metricas
covid
Buscar en
Clinics
Toda la web
Inicio Clinics Regression of Major Recurrent Aphthous Ulcerations Using a Combination of Intral...
Journal Information

Statistics

Follow this link to access the full text of the article

Letter to the Editor
Regression of Major Recurrent Aphthous Ulcerations Using a Combination of Intralesional Corticosteroids and Levamisole: A Case Report
Bruna Lavinas Sayed Picciani, Geraldo Oliveira Silva-Junior, Davi Silva Barbirato, Ruth Tramontani Ramos, Marilia Heffer Cantisano
Corresponding author
mcantisano@terra.com.br

Tel.: 55 21 2587-6457
Department of Diagnosis and Surgery, Stomatology, School of Dentistry, State University of Rio de Janeiro - Rio de Janeiro/RJ, Brazil
Read
696
Times
was read the article
277
Total PDF
419
Total HTML
Share statistics
 array:23 [
  "pii" => "S1807593222024309"
  "issn" => "18075932"
  "doi" => "10.1590/S1807-59322010000600015"
  "estado" => "S300"
  "fechaPublicacion" => "2010-06-01"
  "aid" => "20222430"
  "copyright" => "CLINICS"
  "copyrightAnyo" => "2010"
  "documento" => "simple-article"
  "crossmark" => 0
  "licencia" => "https://creativecommons.org/licenses/by-nc/3.0/"
  "subdocumento" => "cor"
  "cita" => "Clinics. 2010;65:650-2"
  "abierto" => array:3 [
    "ES" => true
    "ES2" => true
    "LATM" => true
  ]
  "gratuito" => true
  "lecturas" => array:1 [
    "total" => 0
  ]
  "itemAnterior" => array:19 [
    "pii" => "S1807593222024292"
    "issn" => "18075932"
    "doi" => "10.1590/S1807-59322010000600014"
    "estado" => "S300"
    "fechaPublicacion" => "2010-06-01"
    "aid" => "20222429"
    "copyright" => "CLINICS"
    "documento" => "simple-article"
    "crossmark" => 0
    "licencia" => "https://creativecommons.org/licenses/by-nc/3.0/"
    "subdocumento" => "cor"
    "cita" => "Clinics. 2010;65:647-9"
    "abierto" => array:3 [
      "ES" => true
      "ES2" => true
      "LATM" => true
    ]
    "gratuito" => true
    "lecturas" => array:1 [
      "total" => 0
    ]
    "en" => array:10 [
      "idiomaDefecto" => true
      "cabecera" => "<span class="elsevierStyleTextfn">Letter to the Editor</span>"
      "titulo" => "Distinctive Tomographic Abnormalities of the Craniocervical Region in a Patient with Osteogensis Imperfecta Type IV B"
      "tienePdf" => "en"
      "tieneTextoCompleto" => "en"
      "paginas" => array:1 [
        0 => array:2 [
          "paginaInicial" => "647"
          "paginaFinal" => "649"
        ]
      ]
      "contieneTextoCompleto" => array:1 [
        "en" => true
      ]
      "contienePdf" => array:1 [
        "en" => true
      ]
      "resumenGrafico" => array:2 [
        "original" => 0
        "multimedia" => array:7 [
          "identificador" => "f4-cln_65p647"
          "etiqueta" => "Figure 4"
          "tipo" => "MULTIMEDIAFIGURA"
          "mostrarFloat" => true
          "mostrarDisplay" => false
          "figura" => array:1 [
            0 => array:4 [
              "imagen" => "gr4.jpeg"
              "Alto" => 345
              "Ancho" => 413
              "Tamanyo" => 10975
            ]
          ]
          "descripcion" => array:1 [
            "en" => "<p id="spara40" class="elsevierStyleSimplePara elsevierViewall">An axial reformatted CT scan revealed clefting of the anterior arch of the atlas and dysplasia of the posterior arch &#40;arrows&#41;&#46; The odontoid has been impacted between the synchondrosis</p>"
          ]
        ]
      ]
      "autores" => array:1 [
        0 => array:2 [
          "autoresLista" => "Ali Al Kaissi, Klaus Klaushofer, Franz Grill"
          "autores" => array:3 [
            0 => array:2 [
              "nombre" => "Ali Al"
              "apellidos" => "Kaissi"
            ]
            1 => array:2 [
              "nombre" => "Klaus"
              "apellidos" => "Klaushofer"
            ]
            2 => array:2 [
              "nombre" => "Franz"
              "apellidos" => "Grill"
            ]
          ]
        ]
      ]
    ]
    "idiomaDefecto" => "en"
    "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1807593222024292?idApp=UINPBA00004N"
    "url" => "/18075932/0000006500000006/v1_202212011625/S1807593222024292/v1_202212011625/en/main.assets"
  ]
  "en" => array:13 [
    "idiomaDefecto" => true
    "cabecera" => "<span class="elsevierStyleTextfn">Letter to the Editor</span>"
    "titulo" => "Regression of Major Recurrent Aphthous Ulcerations Using a Combination of Intralesional Corticosteroids and Levamisole&#58; A Case Report"
    "tieneTextoCompleto" => true
    "paginas" => array:1 [
      0 => array:2 [
        "paginaInicial" => "650"
        "paginaFinal" => "652"
      ]
    ]
    "autores" => array:1 [
      0 => array:4 [
        "autoresLista" => "Bruna Lavinas Sayed Picciani, Geraldo Oliveira Silva-Junior, Davi Silva Barbirato, Ruth Tramontani Ramos, Marilia Heffer Cantisano"
