What is the role of immunomodulators in the treatment of pediatric aphthous ulcers?

Updated: Feb 25, 2019
  • Author: Michael C Plewa, MD; Chief Editor: Russell W Steele, MD  more...
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Answer

Immunomodulators, including colchicine, [65, 36] dapsone, [66] clofazimine, [67] cyclosporine, interferon, tumor necrosis factor antagonists (infliximab, etanercept, adalimumab, pentoxifylline), [66, 68] T-cell modulator modifiers (efalizumab, alefacept), antimetabolites (methotrexate), alkylating agents (cyclophosphamide) and thalidomide [69] are used in severe, refractory cases, such as in patients with human immunodeficiency virus (HIV) or acquired immunodeficiency syndrome (AIDS) [70, 20] or Behçet syndrome. [71, 72] However, the indications and uses of such therapy are beyond the scope of this article, and adverse effects can be both problematic and clinically significant. The patient must be closely observed; therefore, use of this therapy stretches beyond the scope of practice of most primary care providers.


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