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Lavoro A, Cultrera G, Gattuso G, Lombardo C, Falzone L, Saverio C, Libra M, Salmeri M. Role of Oral Microbiota Dysbiosis in the Development and Progression of Oral Lichen Planus. J Pers Med 2024; 14:386. [PMID: 38673013 PMCID: PMC11050998 DOI: 10.3390/jpm14040386] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2024] [Revised: 03/25/2024] [Accepted: 04/01/2024] [Indexed: 04/28/2024] Open
Abstract
Oral lichen planus (OLP) is a chronic inflammatory autoimmune disease of the oral cavity with malignant potential affecting 1.01% of the worldwide population. The clinical patterns of this oral disorder, characterized by relapses and remissions of the lesions, appear on buccal, lingual, gingival, and labial mucosa causing a significant reduction in the quality of life. Currently, there are no specific treatments for this disease, and the available therapies with topical and systemic corticosteroids only reduce symptoms. Although the etiopathogenesis of this pathological condition has not been completely understood yet, several exogenous and endogenous risk factors have been proposed over the years. The present review article summarized the underlying mechanisms of action involved in the onset of OLP and the most well-known triggering factors. According to the current data, oral microbiota dysbiosis could represent a potential diagnostic biomarker for OLP. However, further studies should be undertaken to validate their use in clinical practice, as well as to provide a better understanding of mechanisms of action and develop novel effective intervention strategies against OLP.
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Affiliation(s)
- Alessandro Lavoro
- Department of Biomedical and Biotechnological Sciences, University of Catania, Via Santa Sofia 97, 95123 Catania, Italy; (A.L.); (G.C.); (G.G.); (C.L.); (C.S.); (M.L.); (M.S.)
| | - Giovanni Cultrera
- Department of Biomedical and Biotechnological Sciences, University of Catania, Via Santa Sofia 97, 95123 Catania, Italy; (A.L.); (G.C.); (G.G.); (C.L.); (C.S.); (M.L.); (M.S.)
| | - Giuseppe Gattuso
- Department of Biomedical and Biotechnological Sciences, University of Catania, Via Santa Sofia 97, 95123 Catania, Italy; (A.L.); (G.C.); (G.G.); (C.L.); (C.S.); (M.L.); (M.S.)
| | - Cinzia Lombardo
- Department of Biomedical and Biotechnological Sciences, University of Catania, Via Santa Sofia 97, 95123 Catania, Italy; (A.L.); (G.C.); (G.G.); (C.L.); (C.S.); (M.L.); (M.S.)
| | - Luca Falzone
- Department of Biomedical and Biotechnological Sciences, University of Catania, Via Santa Sofia 97, 95123 Catania, Italy; (A.L.); (G.C.); (G.G.); (C.L.); (C.S.); (M.L.); (M.S.)
| | - Candido Saverio
- Department of Biomedical and Biotechnological Sciences, University of Catania, Via Santa Sofia 97, 95123 Catania, Italy; (A.L.); (G.C.); (G.G.); (C.L.); (C.S.); (M.L.); (M.S.)
- Research Center for Prevention, Diagnosis and Treatment of Cancer, University of Catania, 95123 Catania, Italy
| | - Massimo Libra
- Department of Biomedical and Biotechnological Sciences, University of Catania, Via Santa Sofia 97, 95123 Catania, Italy; (A.L.); (G.C.); (G.G.); (C.L.); (C.S.); (M.L.); (M.S.)
- Research Center for Prevention, Diagnosis and Treatment of Cancer, University of Catania, 95123 Catania, Italy
| | - Mario Salmeri
- Department of Biomedical and Biotechnological Sciences, University of Catania, Via Santa Sofia 97, 95123 Catania, Italy; (A.L.); (G.C.); (G.G.); (C.L.); (C.S.); (M.L.); (M.S.)
- Research Center for Prevention, Diagnosis and Treatment of Cancer, University of Catania, 95123 Catania, Italy
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Islam NM, Alramadhan SA. Lichenoid Lesions of the Oral Mucosa. Oral Maxillofac Surg Clin North Am 2023; 35:189-202. [PMID: 36805899 DOI: 10.1016/j.coms.2022.10.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/17/2023]
Abstract
Lichenoid lesions involving the oral cavity present with an array of complex clinical manifestations and etiologies. The etiology ranges from local factors, systemic entities, and even autoimmune conditions. Several different types of lichenoid lesions may affect the oral cavity, and it is imperative that these are correctly diagnosed to ensure effective patient care. Lichenoid lesions such as chronic ulcerative stomatitis prove to be challenging as these are recalcitrant, present with overlapping features, require unique treatment and patients suffer a long time if not promptly diagnosed.