        "autores" => array:5 [
          0 => array:2 [
            "nombre" => "Bruna Lavinas Sayed"
            "apellidos" => "Picciani"
          ]
          1 => array:2 [
            "nombre" => "Geraldo Oliveira"
            "apellidos" => "Silva-Junior"
          ]
          2 => array:2 [
            "nombre" => "Davi Silva"
            "apellidos" => "Barbirato"
          ]
          3 => array:2 [
            "nombre" => "Ruth Tramontani"
            "apellidos" => "Ramos"
          ]
          4 => array:4 [
            "nombre" => "Marilia Heffer"
            "apellidos" => "Cantisano"
            "email" => array:1 [
              0 => "mcantisano@terra.com.br"
            ]
            "referencia" => array:1 [
              0 => array:2 [
                "etiqueta" => "&#42;"
                "identificador" => "c1-cln_65p650"
              ]
            ]
          ]
        ]
        "afiliaciones" => array:1 [
          0 => array:2 [
            "entidad" => "Department of Diagnosis and Surgery&#44; Stomatology&#44; School of Dentistry&#44; State University of Rio de Janeiro - Rio de Janeiro&#47;RJ&#44; Brazil"
            "identificador" => "af1-cln_65p650"
          ]
        ]
        "correspondencia" => array:1 [
          0 => array:3 [
            "identificador" => "c1-cln_65p650"
            "etiqueta" => "&#42;"
            "correspondencia" => "Tel&#46;&#58; 55 21 2587-6457"
          ]
        ]
      ]
    ]
    "resumenGrafico" => array:2 [
      "original" => 0
      "multimedia" => array:7 [
        "identificador" => "f1-cln_65p650"
        "etiqueta" => "Figure 1"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "figura" => array:1 [
          0 => array:4 [
            "imagen" => "gr1.jpeg"
            "Alto" => 477
            "Ancho" => 633
            "Tamanyo" => 62583
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spara10" class="elsevierStyleSimplePara elsevierViewall">&#40;a&#41; Major recurrent aphthous ulceration on the right border of the tongue&#59; &#40;b&#41; intralesional injection of corticosteroids&#59; &#40;c&#41; partial regression of the lesions was achieved one week after the administration of intralesional corticosteroids&#59; &#40;d&#41; the major recurrent aphthous ulceration was resolved and no recurrence was observed after four weeks treatment with levamisole&#46;</p>"
        ]
      ]
    ]
    "textoCompleto" => "<span class="elsevierStyleSections"><span id="cesec10" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="cestitle10">INTRODUCTION</span><p id="para10" class="elsevierStylePara elsevierViewall">Recurrent aphthous ulcerations &#40;RAU&#41; are common oral lesions that affect approximately 10&#37; to 20&#37; of the population&#46; The disease is characterized by recurrent and painful ulcerations of the oral non-keratinized mucosa&#44; which measure from 3 to 10 mm in diameter and heal without scarring in 7 to 14 days&#46;<a class="elsevierStyleCrossRef" href="#bib1">1</a> The etiology of RAU remains unknown&#44; but there is increasing evidence that its development has an immunogenic basis&#46; The search for its cause should concentrate on disorders associated with immunoderegulation&#44; decreased mucosal barriers&#44; or conditions that elevate the antigenic stimulus&#46; Major RAU have irregular margins&#44; frequently exceed 10 mm in size&#44; and typically leave scars&#46;<a class="elsevierStyleCrossRef" href="#bib2">2</a></p><p id="para20" class="elsevierStylePara elsevierViewall">There have been many attempts over the years to find an effective treatment for RAU&#46; Because the etiology of RAU remains unknown&#44; its treatment consists of therapeutic measures to suppress its symptoms rather than bringing about a definitive cure&#46; The therapeutic choice depends on the severity of the disease&#44; which is measured by the frequency of ulcer recurrence&#44; the number of ulcers&#44; their location and duration&#44; and the level of associated orofacial pain&#46;<a class="elsevierStyleCrossRefs" href="#bib3">3&#44;4</a> Cases of major RAU that are characterized by pain&#44; fever&#44; and dysphagia and that are recurrent usually require systemic therapy&#46; Several systemic drugs have been used to treat major RAU&#44; including systemic corticosteroids&#44; dapsone&#44; colchicine&#44; thalidomide&#44; pentoxifylline&#44; low-dose interferon-&#945;&#44; and levamisole&#46;<a class="elsevierStyleCrossRefs" href="#bib2">2&#44;5</a></p><p id="para30" class="elsevierStylePara elsevierViewall">The use of systemic corticosteroids and immuno-modulating agents has been the mainstay of treatment for major RAU&#46; Intralesional steroid injections&#44; which contain betamethasone dipropionate and