and joint disease measures were not correlated. Psoriatic arthritis was newly diagnosed in 23% of the patients. Most had received prior therapy for psoriasis, but only half had received systemic therapy for psoriatic arthritis. Conclusion: Assessment for joint disease in psoriasis patients being treated at dermatology clinics may facilitate earlier psoriatic arthritis diagnosis and treatment initiation, which may prevent disability and other negative impacts. [ABSTRACT FROM AUTHOR]

Oral lichen planus is a chronic mucocutaneous disease that is relatively common. Although many patients are asymptomatic and require no therapy, those who exhibit atrophic and erosive lesions are often a challenge to treat. All therapies are palliative, and none is effective universally. Currently employed treatment modalities include corticosteroids administered topically, intralesionally, or systemically. Alternative therapies include topical and systemic retinoids, griseofulvin, Cyclosporine, and surgery. Other medical treatments and experimental modalities, including mouth PUVA, have been reported to be effective. Controversy concerning the efficacy of all these treatments suggests that oral lichen planus is a heterogeneous disorder. Eliminating lichenoid drug eruptions, candidiasis, trauma, contact mucositis, and emotional stress may play a role in the management of these patients. This article is a review of the many treatments and measures that have been employed in the management of patients with oral lichen planus. [ABSTRACT FROM AUTHOR]

The oral antiviral valacyclovir, which is 3 to 5 times more bioavailable than its parent compound acyclovir, is a good candidate for effective therapy to suppress recurrent herpes labialis lesions. The efficacy of oral valacyclovir in the suppression of herpes labialis has not previously been reported. Two identical, randomized, double-blind, parallel-group studies were conducted to evaluate the efficacy of oral valacyclovir 500 mg (n=49) versus placebo (n=49) once daily for 16 weeks in the suppression of herpes labialis among patients with a history of 4 or more recurrent lesions in the previous year. Data from the studies were pooled for analysis. Twenty-eight patients (60%) in the valacyclovir group compared with only 18 patients (38%) in the placebo group were recurrence-free throughout the 4-month treatment period (P=.041). The mean time to first recurrence was significantly longer with valacyclovir (13.1 weeks) compared with placebo (9.6 weeks) (P=.016). The total number of recurrences in patients using valacyclovir was 24 compared with 41 in patients using placebo. The incidence of adverse events during the 4-month treatment period was slightly lower in the valacyclovir group (22 events, 33% of patients) compared with the placebo group (29 events, 39% of patients). The results of these small double-blind, placebo-controlled studies suggest that oral valacyclovir 500 mg once daily for 4 months is effective and well tolerated for the prevention of recurrent herpes labialis. More research with larger patient numbers is warranted to corroborate and extend these findings.