Introduction: Diagnosis and management of orofacialpain of non-odontogenic origin has always been achallenge to dentists. Inaccurate diagnosis wouldresult in delay of treatment and in cases of orofacialpain, affects patient’s quality of life. Temporomandibularpain dysfunction syndrome is the mostcommon temporomandibular disorder that presents todental clinics. Trigeminal neuralgia, also known as ticdouloureux is a relatively rare condition that causeselectric shock-like pain when the trigger zone isstimulated by triggering factor. Case report: A caseof temporomandibular pain dysfunction syndromein a 52 years old Indian lady that was managed astrigeminal neuralgia for 7 years is presented.Conclusion: The aim of this case report is to makedentists aware of the signs and symptoms of differentorofacial pain, so that early and accurate diagnosis canbe made and appropriate treatment instituted.Key words: orofacial pain; temporomandibular paindysfunction syndrome; trigeminal neuralgia

BACKGROUND: Narrow-band UVB and topical corticosteroids are treatments for vitiligo. The possible synergistic effect of these modalities has not yet been investigated.
OBJECTIVE: This study aims to compare the efficacy of combining narrow-band UVB (NB-UVB) and 0.05% clobetasol propionate ointment (CP) with that of NB-UVB and placebo in inducing initial and overall repigmentation and control of disease activity after 6 months of therapy. Moreover, it aims to assess the safety and determine the permanence ofrepigmentation within I year post-treatment in both regimens.
METHODS: Randomized, placebo-controlled, double-blind, left-right comparison was conducted on generalized vitiligo patients with 5-50% body surface area involvement, having at least 2 bilateral, comparative lesions. CP or placebo was applied once daily on either side of the body, each combined with NB-UVB thrice weekly for 6 months.
OUTCOME MEASURES: (1) number of exposures and cumulative dose (CD) of NB-UVB that induced initial repigmentation; (2) quantity of repigmentation after 6 months estimated by comparing pre- and post-treatment photographs; (3) effect on disease activity by comparing pre- and post-treatment VIDA (vitiligo disease activity) scores; and (4) permanence of repigmentation and development of new lesions within 1 year post-treatment documented by photographs.
ANALYSIS: Sample size was calculated using formula for testing two proportions at 0.05 level of significance and a power of 0.80. Data was analyzed with Student t test (paired), Exact test for symmetry and Wilcoxon signed rank test, depending on the data set involved.
RESULTS: Twenty-five patients were recruited, but only 20 were evaluable at the end of the study. Initial repigmentation was noted after a mean of 9.30 +/- 3.54 exposures (mean CD 1,887.8 +/- 1195.81 mJ/cm2) of NB-UVB on the CP-treated side, and after a mean of 15.85 +/- 5.61 exposures (mean CD 4,152.2 +/- 2231.9 mJ/cm2) on the placebo side. After 6 months, 55% (11/20) and 40%(8/20) of patients exhibited marked (>75 %) repigmentation in the NB-UVB with CP side, and NB-UVB with placebo side, respectively. Adverse events were minimal and transient. VIDA scores improved and repigmentation induced by both treatment regimens remained stable in majority within one year post-treatment.
CONCLUSIONS: Combination NB-UVB and CP induced repigmentation earlier, requiring significantly lower cumulative dose of NB-UVB than NB-UVB plus placebo. Over all quantity and permanence of repigmentation, as well as control of disease activity and safety, were comparable in the two regimens.

 

 

Human ; Male ; Female ; Middle Aged ; Adult ; Young Adult ; Adolescent ; Child ; Adrenal Cortex Hormones ; Clinical Protocols ; Clobetasol ; Dermatologic Agents ; Outcome Assessment (health Care) ; Ultraviolet Therapy ; Vitiligo