betamethasone disodium phosphate&#44; combined with levamisole therapy may successfully treat the large ulcers associated with major RAU&#46;<a class="elsevierStyleCrossRef" href="#bib6">6</a></p><p id="para40" class="elsevierStylePara elsevierViewall">This paper presents a case report of major RAU where we tested the therapeutic efficacy of a treatment combining an intralesional corticosteroid and a drug used to modulate immune responses&#46;</p></span><span id="cesec20" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="cestitle20">CASE REPORT</span><p id="para50" class="elsevierStylePara elsevierViewall">A 30-year-old woman presented a 15-year history of successive episodes of multiple major recurrent ulcers in the oral mucosa and tongue region of the mouth&#44; which left scars after lesion regression&#46; During the patient&#8217;s anamnesis&#44; she reported having had these episodes since adolescence and having already been treated with corticosteroids&#44; but without success&#46; Clinical examination revealed symptomatic ulcers with perilesional erythematous halos that were covered with a pseudo membrane and located in the jugal mucosa and on the right side border of the tongue&#44; exceeding 10 mm in diameter &#40;<a class="elsevierStyleCrossRef" href="#f1-cln_65p650">Fig&#46; 1a</a>&#41;&#46; There were also areas of scarring on the right jugal mucosa&#46; A clinical diagnosis of major RAU was made on the basis of the history and the clinical examinations&#46; The other aspects of the patient&#8217;s medical history and family medical history were insignificant&#46; Laboratory tests including a blood count analysis were performed to determine the levels of folic acid&#44; iron&#44; ferritin&#44; as well as vitamins B2&#44; B6&#44; and B12&#44; all of which showed normal results&#46;</p><elsevierMultimedia ident="f1-cln_65p650"></elsevierMultimedia><p id="para60" class="elsevierStylePara elsevierViewall">The patient was subjected to a therapeutic consisting of prednisone &#40;15 mg per day&#41; and a topical mouthwash containing dexamethasone &#40;20 mg per day&#41; for two weeks&#44; which was unsuccessful&#46; Thus&#44; a regimen was proposed consisting of an intralesional injection of betamethasone dipropionate &#40;5 mg&#47;ml&#41; and betamethasone disodium phosphate &#40;2 mg&#47;ml&#41; &#40;<a class="elsevierStyleCrossRef" href="#f1-cln_65p650">Fig&#46; 1b</a>&#41;&#46; After the first application&#44; there was a partial regression of the lesions&#46; Only one application was needed to bring about partial healing of the ulcers &#40;<a class="elsevierStyleCrossRef" href="#f1-cln_65p650">Fig&#46; 1c</a>&#41;&#46; To reduce the frequency of ulceration&#44; levamisole hydrochloride &#40;150 mg&#41; was administered once a week for one month&#46; Despite considerable improvement in the patient&#8217;s status&#44; it has not yet been possible to precisely establish the etiologic agent&#46; There was no recurrence during the 6-month follow-up period &#40;<a class="elsevierStyleCrossRef" href="#f1-cln_65p650">Fig&#46; 1d</a>&#41;&#46;</p></span><span id="cesec30" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="cestitle30">DISCUSSION</span><p id="para70" class="elsevierStylePara elsevierViewall">The clinical features&#44; etiology&#44; and treatment of major recurrent aphthous ulcerations have been discussed&#46; The primary goals of administering therapy for major RAU are to bring about relief from pain&#44; reduction in ulcer duration&#44; and the restoration of normal oral function&#46; Secondary goals include a reduction in the frequency and severity of recurrences and the maintenance of remission&#46; Topical medications&#44; such as corticosteroids&#44; can achieve the primary goals but have not been shown to alter recurrence or remission rates&#46; Systemic medications can be combined with the topical therapy to achieve the secondary goals&#46;<a class="elsevierStyleCrossRefs" href="#bib7">7&#44;8</a> Levamisole&#44; an antihelminthic drug that can modulate immune responses&#44; has been used successfully as a monotherapy and as an adjunct to treatment in a variety of diseases&#46; Because of its modulating effects on immune responses&#44; levamisole has been used in a wide range of diseases with varying degrees of success&#46; It has also been used in combination with corticosteroids to treat a number of mouth dermatologic disorders&#44; such as major RAU&#46;<a class="elsevierStyleCrossRefs" href="#bib9">9&#44;10</a></p><p id="para80" class="elsevierStylePara elsevierViewall">The therapeutic method used in this case provided significant relief from symptoms and decreased the rate of recurrence&#46; Additional studies are needed to evaluate the full potential of levamisole in oral dermatological diseases&#46;</p></span></span>"
