Oral Submucous Fibrosis Medication

  • Author: Nektarios I Lountzis, MD; Chief Editor: William D James, MD   more...
 
Updated: Jan 18, 2012
 

Medication Summary

The goals of pharmacotherapy are to reduce morbidity and to prevent complications.[54] In addition to the medications listed below, placental extract has been used experimentally at a dose of 50 mcg/m2 SC 3 times per week if the patient's body surface area (BSA) is greater than 0.52 m2 or 1.5 mcg/kg/dose SC 3 times per week if the BSA is less than or equal to 0.5 m2.

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Corticosteroids

Class Summary

Can be used in pharmacologic doses for their anti-inflammatory and immunosuppressant properties and their effects on blood and lymphatic systems in the palliative treatment of various diseases.

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Dexamethasone (Decadron)

 

For various inflammatory diseases. Decreases inflammation by suppressing migration of polymorphonuclear leukocytes and reducing capillary permeability.

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Triamcinolone acetonide (Aristocort, Kenaject)

 

Suppresses immune system by reducing activity and volume of lymphatic system. Treats inflammatory mucosal lesions that are responsive to steroids. Decreases inflammation by suppressing the migration of polymorphonuclear leukocytes and by reversing capillary permeability.

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Betamethasone valerate (Diprosone)

 

For inflammatory reactions responsive to steroids. Decreases inflammation by suppressing migration of polymorphonuclear leukocytes and by reversing capillary permeability. Affects production of lymphokines and has inhibitory effect on Langerhans cells.

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Extravasation antidotes

Class Summary

Can enhance diffusion of locally irritating or toxic drugs in the management of intravenous extravasation.

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Hyaluronidase (Wydase Injection)

 

Stimulates hydrolysis of hyaluronic acid, one of the chief ingredients of tissue cement, which offers resistance to diffusion of liquids through tissues. Used to aid in absorption and dispersion of injected drugs.

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Interferons

Class Summary

Naturally produced proteins with antiviral, antitumor, and immunomodulatory actions. Alpha-, beta-, and gamma-interferons may be given topically, systemically, or intralesionally.

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Interferon gamma (Actimmune)

 

Believed to act via ability to counteract cell surface expression of proinflammatory or proadhesion molecules on immune cells, among other effects. More studies needed to fully understand mechanisms of action.

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Antioxidant

Class Summary

Has been found to possess antioxidant and antiproliferative properties in animal and laboratory studies, although activity in humans remains controversial. Adult dose below suggested from 1 study.[50]

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Lycopene (LycoRed)

 

Considered an antioxidant and has antiproliferative properties in animal and laboratory studies, although activity in humans remains controversial.

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Vasodilator

Class Summary

Methylxanthine derivative that has vasodilating properties and may increase mucosal vascularity. Adult dosage suggested by Rajendran et al.[51]

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Pentoxifylline (Trental)

 

Methylxanthine derivative that has vasodilating properties and may increase mucosal vascularity.

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Contributor Information and Disclosures
Author

Nektarios I Lountzis, MD  Consulting Staff, Departments of Dermatology and Pathology, Geisinger Wyoming Valley Medical Center

Nektarios I Lountzis, MD is a member of the following medical societies: American Academy of Dermatology

Disclosure: Nothing to disclose.

Coauthor(s)

Tammie Ferringer, MD  Dermatopathology Section Head, Dermatopathology Fellowship Director, Departments of Dermatology and Pathology, Geisinger Medical Center

Tammie Ferringer, MD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Dermatology, American Society of Dermatopathology, and International Society of Dermatopathology

Disclosure: Nothing to disclose.

Nada Macaron  MD, Consultant Pathologist, Institute of Pathology and Laboratory Medicine, Sheikh Khalifa Medical City, Abu Dhabi, UAE

Nada Macaron is a member of the following medical societies: College of American Pathologists and United States and Canadian Academy of Pathology

Disclosure: Nothing to disclose.

Amy Howard, MD  Fellow, Department of Dermatopathology, Emory University

Disclosure: Nothing to disclose.

