Asia-Pacific Journal of Oncology Nursing

LETTER TO EDITOR
Year
: 2015  |  Volume : 2  |  Issue : 1  |  Page : 51-

Medical management of oral submucous fibrosis


Vagish Kumar Laxman Shanbhag 
 Department of Oral Medicine and Radiology, Yenepoya Dental College and Hospital, Yenepoya Research Centre, Yenepoya University, Mangalore, Karnataka, India

Correspondence Address:
Vagish Kumar Laxman Shanbhag
Department of Oral Medicine and Radiology, Yenepoya Dental College and Hospital, Yenepoya Research Centre, Yenepoya University, Mangalore - 575 018, Karnataka
India




How to cite this article:
Shanbhag VL. Medical management of oral submucous fibrosis.Asia Pac J Oncol Nurs 2015;2:51-51


How to cite this URL:
Shanbhag VL. Medical management of oral submucous fibrosis. Asia Pac J Oncol Nurs [serial online] 2015 [cited 2020 Jul 5 ];2:51-51
Available from: http://www.apjon.org/text.asp?2015/2/1/51/143766


Full Text

Sir,

About 5 million people in India have oral submucous fibrosis and recent data suggest a male predominance. Age group between second and third decade is commonly involved. Risk of malignant transformation ranges from 7% to 30%. [1] Restricted mouth opening in oral submucous fibrosis makes examination and early diagnosis of cancer difficult. Medical management is the treatment of choice in early stages of this chronic precancerous condition. A patient has to undergo dietary habit counseling and stop intaking arecanut, tobacco and spicy food. Patient's diet should include proteins, vitamin D, E and B complex and micronutrients.

Intralesional steroids such as dexamethasone are the main treatment modality. These are injected submucosally into the fibrotic bands weekly for 6 to 8 weeks with regular monitoring of mouth opening. They are commonly used with hyaluronidase, a proteolytic enzyme. Antioxidants like alpha lipoic acid and lycopene are also commonly used as first line of treatment. Lycopene is anti-poliferative, anti-inflammatory and anti-oxidant. Antioxidants restrict the damage caused by reactive free radicals to cells and cellular components. [1],[2] Novel therapies include zinc actetate tablets for 4 months, 50 mg three times daily, and vitamin A 25,000 IU, once daily, with regular follow-up at an interval of 1 month. [3] Also, Salvianolic acid B, an antifibrotic, which is used with triamcinolone acetonide represents the promising newest mode of management. Salvianolic acid B has antifibrosis, anticoagulation, antitumor activities. [4] Turmeric, immunomodulatory drug levamisole, vasodilator pentoxyfilline, placental extract, interferon gamma, spirulina, colchicine, herbal antioxidants oxitard and Aloe vera are also promising in the management of this chronic disease. [1],[2],[5],[6],[7] Antioxidant property of spirulina is attributed to high amount of beta carotene and superoxide dismutase. Colchicine has antifibrotic and anti-inflammatory properties. [5],[6]

References

1Arakeri G, Brennan PA. Oral submucous fibrosis: An overview of the aetiology, pathogenesis, classification, and principles of management. Br J Oral Maxillofac Surg 2013;51:587-93.
2Yoithapprabhunath TR, Maheswaran T, Dineshshankar J, Anusushanth A, Sindhuja P, Sitra G. Pathogenesis and therapeutic intervention of oral submucous fibrosis. J Pharm Bioall Sci 2013;5:(Suppl 1):S85-8.
3Dhariwal R, Mukherjee S, Mohanty SP, Chakraborty A, Ray GJ, Chaudhuri K. Zinc and vitamin A can minimise the severity of oral submucous fibrosis. BMJ Case Rep. 2010. doi: 10.1136/bcr.10.2009.2348.
4Jiang WX, Zhang Y, Yang KS, Zhang H, Lu K, Sun LG. Efficacy of salvianolic acid B combined with triamcinolone acetonide in the treatment of oral submucous fibrosis. Oral Surg Oral Med Oral Pathol Oral Radiol 2013;115:339-44.
5Mulk BS, Deshpande P, Velpula N, Chappidi V, Chintamaneni RL, Goyal S. Spirulina and pentoxyfilline - a novel approach for treatment of oral submucous fibrosis. J Clin Diagn Res 2013;7:3048-50.
6Krishnamoorthy B, Khan M. Management of oral submucous fibrosis by two different drug regimens: A comparative study. Dent Res J (Isfahan) 2013;10:527-32.
7Patil S, Halgatti V, Maheshwari S, Santosh BS. Comparative study of the efficacy of herbal antioxdants oxitard and aloe vera in the treatment of oral submucous fibrosis. J Clin Exp Dent 2014;6:e265-70.