P76: Long‐term oral prednisolone exposure in primary care for bullous pemphigoid: a population‐based study

(4%) each for oral Crohn disease (CD) and discoid lupus erythematous (DLE). The mean duration of the underlying condition was 5 4 years (range 7 months–20 years). Twenty (87%) patients used topical steroids while taking hydroxychloroquine. Of the patients whose weight was measured at baseline (n = 20), 75% (n = 15) were initiated on a dose < 5 mg kg and 90% (n = 18) < 6 5 mg kg. The maximum dose was kept at < 6 5 mg kg in 75% of cases. Duration of treatment ranged from 1 week to 55 months (mean 21 months). Routine haematological and biochemical investigations were done, as recommended by national guidelines, in all patients. Treatment efficacy was assessed by the presence of adjective terms in the case records that would indicate either response (‘improved’, ‘better’, ‘cleared’) or nonresponse (‘no better’, ‘worse’, ‘same’). Overall, 15 (65%) of patients demonstrated a response to treatment after 6 months. Response rates for individual conditions were 63% (n = 10/16) for OLP, 67% (n = 2/3) for OFG, 100% (n = 2/2) for MMP, 100% (n = 1/1) for oral CD and 0% (n = 0/1) for DLE. Side-effects, including nausea and rash, occurred in two patient, five patients had no response and one patient was lost to follow-up. The mechanisms of action of hydroxychloroquine that have been identified include inhibition of antigen presentation and Toll-like receptor signalling, reducing the production of proinflammatory cytokines. While the available evidence is sparse, hydroxychloroquine has been reported to be effective in the management of oral lichen planus with a case series demonstrating either full or partial improvement in 17/21 cases. Further robust studies are required to assess the effectiveness of hydroxychloroquine in inflammatory oral mucosal conditions.