Specialty Editor Board

Alexa F Boer Kimball, MD, MPH  Associate Professor of Dermatology, Harvard University School of Medicine; Vice Chair, Department of Dermatology, Massachusetts General Hospital; Director of Clinical Unit for Research Trials in Skin (CURTIS), Department of Dermatology, Massachusetts General Hospital

Alexa F Boer Kimball, MD, MPH is a member of the following medical societies: Alpha Omega Alpha, American Academy of Dermatology, and Society for Investigative Dermatology

Disclosure: Nothing to disclose.

David F Butler, MD  Professor of Dermatology, Texas A&M University College of Medicine; Chair, Department of Dermatology, Director, Dermatology Residency Training Program, Scott and White Clinic, Northside Clinic

David F Butler, MD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Dermatology, American Medical Association, American Society for Dermatologic Surgery, American Society for MOHS Surgery, Association of Military Dermatologists, and Phi Beta Kappa

Disclosure: Nothing to disclose.

Drore Eisen, MD, DDS  Consulting Staff, Department of Dermatology, Dermatology Research Associates of Cincinnati

Drore Eisen, MD, DDS is a member of the following medical societies: American Academy of Dermatology, American Academy of Oral Medicine, and American Dental Association

Disclosure: Nothing to disclose.

Joel M Gelfand, MD, MSCE  Medical Director, Clinical Studies Unit, Assistant Professor, Department of Dermatology, Associate Scholar, Center for Clinical Epidemiology and Biostatistics, University of Pennsylvania

Joel M Gelfand, MD, MSCE is a member of the following medical societies: Society for Investigative Dermatology

Disclosure: AMGEN Consulting fee Consulting; AMGEN Grant/research funds Investigator; Genentech Grant/research funds investigator; Centocor Consulting fee Consulting; Abbott Grant/research funds investigator; Abbott Consulting fee Consulting; Novartis investigator; Pfizer Grant/research funds investigator; Celgene Consulting fee DMC Chair; NIAMS and NHLBI Grant/research funds investigator

Chief Editor

William D James, MD  Paul R Gross Professor of Dermatology, Vice-Chairman, Residency Program Director, Department of Dermatology, University of Pennsylvania School of Medicine

William D James, MD is a member of the following medical societies: American Academy of Dermatology and Society for Investigative Dermatology

Disclosure: Elsevier Royalty Other

References

  1. Schwartz J. Atrophia Idiopathica Mucosae Oris. London: Demonstrated at the 11th Int Dent Congress; 1952.

  2. Joshi SG. Fibrosis of the palate and pillars. Indian J Otolaryngol. 1953;4:1.

  3. Cox SC, Walker DM. Oral submucous fibrosis. A review. Aust Dent J. Oct 1996;41(5):294-9. [Medline].

  4. Aziz SR. Oral submucous fibrosis: an unusual disease. J N J Dent Assoc. Spring 1997;68(2):17-9. [Medline].

  5. Paissat DK. Oral submucous fibrosis. Int J Oral Surg. Oct 1981;10(5):307-12. [Medline].

  6. Centers for Disease Control and Prevention. Fact Sheet. Betel Quid with Tobacco (Gutka). Centers for Disease Control and Prevention. Available at http://www.cdc.gov/tobacco/data_statistics/fact_sheets/smokeless/betel_quid.htm. Accessed February 2007.

  7. Gupta PC. UICC Tobacco Control Fact Sheet No. 17: Areca Nut. International Union Against Cancer. Available at http://www.globalink.org/tobacco/fact_sheets/17fact.htm. Accessed February 1996.

  8. Tilakaratne WM, Klinikowski MF, Saku T, Peters TJ, Warnakulasuriya S. Oral submucous fibrosis: review on aetiology and pathogenesis. Oral Oncol. Jul 2006;42(6):561-8. [Medline].

  9. Liao PH, Lee TL, Yang LC, Yang SH, Chen SL, Chou MY. Adenomatous polyposis coli gene mutation and decreased wild-type p53 protein expression in oral submucous fibrosis: a preliminary investigation. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. Aug 2001;92(2):202-7. [Medline].

  10. Jacob BJ, Straif K, Thomas G, et al. Betel quid without tobacco as a risk factor for oral precancers. Oral Oncol. Aug 2004;40(7):697-704. [Medline].

