{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,19]],"date-time":"2026-09-19T10:33:32Z","timestamp":1789814012650,"version":"4.0.1"},"reference-count":113,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2012,4,4]],"date-time":"2012-04-04T00:00:00Z","timestamp":1333497600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Oral Diseases"],"published-print":{"date-parts":[[2013,1]]},"abstract":"<jats:p><jats:italic>Oral Diseases<\/jats:italic> (2012) <jats:bold>19<\/jats:bold>, 37\u201345<\/jats:p><jats:p>Inflammatory ulcerative diseases of the oral mucosa are wide ranging but include especially aphthous and aphthous\u2010like ulceration, vesiculobullous disorders and erosive lichen planus (LP). While most patients with these conditions respond to conventional topical and\/or systemic immunosuppressive agents, treatment\u2010resistant cases remain challenging. In these, the use of biologics such as tumour necrosis factor alpha (TNF\u2010\u03b1) inhibitors or rituximab may be of benefit. This article reviews the use of biologics in ulcerative oral conditions, highlighting potential benefits, adverse effects and principles of use and future developments. TNF\u2010\u03b1 inhibitors such as infliximab can be effective in inducing resolution in oral aphthous and aphthous\u2010like ulcers and may be an appropriate therapy in those patients in which disease is severe and refractory to, or patients are intolerant of, traditional immunomodulatory regimens. There would also seem support and rationale for use of biologics (mainly rituximab) in pemphigus but not in oral LP or other oral ulcerative conditions.<\/jats:p>","DOI":"10.1111\/j.1601-0825.2012.01931.x","type":"journal-article","created":{"date-parts":[[2012,3,13]],"date-time":"2012-03-13T18:00:43Z","timestamp":1331661643000},"page":"37-45","source":"Crossref","is-referenced-by-count":37,"title":["Biologics in oral medicine: ulcerative disorders"],"prefix":"10.1111","volume":"19","author":[{"given":"ID","family":"O\u2019Neill","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"C","family":"Scully","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2012,4,4]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa062930"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00296-009-1276-x"},{"key":"e_1_2_7_4_1","first-page":"S99","article-title":"Infliximab for the treatment of resistant oral ulcers in Beh\u00e7et\u2019s disease: a case report and review of the literature","volume":"25","author":"Almoznino G","year":"2007","journal-title":"Clin Exp Rheumatol"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.semarthrit.2010.09.002"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaad.2008.09.032"},{"key":"e_1_2_7_7_1","first-page":"729","article-title":"Successful treatment of resistant Beh\u00e7et\u2019s disease with etanercept","volume":"23","author":"Atzeni F","year":"2005","journal-title":"Clin Exp Rheumatol"},{"key":"e_1_2_7_8_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1601-0825.2011.01840.x"},{"key":"e_1_2_7_9_1","first-page":"245","article-title":"Treatment of recalcitrant pemphigus vulgaris with tumor necrosis factor alpha antagonist etanercept","volume":"74","author":"Berookhim B","year":"2004","journal-title":"Cutis"},{"key":"e_1_2_7_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.tripleo.2011.04.009"},{"key":"e_1_2_7_11_1","doi-asserted-by":"publisher","DOI":"10.1159\/000243805"},{"key":"e_1_2_7_12_1","first-page":"269","article-title":"Anti\u2010CD20 monoclonal antibody (rituximab) for refractory erosive stomatitis secondary to CD20(+) follicular lymphoma\u2010associated paraneoplastic pemphigus","volume":"137","author":"Borradori L","year":"2001","journal-title":"Arch