    "textoCompletoSecciones" => array:1 [
      "secciones" => array:4 [
        0 => array:2 [
          "identificador" => "cesec10"
          "titulo" => "INTRODUCTION"
        ]
        1 => array:2 [
          "identificador" => "cesec20"
          "titulo" => "CASE REPORT"
        ]
        2 => array:2 [
          "identificador" => "cesec30"
          "titulo" => "DISCUSSION"
        ]
        3 => array:1 [
          "titulo" => "REFERENCES"
        ]
      ]
    ]
    "pdfFichero" => "main.pdf"
    "tienePdf" => true
    "multimedia" => array:1 [
      0 => array:7 [
        "identificador" => "f1-cln_65p650"
        "etiqueta" => "Figure 1"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "figura" => array:1 [
          0 => array:4 [
            "imagen" => "gr1.jpeg"
            "Alto" => 477
            "Ancho" => 633
            "Tamanyo" => 62583
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spara10" class="elsevierStyleSimplePara elsevierViewall">&#40;a&#41; Major recurrent aphthous ulceration on the right border of the tongue&#59; &#40;b&#41; intralesional injection of corticosteroids&#59; &#40;c&#41; partial regression of the lesions was achieved one week after the administration of intralesional corticosteroids&#59; &#40;d&#41; the major recurrent aphthous ulceration was resolved and no recurrence was observed after four weeks treatment with levamisole&#46;</p>"
        ]
      ]
    ]
    "bibliografia" => array:2 [
      "titulo" => "REFERENCES"
      "seccion" => array:1 [
        0 => array:2 [
          "identificador" => "cebibsec10"
          "bibliografiaReferencia" => array:10 [
            0 => array:3 [
              "identificador" => "bib1"
              "etiqueta" => "1"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Recurrent aphthous ulcers today&#58; a review of the growing knowledge"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:6 [
                            0 => """
                              SS Natah \n
                              \t\t\t\t\t\t\t\t
                              """
                            1 => """
                              YT Konttinen \n
                              \t\t\t\t\t\t\t\t
                              """
                            2 => """
                              NS Enattah \n
                              \t\t\t\t\t\t\t\t
                              """
                            3 => """
                              N Ashammakhi \n
                              \t\t\t\t\t\t\t\t
                              """
                            4 => """
                              KA Sharkey \n
                              \t\t\t\t\t\t\t\t
                              """
                            5 => """
                              R Hayrinen-Immonen \n
                              \t\t\t\t\t\t\t\t
                              """
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1006/ijom.2002.0446"
                      "Revista" => array:6 [
                        "tituloSerie" => "Int J Oral Maxillofac Surg"
                        "fecha" => "2004"
                        "volumen" => "33"
                        "paginaInicial" => "221"
                        "paginaFinal" => "234"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/15287304"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            1 => array:3 [
              "identificador" => "bib2"
              "etiqueta" => "2"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "&#91;Major aphthous stomatitis &#40;Sutton&#8217;s disease&#41;&#58; etiopathogenesis&#44; histological and clinical aspects&#93;"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => """
                              F Burruano \n
                              \t\t\t\t\t\t\t\t
                              """
                            1 => """
                              S Tortorici \n
                              \t\t\t\t\t\t\t\t
                              """
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Minerva Stomatol"
                        "fecha" => "2000"
                        "volumen" => "49"
                        "paginaInicial" => "41"
                        "paginaFinal" => "50"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/10932907"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            2 => array:3 [
              "identificador" => "bib3"
              "etiqueta" => "3"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Oral ulcers&#58; clinical aspects&#46; A tool for dermatologists&#46; Part I&#46; Acute ulcers"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => """
                              M Munoz-Corcuera \n
                              \t\t\t\t\t\t\t\t
                              """