  11. Ranganathan K, Devi MU, Joshua E, Kirankumar K, Saraswathi TR. Oral submucous fibrosis: a case-control study in Chennai, South India. J Oral Pathol Med. May 2004;33(5):274-7. [Medline].

  12. Canniff JP, Harvey W. The aetiology of oral submucous fibrosis: the stimulation of collagen synthesis by extracts of areca nut. Int J Oral Surg. 1981;10:163-7. [Medline].

  13. Chung-Hung T, Shun-Fa Y, Yu-Chao C. The upregulation of cystatin C in oral submucous fibrosis. Oral Oncol. Aug 2007;43(7):680-5. [Medline].

  14. Tsai CH, Yang SF, Chen YJ, Chou MY, Chang YC. Raised keratinocyte growth factor-1 expression in oral submucous fibrosis in vivo and upregulated by arecoline in human buccal mucosal fibroblasts in vitro. J Oral Pathol Med. Feb 2005;34(2):100-5. [Medline].

  15. Tsai CH, Yang SF, Chen YJ, Chu SC, Hsieh YS, Chang YC. Regulation of interleukin-6 expression by arecoline in human buccal mucosal fibroblasts is related to intracellular glutathione levels. Oral Dis. Nov 2004;10(6):360-4. [Medline].

  16. Tsai CH, Yang SF, Chen YJ, Chou MY, Chang YC. The upregulation of insulin-like growth factor-1 in oral submucous fibrosis. Oral Oncol. Oct 2005;41(9):940-6. [Medline].

  17. Chang YC, Yang SF, Tai KW, Chou MY, Hsieh YS. Increased tissue inhibitor of metalloproteinase-1 expression and inhibition of gelatinase A activity in buccal mucosal fibroblasts by arecoline as possible mechanisms for oral submucous fibrosis. Oral Oncol. Feb 2002;38(2):195-200. [Medline].

  18. Tu HF, Liu CJ, Chang CS, et al. The functional (-1171 5A-->6A) polymorphisms of matrix metalloproteinase 3 gene as a risk factor for oral submucous fibrosis among male areca users. J Oral Pathol Med. Feb 2006;35(2):99-103. [Medline].

  19. Lin SC, Chung MY, Huang JW, Shieh TM, Liu CJ, Chang KW. Correlation between functional genotypes in the matrix metalloproteinases-1 promoter and risk of oral squamous cell carcinomas. J Oral Pathol Med. Jul 2004;33(6):323-6. [Medline].

  20. Harvey W, Scutt A, Meghji S, Canniff JP. Stimulation of human buccal mucosa fibroblasts in vitro by betel-nut alkaloids. Arch Oral Biol. 1986;31(1):45-9. [Medline].

  21. van Wyk CW, Stander I, Padayachee A, Grobler-Rabie AF. The areca nut chewing habit and oral squamous cell carcinoma in South African Indians. A retrospective study. S Afr Med J. Jun 1993;83(6):425-9. [Medline].

  22. Ni WF, Tsai CH, Yang SF, Chang YC. Elevated expression of NF-kappaB in oral submucous fibrosis--evidence for NF-kappaB induction by safrole in human buccal mucosal fibroblasts. Oral Oncol. Jul 2007;43(6):557-62. [Medline].

  23. Trivedy CR, Warnakulasuriya KA, Peters TJ, Senkus R, Hazarey VK, Johnson NW. Raised tissue copper levels in oral submucous fibrosis. J Oral Pathol Med. Jul 2000;29(6):241-8. [Medline].

  24. Khanna SS, Karjodkar FR. Circulating immune complexes and trace elements (Copper, Iron and Selenium) as markers in oral precancer and cancer : a randomised, controlled clinical trial. Head Face Med. Oct 16 2006;2:33. [Medline].

  25. Pillai R, Balaram P, Reddiar KS. Pathogenesis of oral submucous fibrosis. Relationship to risk factors associated with oral cancer. Cancer. Apr 15 1992;69(8):2011-20. [Medline].

