[Topical tretinoin in the treatment of lichen planus and leukoplakia of the oral mucosa. A biochemical evaluation of the keratinization].
In earlier work, we demonstrated that 0.1 p. 100 topical tretinoin is clinically effective and well tolerated compared with placebo for the treatment of oral leukoplakia and oral keratosic or erythematous lichen planus. Here we aimed to complete this clinical protocol with histological and biochemical analyses comparing the biopsy specimens collected at inclusion and those collected after 4 months of treatment. Histological results were based on changes in keratinization observed between onset of treatment and 4 months treatment. Biochemical studies included the use of antibodies (anti-cytokeratins 10-11, anti-filaggrine) for the immunohistochemical evaluation of keratinization and 2-dimensional gel electrophoresis for measuring cytokeratins. In patients with lichen planus, histological changes during treatment showed that, in the 10 patients in the tretinoin group, keratinization disappeared in 6 and decreased significantly in 3. Immunohistochemistry revealed that cytokeratins 10-11 and filaggrin disappeared in 57 p. 100 of the patients treated with tretinoin versus 25 p. 100 in the patients given placebo. Bidimensional gel electrophoresis showed that cytokeratins 1, 2, 10 and 11 disappeared only in the tretinoin group (60 p. 100 of the cases). In patients with leukoplakia, histological changes during treatment showed that, in the tretinoin group, keratinization disappeared in 5 cases and decreased in 5 others. Immunohistochemistry revealed that cytokeratins 10-11 disappeared in 30 p. 100 of the patients treated with tretinoin versus 25 p. 100 in the placebo group. Bidimensional electrophoresis demonstrated that cytokeratins 1, 2, 10 and 11 disappeared in 43 p. 100 of the patients treated with tretinoin.
Branchet
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MC
Association pour la Promotion de l'Oncologie et de la Stomatologie Médicale (APOSM), Département d'Oncologie et de Stomatologie Médicale, Paris.
Boisnic
S
S
Pascal
F
F
Ben Slama
L
L
Rostin
M
M
Szpirglas
H
H
D000287:Administration, Topical; D015180:Electrophoresis, Gel, Two-Dimensional; D000091344:Filaggrin Proteins; D006801:Humans; D007150:Immunohistochemistry; D007633:Keratins / Q000032:analysis*; D007972:Leukoplakia, Oral / Q000188:drug therapy* / Q000473:pathology; D017676:Lichen Planus, Oral / Q000188:drug therapy* / Q000473:pathology; D009061:Mouth Mucosa / Q000187:drug effects; D016896:Treatment Outcome; D014212:Tretinoin / Q000627:therapeutic use*
C000717249:FLG protein, human; D000091344:Filaggrin Proteins; D014212:Tretinoin; D007633:Keratins