Dermatol"},{"key":"e_1_2_7_13_1","doi-asserted-by":"publisher","DOI":"10.1159\/000318008"},{"key":"e_1_2_7_14_1","doi-asserted-by":"publisher","DOI":"10.1001\/archderm.143.4.519"},{"key":"e_1_2_7_15_1","doi-asserted-by":"publisher","DOI":"10.1136\/ard.2010.144998"},{"key":"e_1_2_7_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.reuma.2010.10.003"},{"key":"e_1_2_7_17_1","doi-asserted-by":"publisher","DOI":"10.1001\/archderm.142.11.1457"},{"key":"e_1_2_7_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.annder.2009.02.007"},{"key":"e_1_2_7_19_1","first-page":"379","article-title":"Alefacept for erosive lichen planus: a case series","volume":"7","author":"Chang AL","year":"2008","journal-title":"J Drugs Dermatol"},{"key":"e_1_2_7_20_1","first-page":"325","article-title":"Adalimumab in the management of cutaneous and oral lichen planus","volume":"84","author":"Chao TJ","year":"2009","journal-title":"Cutis"},{"key":"e_1_2_7_21_1","doi-asserted-by":"publisher","DOI":"10.1001\/archderm.142.6.680"},{"key":"e_1_2_7_22_1","doi-asserted-by":"publisher","DOI":"10.1001\/archderm.143.8.1033"},{"key":"e_1_2_7_23_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaad.2011.11.007"},{"key":"e_1_2_7_24_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1601-0825.2011.01899.x"},{"key":"e_1_2_7_25_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2133.2005.06914.x"},{"key":"e_1_2_7_26_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-0714.2011.01017.x"},{"key":"e_1_2_7_27_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2133.2006.07596.x"},{"key":"e_1_2_7_28_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10067-008-0857-5"},{"key":"e_1_2_7_29_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1468-3083.2008.02929.x"},{"key":"e_1_2_7_30_1","doi-asserted-by":"publisher","DOI":"10.1038\/ajg.2010.392"},{"key":"e_1_2_7_31_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-0714.2010.00976.x"},{"key":"e_1_2_7_32_1","doi-asserted-by":"publisher","DOI":"10.1093\/rheumatology\/41.10.1213-b"},{"key":"e_1_2_7_33_1","doi-asserted-by":"publisher","DOI":"10.1586\/eci.11.22"},{"key":"e_1_2_7_34_1","doi-asserted-by":"publisher","DOI":"10.1001\/archdermatol.2010.409"},{"key":"e_1_2_7_35_1","doi-asserted-by":"publisher","DOI":"10.1001\/archderm.142.2.151"},{"key":"e_1_2_7_36_1","doi-asserted-by":"publisher","DOI":"10.1159\/000287254"},{"key":"e_1_2_7_37_1","doi-asserted-by":"publisher","DOI":"10.1136\/ard.2010.146852"},{"key":"e_1_2_7_38_1","doi-asserted-by":"publisher","DOI":"10.1097\/RHU.0b013e3181dfce16"},{"key":"e_1_2_7_39_1","doi-asserted-by":"publisher","DOI":"10.1136\/ard.60.6.637"},{"key":"e_1_2_7_40_1","doi-asserted-by":"publisher","DOI":"10.1136\/ard.2007.080432"},{"key":"e_1_2_7_41_1","doi-asserted-by":"publisher","DOI":"10.1001\/archderm.142.10.1268"},{"key":"e_1_2_7_42_1","first-page":"310","article-title":"A single\u2010center, open\u2010label, prospective pilot study of subcutaneous efalizumab for oral erosive lichen planus","volume":"6","author":"Heffernan MP","year":"2007","journal-title":"J Drugs Dermatol"},{"key":"e_1_2_7_43_1","doi-asserted-by":"publisher","DOI":"10.1097\/MD.0b013e3181dfca14"},{"key":"e_1_2_7_44_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1365-2133.2003.05209_10.x"},{"key":"e_1_2_7_45_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1610-0387.2007.06602.x"},{"key":"e_1_2_7_46_1","doi-asserted-by":"publisher","DOI":"10.1001\/archdermatol.2011.167"},{"key":"e_1_2_7_47_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaad.2010.10.034"},{"key":"e_1_2_7_48_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2133.2005.06744.x"},{"key":"e_1_2_7_49_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1468-3083.2007.02270.x"},{"key":"e_1_2_7_50_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2133.2009.09132.x"},{"key":"e_1_2_7_51_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa067752"},{"key":"e_1_2_7_52_1","doi-asserted-by":"publisher","DOI":"10.2177\/jsci.33.157"},{"key":"e_1_2_7_53_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaad.2010.07.032"},{"key":"e_1_2_7_54_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00296-004-0467-8"},{"key":"e_1_2_7_55_1","first-page":"68","article-title":"Recalcitrant