  26. Sirsat SM, Khanolkar VR. Submucous fibrosis of the palate in diet-preconditioned Wistar rats. Induction by local painting of capsaicin--an optical and electron microscopic study. Arch Pathol. Aug 1960;70:171-9. [Medline].

  27. Hamner JE 3rd, Looney PD, Chused TM. Submucous fibrosis. Oral Surg Oral Med Oral Pathol. Mar 1974;37(3):412-21. [Medline].

  28. Seedat HA, van Wyk CW. Submucous fibrosis in non-betel nut chewing subjects. J Biol Buccale. Mar 1988;16(1):3-6. [Medline].

  29. Canniff JP, Harvey W, Harris M. Oral submucous fibrosis: its pathogenesis and management. Br Dent J. Jun 21 1986;160(12):429-34. [Medline].

  30. Rajendran R, Deepthi K, Nooh N, Anil S. a4ß1 integrin-dependent cell sorting dictates T-cell recruitment in oral submucous fibrosis. J Oral Maxillofac Pathol. Sep 2011;15(3):272-7. [Medline]. [Full Text].

  31. Haque MF, Harris M, Meghji S, Speight PM. An immunohistochemical study of oral submucous fibrosis. J Oral Pathol Med. Feb 1997;26(2):75-82. [Medline].

  32. Liu CJ, Lee YJ, Chang KW, Shih YN, Liu HF, Dang CW. Polymorphism of the MICA gene and risk for oral submucous fibrosis. J Oral Pathol Med. Jan 2004;33(1):1-6. [Medline].

  33. Haque MF, Meghji S, Khitab U, Harris M. Oral submucous fibrosis patients have altered levels of cytokine production. J Oral Pathol Med. Mar 2000;29(3):123-8. [Medline].

  34. Kaur J, Chakravarti N, Mathur M, Srivastava A, Ralhan R. Alterations in expression of retinoid receptor beta and p53 in oral submucous fibrosis. Oral Dis. Jul 2004;10(4):201-6. [Medline].

  35. Paul RR, Mukherjee A, Dutta PK, et al. A novel wavelet neural network based pathological stage detection technique for an oral precancerous condition. J Clin Pathol. Sep 2005;58(9):932-8. [Medline].

  36. Seedat HA, van Wyk CW. Betel-nut chewing and submucous fibrosis in Durban. S Afr Med J. Dec 3 1988;74(11):568-71. [Medline].

  37. VanWyk CW. Oral submucous fibrosis. The South African experience. Indian J Dent Res. Apr-Jun 1997;8(2):39-45. [Medline].

  38. Ahmad MS, Ali SA, Ali AS, Chaubey KK. Epidemiological and etiological study of oral submucous fibrosis among gutkha chewers of Patna, Bihar, India. J Indian Soc Pedod Prev Dent. Jun 2006;24(2):84-9. [Medline].

  39. Oakley E, Demaine L, Warnakulasuriya S. Areca (betel) nut chewing habit among high-school children in the Commonwealth of the Northern Mariana Islands (Micronesia). Bull World Health Organ. Sep 2005;83(9):656-60. [Medline].

  40. Pindborg JJ. Oral submucous fibrosis: a review. Ann Acad Med Singapore. Sep 1989;18(5):603-7. [Medline].

  41. Ahmed A, Amjad M. Localized morphoea associated with oral submucous fibrosis. J Coll Physicians Surg Pak. Feb 2006;16(2):141-2. [Medline].

  42. Rooban T, Saraswathi TR, Al Zainab FH, Devi U, Eligabeth J, Ranganathan K. A light microscopic study of fibrosis involving muscle in oral submucous fibrosis. Indian J Dent Res. Oct-Dec 2005;16(4):131-4. [Medline].

  43. Ranganathan K, Kavitha R, Sawant SS, Vaidya MM. Cytokeratin expression in oral submucous fibrosis--an immunohistochemical study. J Oral Pathol Med. Jan 2006;35(1):25-32. [Medline].

  44. Pindborg JJ. Oral precancer. In: Barnes L, ed. Surgical Pathology of the Head and Neck. New York, NY: Marcel Dekker; 1995:279-331.

  45. van Wyk CW, Seedat HA, Phillips VM. Collagen in submucous fibrosis: an electron-microscopic study. J Oral Pathol Med. Apr 1990;19(4):182-7. [Medline].