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Affiliation(s)
- Nadim M Islam
- Department of Oral and Maxillofacial Diagnostic Sciences, University of Florida College of Dentistry, 1395 Center Drive, Gainesville, FL 32610, USA.
| | - Saja A Alramadhan
- Department of Oral and Maxillofacial Diagnostic Sciences, University of Florida College of Dentistry, 1395 Center Drive, Gainesville, FL 32610, USA
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Utz S, Suter V, Cazzaniga S, Borradori L, Feldmeyer L. Outcome and long-term treatment protocol for topical tacrolimus in oral lichen planus. J Eur Acad Dermatol Venereol 2022; 36:2459-2465. [PMID: 35870137 PMCID: PMC9804806 DOI: 10.1111/jdv.18457] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2021] [Accepted: 07/12/2022] [Indexed: 01/09/2023]
Abstract
BACKGROUND AND OBJECTIVE Topical tacrolimus has been shown to be beneficial in the treatment of oral lichen planus (OLP). However, long-term effects and its optimal application protocol with gradual reduction have not been studied. Accordingly, we analysed the clinical response of OLP to tacrolimus in our daily clinical practice with a focus on the optimal long-term therapeutic scheme. METHODS Retrospective analysis of all consecutive patients diagnosed with OLP and treated with topical tacrolimus (0.03% oral rinse) in a clinical setting between 2015 and 2020. The objective clinical response was measured by a 4-point scale (complete remission, major remission, partial remission and no response), and subjective impairment by a 3-point scale (severe, moderate and none). RESULTS Fifty-seven patients (74% women; median age: 66 years) were included. Fifty-six (98%) patients had prior treatment with topical steroids. After introduction of tacrolimus, objective remission (major or complete) was reached by 28%, 62%, 87% and 97% of patients after 3, 6, 12 and 24 months respectively. Subjective remission was reported by 16%, 48%, 69% and 83% after 3, 6, 12 and 24 months of treatment respectively. The treatment frequency could be gradually reduced from initially twice daily to once daily or less in 28%, 61%, 78% and 87% after 3, 6, 12 and 24 months respectively; 41% of patients completely suspended the treatment at one point, but 67% of them experienced a relapse after a median time of 3.3 months. Four patients (7%) developed a squamous cell carcinoma (SCC) during the observation period. Otherwise, there were only few and minor side-effects. CONCLUSION Topical tacrolimus can be an effective second-line therapy for OLP refractory to potent topical corticosteroids. The therapy frequency can often be reduced during the maintenance period. Both signs of clinical activity and subjective impairment should guide therapy. Regular follow-up is necessary to recognize possible SCC.
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Affiliation(s)
- S. Utz
- Department of Dermatology, Inselspital Bern University HospitalUniversity of BernBernSwitzerland
| | - V.G.A. Suter
- Department of Oral Surgery and Stomatology, School of Dental MedicineUniversity of BernBernSwitzerland
| | - S. Cazzaniga
- Department of Dermatology, Inselspital Bern University HospitalUniversity of BernBernSwitzerland,Centro Studi GISEDBergamoItaly
| | - L. Borradori
- Department of Dermatology, Inselspital Bern University HospitalUniversity of BernBernSwitzerland
| | - L. Feldmeyer
- Department of Dermatology, Inselspital Bern University HospitalUniversity of BernBernSwitzerland
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Marques LC, de Medeiros Nunes da Silva LA, Santos PDPM, de Almeida Lima Borba Lopes A, Cunha KS, Milagres A, Rozza-de-Menezes RE, Junior AS, Conde DC. Oral lichenoid lesion in association with chemotherapy treatment for non-Hodgkin lymphoma or lichen planus? Review of the literature and report of two challenging cases. Head Face Med 2022; 18:32. [PMID: 36068636 PMCID: PMC9447333 DOI: 10.1186/s13005-022-00333-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2022] [Accepted: 08/23/2022] [Indexed: 12/03/2022] Open
Abstract
