{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,21]],"date-time":"2026-07-21T15:23:33Z","timestamp":1784647413485,"version":"3.55.0"},"reference-count":15,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2025,9,23]],"date-time":"2025-09-23T00:00:00Z","timestamp":1758585600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2025,9,23]],"date-time":"2025-09-23T00:00:00Z","timestamp":1758585600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100003725","name":"National Research Foundation of Korea","doi-asserted-by":"publisher","award":["RS\u20102023\u201000211128"],"award-info":[{"award-number":["RS\u20102023\u201000211128"]}],"id":[{"id":"10.13039\/501100003725","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["The Journal of Dermatology"],"published-print":{"date-parts":[[2025,11]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>Oral aphthous ulcer in Beh\u00e7et's disease (BD) and recurrent aphthous stomatitis (RAS) is a cause of discomfort for many patients, especially in cases refractory to colchicine or azathioprine. Roflumilast, a phosphodiesterase\u20104 (PDE4) inhibitor, may be effective for treating refractory oral ulcers (OUs) in BD and RAS, especially in regions where apremilast is unavailable. In this study, we investigated the efficacy and safety profile of low\u2010dose roflumilast for refractory OUs in BD and RAS. This single\u2010center, single\u2010arm, retrospective observational study included 46 patients screened from the outpatient department from May 2023 to Dec 2023. During the 12\u2010week study period, the subjects received roflumilast at a dosage of 0.25\u2009mg daily. For those experiencing adverse events (AEs) requiring adjustment, the dose was reduced to 0.125\u2009mg. Objective clinical responses were evaluated as clinician\u2010assessed treatment categories (complete remission, partial response, or non\u2010response), based on the absence or presence of new OUs and symptom improvement. Subjective symptoms were evaluated through a patient\u2010reported questionnaire, and AEs were monitored through the protocol. At week 12, 71.7% of patients showed a positive response to roflumilast, with 30.4% achieving complete remission. AEs were reported in 76.1% of the 46 subjects with follow\u2010up visits, primarily gastrointestinal (71.7%) and neurological symptoms (17.4%). Among the cohort, 78.3% of patients tolerated roflumilast without discontinuation, including 15.2% with dose reduction, while 21.7% discontinued due to intolerable AEs. Roflumilast demonstrated rapid and sustained efficacy in reducing OUs in BD and RAS. Although AEs were frequent, they were generally tolerable and manageable. While the study has limitations, including its retrospective observational nature and small sample size, it suggests roflumilast as a potential treatment alternative for refractory OUs where apremilast is unavailable, deserving further research.<\/jats:p>","DOI":"10.1111\/1346-8138.17972","type":"journal-article","created":{"date-parts":[[2025,9,23]],"date-time":"2025-09-23T12:15:16Z","timestamp":1758629716000},"page":"1713-1717","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Roflumilast for Oral Ulcers in Beh\u00e7et's Disease and Recurrent Aphthous Stomatitis"],"prefix":"10.1111","volume":"52","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2121-3553","authenticated-orcid":false,"given":"Kyung Bae","family":"Chung","sequence":"first","affiliation":[{"name":"Department of Dermatology, Cutaneous Biology Research Institute Yonsei University College of Medicine  Seoul Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hae June","family":"Sung","sequence":"additional","affiliation":[{"name":"Department of Dermatology, Cutaneous Biology Research Institute Yonsei University College of Medicine  Seoul Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eun Hye","family":"Kim","sequence":"additional","affiliation":[{"name":"Department of Dermatology, Cutaneous Biology Research Institute Yonsei University College of Medicine  Seoul Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hyunwoo","family":"Jang","sequence":"additional","affiliation":[{"name":"Department of Dermatology, Cutaneous Biology Research Institute Yonsei University College of Medicine  Seoul Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0194-9854","authenticated-orcid":false,"given":"Do\u2010Young","family":"Kim","sequence":"additional","affiliation":[{"name":"Department of Dermatology, Cutaneous Biology Research Institute Yonsei University College of Medicine  Seoul Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,9,23]]},"reference":[{"issue":"2","key":"e_1_2_8_2_1","article-title":"Recurrent Oral Ulcers and Its Association With Stress Among Dental Students in the Northeast Indian Population: A Cross\u2010Sectional Questionnaire\u2010Based Survey","volume":"15","author":"Verma S.","year":"2023","journal-title":"Cureus"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.3389\/fmed.2022.987393"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1093\/rheumatology\/keaa086"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1816594"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.55563\/clinexprheumatol\/ra8ize"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.3389\/fphar.2018.01048"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41584-021-00718-8"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.3349\/ymj.2016.57.4.928"},{"issue":"6","key":"e_1_2_8_10_1","first-page":"98","article-title":"Oral Ulcer Activity Assessment With the Composite Index According to Different Treatment Modalities in Behcet's Syndrome: A Multicentre Study","volume":"37","author":"Mumcu G.","year":"2019","journal-title":"Clinical and Experimental 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