English (United Kingdom)

https://curated-unify.zendy.io/wp-json/zendy-region/v1/featured_content/oa?rat=en

https://curated-unify.zendy.io/wp-json/zendy-region/v1/highlighted_journal/

Global: Zendy Plus annual

Presents the access of premium content as premium feature

Premium Content

Presents the keyphrase highlighting as premium feature

Keyphrase Highlighting

Presents the summarisation as premium feature

Summarisation

Insights

Presents the pdf analysis as premium feature

PDF Analysis

Presents the zaia usage as premium feature

ZAIA

Global: Zendy Tools annual

Global: Zendy Free Plan

Global: Zendy Tools monthly

Global: Zendy Plus monthly

MATERIAL AND METHODS sponsive to other modalities of treatment (7-9). When used Nine patients (4 males, 5 females, 5-54 years of age; mean 32.2 years) in this situation, azathioprine probably acts by inhibiting the with clinical diagnoses of severe erosive oral lichen planus and/or T-lymphocytes. In the past we used azathioprine in one patient generalized lichen planus were included in the study. The duration of with unresponsive, generalized and severe lichen planus, with the disease in these patients varied from 3 months to 4 years. The a dramatic improvement in 12 weeks and without any side diagnosis in each patient was made on the characteristic morphology of skin/mucosal lesions, coné rmed by skin/mucosal biopsy. Baseline eVects (7). Encouraged by the results, we decided to carry out investigations including a complete hemogram with platelet counts, an open study in patients with severe erosive oral and gen- renal and liver function tests, blood sugar tests, chest X-ray, routine eralized lichen planus. Out of 9 patients, 7 showed excellent urine and stool examination and ECG were done in all the patients responses, one showed a good response and only one patient before starting treatment. Patients with deranged renal/liver function tests, with any focus of infection, and pregnant and lactating mothers had a poor response. There were no side eVects of the therapy. were excluded from the study. The patients were treated with azathio- The drug is metabolized by three competiting enzymes, hypox- prine, 50mg twice daily orally (about 2mg/kg day), for a period anthine-guanine phosphoribosyl transferase, xanthine oxidase varying from 3 to 7 months (average 5 months). Complete hemograms and thiopurine methyl transferase (TPMT) (12), but its con- with platelet counts, liver and renal function tests were repeated every version into inactive metabolites is mainly done by TPMT. 4 weeks. All patients were clinically evaluated every 4 weeks to assess the therapeutic response, which was determined by è attening of the Therefore the patients with low TPMT levels are at a major lesions, appearance of new lesions and change in severity of itching. risk of developing myelotoxicity, gastrointestinal and hepatic Mucosal lesions were assessed in terms of è attening/healing of the side eVects. About one in 200-300 people in the general lesions and decrease in severity of irritation and burning sensation. population are deé cient in this enzyme. Determination of The response to therapy was considered to be excellent if there was an overall 75-100% improvement in the lesions and itching/irritation, TPMT levels in patients before initiating this therapy would good if it was 50-75% and poor if it was less than 50%. facilitate the exclusion of such susceptible individuals. If such a facility is not available, a regular hemogram is recommended to detect early myelosuppression. We used this drug in patients RESULTS who had air-borne contact dermatitis due to weed Parthenium, with very good results and minimal side eVects even when it Out of 9 patients, 4 patients had only oral mucosal lesions, 3 had oral mucosal as well as skin lesions and the other 2 had was continuously used for 2-3 years (13). We also investigated the long-term toxicity of the drug with regular monitoring of generalized skin lesions. Within 3 to 7 months (average 5 months) of azathioprine therapy, 7 (77.8%) patients had an hematological, hepatic and renal parameters in these patients (14). We therefore suggest that azathioprine may be used as

Azathioprine for the Treatment of Severe Erosive Oral and Generalized Lichen Planus