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Clinical Studies Evaluate Potential Treatments for Mouth Ulcers

The drug pentoxifylline appears to have limited benefit in the first-line treatment of mouth ulcers due to recurrent apthous stomatitis,// according to a report in the April issue of Archives of Dermatology, one of the JAMA/Archives journals. However, a second report in the same issue finds that a cream commonly used to treat eczema may be effective in patients with another ulcer-causing mouth disease, oral erosive lichen planus.

Mouth ulcers are among the most common oral health problems, according to background information in the articles. Recurrent apthous stomatitis is characterized by recurring episodes of mouth ulcers in an otherwise healthy individual, and affects approximately 20 percent of the population. Oral erosive lichen planus is a severe inflammatory condition that causes painful wounds in the mouth. Approximately 1 percent of the population is affected—about the same percentage as are affected by psoriasis—and those who develop the condition may lose weight because of pain during eating. Few effective treatments are available for either condition.

In the first study, Martin H. Thornhill, M.B.B.S., Ph.D., of the University of Sheffield School of Clinical Dentistry, Sheffield, England, and colleagues conducted a 60-day, randomized, double-blind trial in 26 individuals (average age 33) with recurrent apthous stomatitis. In a 60-day pre-trial phase, participants kept a daily ulcer diary in which they recorded the number and size of ulcers if any were present, and also the pain associated with them on a scale of one to 10. Then, 14 patients were assigned to take one tablet containing 400 milligrams of pentoxifylline three times per day for 60 days, while 12 took three placebo pills per day. Both groups continued to keep diaries and also returned to the clinic for examinations after 30 and 60 days, and again 60 days after completing treatment.

"Patients taking pentoxifylline had less pain and reported smaller and fewe
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