  46. Sur TK, Biswas TK, Ali L, Mukherjee B. Anti-inflammatory and anti-platelet aggregation activity of human placental extract. Acta Pharmacol Sin. Feb 2003;24(2):187-92. [Medline].

  47. Anil S, Beena VT. Oral submucous fibrosis in a 12-year-old girl: case report. Pediatr Dent. Mar-Apr 1993;15(2):120-2. [Medline].

  48. Kakar PK, Puri RK, Venkatachalam VP. Oral submucous fibrosis--treatment with hyalase. J Laryngol Otol. Jan 1985;99(1):57-9. [Medline].

  49. Haque MF, Meghji S, Nazir R, Harris M. Interferon gamma (IFN-gamma) may reverse oral submucous fibrosis. J Oral Pathol Med. Jan 2001;30(1):12-21. [Medline].

  50. Kumar A, Bagewadi A, Keluskar V, Singh M. Efficacy of lycopene in the management of oral submucous fibrosis. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. Feb 2007;103(2):207-13. [Medline].

  51. Rajendran R, Rani V, Shaikh S. Pentoxifylline therapy: a new adjunct in the treatment of oral submucous fibrosis. Indian J Dent Res. Oct-Dec 2006;17(4):190-8. [Medline].

  52. Hosein M. Oral cancer in Pakistan. The problem and can we reduce it?. In: Oral Oncology. Kluwer Academic: 1994.

  53. Nayak DR, Mahesh SG, Aggarwal D, Pavithran P, Pujary K, Pillai S. Role of KTP-532 laser in management of oral submucous fibrosis. J Laryngol Otol. Oct 10 2008;1-4. [Medline].

  54. Chole RH, Gondivkar SM, Gadbail AR, Balsaraf S, Chaudhary S, Dhore SV, et al. Review of drug treatment of oral submucous fibrosis. Oral Oncol. Dec 27 2011;[Medline].

  55. Borle RM, Borle SR. Management of oral submucous fibrosis: a conservative approach. J Oral Maxillofac Surg. Aug 1991;49(8):788-91. [Medline].

  56. Gupta SC, Khanna S, Singh M, Singh PA. Histological changes to palatal and paratubal muscles in oral submucous fibrosis. J Laryngol Otol. Dec 2000;114(12):947-50. [Medline].

  57. Eipe N. The chewing of betel quid and oral submucous fibrosis and anesthesia. Anesth Analg. Apr 2005;100(4):1210-3. [Medline].

  58. Murti PR, Bhonsle RB, Pindborg JJ, Daftary DK, Gupta PC, Mehta FS. Malignant transformation rate in oral submucous fibrosis over a 17-year period. Community Dent Oral Epidemiol. Dec 1985;13(6):340-1. [Medline].

  59. Jeng JH, Kuo ML, Hahn LJ, Kuo MY. Genotoxic and non-genotoxic effects of betel quid ingredients on oral mucosal fibroblasts in vitro. J Dent Res. May 1994;73(5):1043-9. [Medline].

  60. Maher R, Lee AJ, Warnakulasuriya KA, Lewis JA, Johnson NW. Role of areca nut in the causation of oral submucous fibrosis: a case-control study in Pakistan. J Oral Pathol Med. Feb 1994;23(2):65-9. [Medline].

  61. Mehrotra D, Agarwal GG, Kumar S, Shukla A, Asthana A. Development and Validation of a Questionnaire to Evaluate Association of Tobacco Abuse With Oral Submucous Fibrosis. Asia Pac J Public Health. Dec 22 2011;[Medline].

  62. International Agency for Research on Cancer. Tobacco habits other than smoking, betel-quid and areca nut chewing, and some related nitrosamines. Lyon, France: International Agency for Research on Cancer; 1984. IARC Monographs on the Evaluation of the Carcinogenic Risk of Chemicals to Humans.

  63. Khanna JN, Andrade NN. Oral submucous fibrosis: a new concept in surgical management. Report of 100 cases. Int J Oral Maxillofac Surg. Dec 1995;24(6):433-9. [Medline].

 
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