                            1 => """
                              G Esparza-Gomez \n
                              \t\t\t\t\t\t\t\t
                              """
                            2 => """
                              MA Gonzalez-Moles \n
                              \t\t\t\t\t\t\t\t
                              """
                            3 => """
                              A Bascones-Martinez \n
                              \t\t\t\t\t\t\t\t
                              """
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1111/j.1365-2230.2009.03220.x"
                      "Revista" => array:6 [
                        "tituloSerie" => "Clin Exp Dermatol"
                        "fecha" => "2009"
                        "volumen" => "34"
                        "paginaInicial" => "289"
                        "paginaFinal" => "294"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/19309371"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            3 => array:3 [
              "identificador" => "bib4"
              "etiqueta" => "4"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Recurrent aphthous stomatitis&#46; An update"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [
                            0 => """
                              JA Ship \n
                              \t\t\t\t\t\t\t\t
                              """
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Oral Surg Oral Med Oral Pathol Oral Radiol Endod"
                        "fecha" => "1996"
                        "volumen" => "81"
                        "paginaInicial" => "141"
                        "paginaFinal" => "147"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            4 => array:3 [
              "identificador" => "bib5"
              "etiqueta" => "5"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Treatment of severe&#44; recalcitrant&#44; major aphthous stomatitis with adalimumab"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => """
                              J Vujevich \n
                              \t\t\t\t\t\t\t\t
                              """
                            1 => """
                              M Zirwas \n
                              \t\t\t\t\t\t\t\t
                              """
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Cutis"
                        "fecha" => "2005"
                        "volumen" => "76"
                        "paginaInicial" => "129"
                        "paginaFinal" => "132"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/16209159"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            5 => array:3 [
              "identificador" => "bib6"
              "etiqueta" => "6"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Current concepts in the treatment of recurrent aphthous stomatitis"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => """
                              A Altenburg \n
                              \t\t\t\t\t\t\t\t
                              """
                            1 => """
                              CC Zouboulis \n
                              \t\t\t\t\t\t\t\t
                              """
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Skin Therapy Lett"
                        "fecha" => "2008"
                        "volumen" => "13"
                        "paginaInicial" => "1"
                        "paginaFinal" => "4"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/19145382"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            6 => array:3 [
              "identificador" => "bib7"
              "etiqueta" => "7"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Treatment strategies for recurrent oral aphthous ulcers"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [
                            0 => """
                              RW Barrons \n
                              \t\t\t\t\t\t\t\t
                              """
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:6 [
                        "tituloSerie" => "Am J Health Syst Pharm"
                        "fecha" => "2001"
                        "volumen" => "58"
                        "paginaInicial" => "41"
                        "paginaFinal" => "50"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/11194135"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            7 => array:3 [
              "identificador" => "bib8"
              "etiqueta" => "8"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Topical and systemic therapy for recurrent aphthous stomatitis"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:1 [
                            0 => """
                              L MacPhail \n