cicatricial pemphigoid treated with the anti\u2010TNF\u2010alpha agent etanercept","volume":"9","author":"Kennedy JS","year":"2010","journal-title":"J Drugs Dermatol"},{"key":"e_1_2_7_56_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2133.2011.10411.x"},{"key":"e_1_2_7_57_1","doi-asserted-by":"publisher","DOI":"10.1001\/archdermatol.2009.175"},{"key":"e_1_2_7_58_1","doi-asserted-by":"publisher","DOI":"10.1136\/ard.2006.064279"},{"key":"e_1_2_7_59_1","doi-asserted-by":"publisher","DOI":"10.1001\/archdermatol.2011.54"},{"key":"e_1_2_7_60_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaad.2009.09.045"},{"key":"e_1_2_7_61_1","doi-asserted-by":"publisher","DOI":"10.1001\/archderm.141.6.680"},{"key":"e_1_2_7_62_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1601-0825.2010.01670.x"},{"key":"e_1_2_7_63_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1468-3083.2010.03889.x"},{"key":"e_1_2_7_64_1","doi-asserted-by":"publisher","DOI":"10.1093\/rheumatology\/keq368"},{"key":"e_1_2_7_65_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaad.2010.04.039"},{"key":"e_1_2_7_66_1","first-page":"98","article-title":"Short\u2010term trial of etanercept in Beh\u00e7et\u2019s disease: a double blind, placebo controlled study","volume":"32","author":"Melikoglu M","year":"2005","journal-title":"J Rheumatol"},{"key":"e_1_2_7_67_1","unstructured":"MullerS McCrearyC MurphyM(2008).Vulvovaginal\u2010gingival lichen planus with initial response to infliximab. Irish Association of Dermatologists Spring meeting (Abstract 08)."},{"key":"e_1_2_7_68_1","doi-asserted-by":"publisher","DOI":"10.1007\/978-1-4419-6612-4_43"},{"key":"e_1_2_7_69_1","doi-asserted-by":"publisher","DOI":"10.1093\/rheumatology\/keq240"},{"key":"e_1_2_7_70_1","doi-asserted-by":"publisher","DOI":"10.1001\/archderm.143.2.192"},{"key":"e_1_2_7_71_1","first-page":"930","article-title":"Successful treatment of severe Beh\u00e7et\u2019s disease with infliximab in an Italian Olympic athlete","volume":"35","author":"Olivieri I","year":"2008","journal-title":"J Rheumatol"},{"key":"e_1_2_7_72_1","doi-asserted-by":"publisher","DOI":"10.3899\/jrheum.081063"},{"key":"e_1_2_7_73_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-0714.2008.00693.x"},{"key":"e_1_2_7_74_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2133.2010.09704.x"},{"key":"e_1_2_7_75_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1468-3083.2011.04041.x"},{"key":"e_1_2_7_76_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1601-0825.2012.01919.x"},{"key":"e_1_2_7_77_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2133.2005.06672.x"},{"key":"e_1_2_7_78_1","doi-asserted-by":"publisher","DOI":"10.1001\/archderm.144.11.1427"},{"key":"e_1_2_7_79_1","first-page":"1","article-title":"Effectiveness and side effects of anti\u2010CD20 therapy for autoantibody\u2010mediated blistering skin diseases: a comprehensive survey of 71 consecutive patients from the Initial use to 2007","volume":"5","author":"Peterson JD","year":"2009","journal-title":"Ther Clin Risk Manag"},{"key":"e_1_2_7_80_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10266-011-0008-3"},{"key":"e_1_2_7_81_1","first-page":"645","article-title":"Tumour necrosis factor\u2010\u03b1 antagonists in patients with concurrent psoriasis and hepatitis B or hepatitis C: a retrospective analysis of 17 patients","volume":"64","author":"Prignano F","year":"2011","journal-title":"Br J Dermatol"},{"key":"e_1_2_7_82_1","doi-asserted-by":"publisher","DOI":"10.1097\/RHU.0b013e3181df8932"},{"key":"e_1_2_7_83_1","doi-asserted-by":"publisher","DOI":"10.1001\/archderm.138.8.1100"},{"key":"e_1_2_7_84_1","doi-asserted-by":"publisher","DOI":"10.1093\/rheumatology\/40.4.473"},{"key":"e_1_2_7_85_1","doi-asserted-by":"publisher","DOI":"10.1001\/archderm.139.10.1259"},{"key":"e_1_2_7_86_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.stomax.2009.07.002"},{"key":"e_1_2_7_87_1","doi-asserted-by":"publisher","DOI":"10.1067\/mjd.2001.119100"},{"key":"e_1_2_7_88_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2133.2007.08048.x"},{"key":"e_1_2_7_89_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2230.2009.03608.x"},{"key":"e_1_2_7_90_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1468-3083.2008.02790.x"},{"key":"e_1_2_7_91_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1601-0825.2011.01793.x"},{"key":"e_1_2_7_92_1","doi-asserted-by":"publisher","DOI":"10.1002\/art.11204"},{"key":"e_1_2_7_93_1","first-page":"733","article-title":"Treatment