Oral PUVA and topical steroids for treatment of oral manifestations of chronic graft-vs.-host disease.
BACKGROUND
Oral manifestations of chronic graft-vs.-host disease (cGVHD) can significantly affect the quality of life and severity often does not correlate with systemic manifestations. We evaluated the use of topical corticosteroids and the intraoral application of psoralen-UVA (PUVA) for treatment of oral manifestations of cGVHD.


METHODS
Overall, 18 patients with oral manifestations of cGVHD were treated with either intraoral PUVA (n=7) or with topical corticosteroids (n=16). Four patients received intraoral PUVA after failure of topical steroids and one patient was treated with topical corticosteroids after failing treatment with intraoral PUVA. A glass fiber extension of an UVA source was used for manual intraoral application. Treatment with topical corticosteroids consisted of 0.1 mg/ml dexamethasone mouth wash four times a day in combination with antifungal prophylaxis.


RESULTS
Four patients showed complete local response (CR) due to intraoral PUVA, two improved and one did not respond. Topical corticosteroids resulted in nine patients in CR, two improved and five did not respond.


CONCLUSIONS
Intraoral PUVA as well as topical corticosteroids are effective in treatment of oral manifestations of oral GVHD with few side-effects and improve quality of life in patients with cGVHD.
Wolff
D
D
Division of Haematology and Oncology, Department of Medicine, University of Rostock, E. Heydemann Strasse 6, 18057 Rostock, Germany. daniel.wolff@medizin.uni-rostock.de
Anders
V
V
Corio
R
R
Horn
T
T
Morison
W L
WL
Farmer
E
E
Vogelsang
G B
GB
D000287:Administration, Topical; D000293:Adolescent; D000305:Adrenal Cortex Hormones / Q000008:administration & dosage*; D000328:Adult; D002908:Chronic Disease; D005260:Female; D006086:Graft vs Host Disease / Q000188:drug therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009059:Mouth Diseases / Q000188:drug therapy*; D011701:PUVA Therapy; D011788:Quality of Life; D016896:Treatment Outcome
D000305:Adrenal Cortex Hormones