                              \t\t\t\t\t\t\t\t
                              """
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1016/s1085-5629(97)80020-x"
                      "Revista" => array:6 [
                        "tituloSerie" => "Semin Cutan Med Surg"
                        "fecha" => "1997"
                        "volumen" => "16"
                        "paginaInicial" => "301"
                        "paginaFinal" => "307"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/9421222"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            8 => array:3 [
              "identificador" => "bib9"
              "etiqueta" => "9"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Levamisole in dermatology &#58; a review"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:3 [
                            0 => """
                              N Scheinfeld \n
                              \t\t\t\t\t\t\t\t
                              """
                            1 => """
                              JD Rosenberg \n
                              \t\t\t\t\t\t\t\t
                              """
                            2 => """
                              JM Weinberg \n
                              \t\t\t\t\t\t\t\t
                              """
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.2165/00128071-200405020-00004"
                      "Revista" => array:6 [
                        "tituloSerie" => "Am J Clin Dermatol"
                        "fecha" => "2004"
                        "volumen" => "5"
                        "paginaInicial" => "97"
                        "paginaFinal" => "104"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/15109274"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
            9 => array:3 [
              "identificador" => "bib10"
              "etiqueta" => "10"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Levamisole can modulate the serum tumor necrosis factor-alpha level in patients with recurrent aphthous ulcerations"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => """
                              A Sun \n
                              \t\t\t\t\t\t\t\t
                              """
                            1 => """
                              JT Wang \n
                              \t\t\t\t\t\t\t\t
                              """
                            2 => """
                              JS Chia \n
                              \t\t\t\t\t\t\t\t
                              """
                            3 => """
                              CP Chiang \n
                              \t\t\t\t\t\t\t\t
                              """
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1111/j.1600-0714.2006.00383.x"
                      "Revista" => array:6 [
                        "tituloSerie" => "J Oral Pathol Med"
                        "fecha" => "2006"
                        "volumen" => "35"
                        "paginaInicial" => "111"
                        "paginaFinal" => "116"
                        "link" => array:1 [
                          0 => array:2 [
                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/16430742"
                            "web" => "Medline"
                          ]
                        ]
                      ]
                    ]
                  ]
                ]
              ]
            ]
          ]
        ]
      ]
    ]
  ]
  "idiomaDefecto" => "en"
  "url" => "/18075932/0000006500000006/v1_202212011625/S1807593222024309/v1_202212011625/en/main.assets"
  "Apartado" => null
  "PDF" => "https://static.elsevier.es/multimedia/18075932/0000006500000006/v1_202212011625/S1807593222024309/v1_202212011625/en/main.pdf?idApp=UINPBA00004N&text.app=https://www.elsevier.es/"
  "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1807593222024309?idApp=UINPBA00004N"
]
Article information
ISSN: 18075932
Original language: English
The statistics are updated each day
Year/Month Html Pdf Total
2024 November 8 0 8
2024 October 34 21 55
2024 September 38 12 50
2024 August 50 19 69
2024 July 28 19 47
2024 June 21 11 32
2024 May 21 14 35
2024 April 23 13 36
2024 March 34 14 48
2024 February 33 18 51
2024 January 31 11 42
2023 December 21 13 34
2023 November 18 30 48
2023 October 12 35 47
2023 September 16 21 37
2023 August 1 5 6
2023 July 8 15 23
2023 June 3 2 5
2023 May 1 1 2
2023 April 3 0 3
2023 March 3 0 3
2023 January 2 1 3
2022 December 10 2 12
Show all

Follow this link to access the full text of the article

es en pt

¿Es usted profesional sanitario apto para prescribir o dispensar medicamentos?

Are you a health professional able to prescribe or dispense drugs?

Você é um profissional de saúde habilitado a prescrever ou dispensar medicamentos