of recurrent oral aphthous ulcers with etanercept","volume":"20","author":"Scheinberg MA","year":"2002","journal-title":"Clin Exp Rheumatol"},{"key":"e_1_2_7_94_1","first-page":"399","article-title":"The diagnosis and treatment of autoimmune blistering skin diseases","volume":"108","author":"Schmidt E","year":"2011","journal-title":"Dtsch Arztebl Int"},{"key":"e_1_2_7_95_1","doi-asserted-by":"publisher","DOI":"10.1001\/archderm.142.2.147"},{"key":"e_1_2_7_96_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2133.2006.07646.x"},{"key":"e_1_2_7_97_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMcp054630"},{"key":"e_1_2_7_98_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.bjoms.2007.07.199"},{"key":"e_1_2_7_99_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.tripleo.2008.07.014"},{"key":"e_1_2_7_100_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1601-0825.2008.01484.x"},{"key":"e_1_2_7_101_1","doi-asserted-by":"publisher","DOI":"10.1093\/rheumatology\/kem034"},{"key":"e_1_2_7_102_1","first-page":"940","article-title":"Successful treatment of pemphigus vulgaris with etanercept in four patients","volume":"8","author":"Shetty A","year":"2009","journal-title":"J Drugs Dermatol"},{"key":"e_1_2_7_103_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2133.2009.09505.x"},{"key":"e_1_2_7_104_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaad.2004.11.031"},{"key":"e_1_2_7_105_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1742-481X.2006.00233.x"},{"key":"e_1_2_7_106_1","first-page":"68","article-title":"The treatment of lower leg ulcers with topical etanercept","volume":"8","author":"Tam A","year":"2007","journal-title":"J Am Osteopath Coll Dermatol"},{"key":"e_1_2_7_107_1","first-page":"129","article-title":"Treatment of severe, recalcitrant, major aphthous stomatitis with adalimumab","volume":"76","author":"Vujevich J","year":"2005","journal-title":"Cutis"},{"key":"e_1_2_7_108_1","doi-asserted-by":"publisher","DOI":"10.1159\/000106585"},{"key":"e_1_2_7_109_1","doi-asserted-by":"publisher","DOI":"10.1093\/rheumatology\/keq155"},{"key":"e_1_2_7_110_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.tripleo.2010.03.034"},{"key":"e_1_2_7_111_1","doi-asserted-by":"publisher","DOI":"10.2165\/00128071-200708020-00010"},{"key":"e_1_2_7_112_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-0714.2011.01029.x"},{"key":"e_1_2_7_113_1","doi-asserted-by":"publisher","DOI":"10.1001\/archdermatol.2011.166"},{"key":"e_1_2_7_114_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1468-3083.2007.02182.x"}],"container-title":["Oral Diseases"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1111%2Fj.1601-0825.2012.01931.x","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/j.1601-0825.2012.01931.x","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,10,30]],"date-time":"2023-10-30T01:25:11Z","timestamp":1698629111000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/j.1601-0825.2012.01931.x"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2012,4,4]]},"references-count":113,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2013,1]]}},"alternative-id":["10.1111\/j.1601-0825.2012.01931.x"],"URL":"https:\/\/doi.org\/10.1111\/j.1601-0825.2012.01931.x","archive":["Portico"],"relation":{},"ISSN":["1354-523X","1601-0825"],"issn-type":[{"value":"1354-523X","type":"print"},{"value":"1601-0825","type":"electronic"}],"subject":[],"published":{"date-parts":[[2012,4,4]]}}}