Funding sources This work was undertaken at University College London/University College London Hospital Trust which received a proportion of funding from the Department of Health's National Institute for Health Research Biomedical Research Centre (BRC) funding scheme.
Clinical and Laboratory Investigations
Long-term effectiveness of intralesional triamcinolone acetonide therapy in orofacial granulomatosis: an observational cohort study
Version of Record online: 15 APR 2014
© 2013 The Authors. British Journal of Dermatology published by John Wiley & Sons Ltd on behalf of British Association of Dermatologists
This is an open access article under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non-commercial and no modifications or adaptations are made.
British Journal of Dermatology
Volume 170, Issue 4, pages 794–801, April 2014
How to Cite
Fedele, S., Fung, P.P.L., Bamashmous, N., Petrie, A. and Porter, S. (2014), Long-term effectiveness of intralesional triamcinolone acetonide therapy in orofacial granulomatosis: an observational cohort study. British Journal of Dermatology, 170: 794–801. doi: 10.1111/bjd.12655
Conflicts of interest None declared.
- Issue online: 15 APR 2014
- Version of Record online: 15 APR 2014
- Accepted manuscript online: 1 OCT 2013 12:29AM EST
- Manuscript Accepted: 23 SEP 2013
- Department of Health's National Institute for Health Research Biomedical Research Centre (BRC) funding scheme
It has been suggested that intralesional triamcinolone injections represent a safe and effective therapeutic strategy in controlling the permanent disfiguring swelling of orofacial granulomatosis (OFG). However, robust supporting evidence is lacking, due to the variable and inconsistent design of available studies.
To investigate whether a standardized regimen of intralesional triamcinolone has beneficial long-term effects on orofacial swelling of OFG. We also studied potential associations with a number of prognostic factors.
We designed a retrospective observational study of a homogeneous cohort of 22 well-phenotyped patients with OFG. The primary outcome was defined as a statistically significant decrease in post-treatment disease severity. Statistically significant association with prognostic factors was the secondary outcome. Statistical analysis included Wilcoxon signed-rank tests and logistic regression.
Compared with pretreatment, there were statistically significant decreases in disease severity scores at all time points until 48 months post-treatment (P < 0·01). Logistic regression analysis showed there was no independent prognostic variable of statistical significance (P > 0·05). The majority of patients (14/22, 63·6%) received one course of intralesional triamcinolone and did not experience disease recurrence. The mean disease-free period after the first course of intralesional therapy was 28·9 ± 18 months (95% confidence interval 28·7–29·1). No adverse effects were reported.
This is the first study to have employed robust cohort methodology and sound statistics to demonstrate long-term effectiveness of intralesional triamcinolone in controlling the disfiguring swelling of OFG. Because of limitations inherent in observational studies, further research in the form of randomized case-control trials is needed to confirm the present findings.