Page 31 - Acrobat J Trad-21-3-2566

514 วารสารการแพทย์แผนไทยและการแพทย์ ทางเลือก ปีที่ 21 ฉบับที่ 3 กันยายน-ธันวาคม 2566

including an inhibition on leukocyte (neutro- OLP is challenging for most clinicians as it is
phils, lymphocytes and macrophages) infil- difficult to achieve complete resolution and

tration, which leads to a suppression of the disease reoccurrence is also very common.
production and the release of pro-inflammatory Time is needed to explore other options, prob-
[3]
mediators. Accordingly, corticosteroids is ably with better clinical safety and therapeutic
widely accepted as the most effective treat- efficacy.
ment of erosive OLP with a success rate of up Curcuminoids (a group of polyphenolic
to 75% in eliminating mucosal erythema or pigment extract from the rhizome of Cur-

ulcerations and alleviating pain. Topical mid- cuma longa) or curcumin (a major constituent
potent corticosteroids preparations [such as contained in curcuminoids powder) is one
triamcinolone acetonide (TA) oral paste/solu- of the most promising of the new treatment

tion, 0.1% fluocinolone acetonide oral paste/ modalities. Curcuminoids or pure curcumin
gel/solution or 0.05% dexamethasone elixir] has been known widely as a potent anti-

are the standard treatment in treating mild to oxidant and anti-inflammatory agent as well
moderate erosive OLP as side effects are fewer as being a powerful enhancer of wound
than with systemic administration. However, healing. [7-10] It was also found to possess anti-

oral candidiasis is a very real considerations bacterial activity against oropharyngeal and
for prolonged use. Systemic antifungals upper respiratory tract bacterial pathogens
[4]
with nystatin suspension of 1:100,000 units and antifungal activity against C. albicans. [11-12]
are usually used to treat candidiasis in OLP Accordingly, topical curcuminoids or cur-
patients, which present many economic and cumin oral paste or gel has been suggested

health related challenges in terms of high to be a potential alternative to topical cortico-
cost of treatment and potential side effects steroids oral paste in treating OLP due to its
respectively, especially in cases of long-term safety and potential therapeutic benefits. [13-14]

use. Besides, cultures or histologic sections Nevertheless, no studies have been under-
from 46% of OLP patients were found positive taken to evaluate the clinical efficacy of topi-
for fungi and more than 80% of yeast found cal curcuminoids or curcumin preparation on

in those patients was Candida albicans. candida-associated OLP and the recurrence of
[5]
In addition, a disease recurrence rate of 20% in the disease. Our previous in vitro study found

patients undergoing topical 0.1% TA ointment that the addition of chitosan in the curcumin
was observed during the follow up period of 6 mouthwash caused the mouthwash to have
months. Currently, management of erosive comparable anti-candida efficacy to a standard
[6]