The purpose of this study was to test the efficacy of 0.05% fluocinonide oral ointment and 0.05% clobetasol propionate oral ointment containing 20% CMC-Na in the treatment of intractable oral lichen planes (OLP) and oral mucous membrane pemphigoid (MMP). With each patient's informed consent, three patients with OLP, and two patients with MMP, participated in this study. Lesions in OLP were scored ranging from 0 to 5, and lesions in MMP were graded from 1 to 3, according to severity. The lesions were evaluated after 2 and 4 weeks of treatment. In all cases, the patient's symptom was remarkably improved, and no systemic adverse effects, like suppression of adreocortical function, were recognized. Although three cases showed acute pseudomembranous candidiasis within 2 weeks, they responded to treatment with miconazole.

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The efficacy of Cevimeline hydrochloride hydrate application in Sjögren's syndrome (SS) patients with dry mouth, was evaluated. A total of 51 patients with dry mouth from SS:2 males and 49 females, of mean age 65.8 years (34-84), took this drug during September 2001 to May 2002, for a mean treatment period of 22.7 weeks (6-37). Fifteen and 36 patients were respectively given doses of 90mg/day and 60mg/day of this drug. The mean sialometric incrcase was 117.2%, and 59.5% of the patients had “improved” sialometric observation. “Improved” and “better” subjective symptoms were achieved in 64.8% of patients, while 81.8% response rate of objective symptoms. Overall efficacy of this treatment was 75.7%, with adverse reactions occurring in 35.3% of patients.

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We performed both MR and conventional X-ray sialography for imaging the major salivary glands in diagnosing Sjögren's syndrome (SS), in 50 patients. Then, the correlation and the diagnostic accuracy of both sialographies in the diagnosis of SS were studied. The MR and conventional X-ray sialographic findings were compared in the same patients. The images produced by both methods were classified according to Rubin and Holt's criteria. There was a highly significant correlation between the two methods (rcc=0.885, p<0.0001). The sensitivity and specificity of MR sialography were 85.3% and 100%, respectively. These data were very similar to those of the conventional method. MR sialography can be considered useful in the diagnosis of SS, with similar sensitivity and specificity to conventional X-ray sialography, and it may be able to replace the conventional method.

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A 49 year-old man presented with extensive ulceration and erosion in the mouth, followed by ocular erosion, bullus formation and erythema on the trunk, and penile ulcers. A CT examination showed a solid tumor in the posterior peritoneum, which revealed B cell-type malignant lymphoma. On serological examination, direct immunofluorescence testing showed IgG and C3 deposition in the epidermal intercellular spaces and basement membrane zone. Indirect immunofluorescence testing showed IgG deposition in the normal human epidermal intercellular spaces, and in the transitional epithelium of rat bladder. Immunoblot analysis demonstrated that the patient's serum reacted to envoplakin (210kDa) and periplakin (190kDa). According to these findings, we diagnosed this case as having PNP. Although a systemic steroid was administered for the mucosal-cutaneous lesions, and chemotherapy (CHOP) was conducted for the lymphoma, no remarkable subsidence was observed in the oral lesions. The patient died 2.5 months after the initial presentation.

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