Background The diagnosis of oral lichenoid lesions (OLL) remains a challenge for clinicians and pathologists. Although, in many cases, OLL cannot be clinically and histopathologically distinguishable from oral lichen planus (OLP), one important difference between these lesions is that OLL has an identifiable etiological factor, e.g. medication, restorative material, and food allergy. The list of drugs that can cause OLL is extensive and includes anti-inflammatory drugs, anticonvulsants, antihypertensives, antivirals, antibiotics, chemotherapeutics, among others. This work aimed to perform a literature review of OLL related to chemotherapy drugs and to report two cases of possible OLL in patients with B-cell and T-cell non-Hodgkin lymphomas in use of chemotherapy and adjuvant medications. We also discuss the challenge to clinically and histopathologically differentiate OLL and OLP. Case presentation In both cases, oral lesions presented reticular, atrophic, erosive/ulcerated, and plaque patterns. The diagnosis of OLL was initially established in both cases by the association of histopathology and history of onset of lesions after the use of medications. Although the patients have presented a significant improvement in the oral clinical picture for more than 2 years of follow-up, they still have some lesions. Conclusion A well-detailed anamnesis associated with the drug history, temporal relationship of the appearance of the lesions, and follow-up of patients are fundamental for the diagnosis of OLL related to drugs. Nevertheless, its differentiation from OLP is still a challenge.
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Affiliation(s)
- Letícia Côgo Marques
- Postgraduate Program in Pathology, School of Medicine, Universidade Federal Fluminense (UFF), Niterói, RJ, Brazil
| | | | | | | | - Karin Soares Cunha
- Postgraduate Program in Pathology, School of Medicine, Universidade Federal Fluminense (UFF), Niterói, RJ, Brazil
| | - Adrianna Milagres
- Department of Pathology, School of Medicine, Universidade Federal Fluminense (UFF), Niterói, RJ, Brazil
| | | | - Arley Silva Junior
- Postgraduate Program in Pathology, School of Medicine, Universidade Federal Fluminense (UFF), Niterói, RJ, Brazil
| | - Danielle Castex Conde
- Postgraduate Program in Pathology, School of Medicine, Universidade Federal Fluminense (UFF), Niterói, RJ, Brazil.
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Prevalence of oral lichen planus among north Indian population: a descriptive epidemiological study. EUREKA: HEALTH SCIENCES 2022. [DOI: 10.21303/2504-5679.2022.002437] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
The aim: oral lichen planus is a chronic inflammatory disease affecting the oral mucous membrane. It can present in various clinical forms: reticular, papular, plaque-like, atrophic, erosive and bullous. Though the exact etiology is not certain - autoimmunity, trauma, stress, and habits are considered as etiological factors. Oral lichen planus has been classified as a premalignant lesion. The present study aims to describe the prevalence of oral lichen planus in a sample of north Indian population.
Materials and methods: the present study was conducted in the outpatient department of Dentistry, GMC Badaun. The parameters recorded were age, gender and site affected. The data was collected and analysed.
Results: a total of 6263 patients reported to the outpatient department of dentistry out of which 43 patients were diagnosed with oral lichen planus. The overall prevalence of oral lichen planus was found to be 0.69 %. The mean age of disease presentation was 37.5 years. A higher prevalence of oral lichen planus was reported in females compared to males with a ratio of 1:1.15. Most affected site was found to be buccal mucosa bilaterally (58.14 %).
Conclusion: the present study estimated the overall prevalence of oral lichen planus as well as its distribution according to age, gender and site in north Indian population. This could contribute to the precise assessment of the disease for better policy making for better treatment and management of oral lichen planus.
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Fractal Dimension and Texture Analysis of Lesion Autofluorescence in the Evaluation of Oral Lichen Planus Treatment Effectiveness. MATERIALS 2021; 14:ma14185448. [PMID: 34576672 PMCID: PMC8466626 DOI: 10.3390/ma14185448] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/01/2021] [Revised: 09/14/2021] [Accepted: 09/17/2021] [Indexed: 12/19/2022]
Abstract
BACKGROUND Oral Lichen planus (OLP) is a chronic inflammatory disease. Topical steroids are used as the treatment of choice. The alternative is photodynamic therapy (PDT). The study aimed to fabricate optimal biodegradable matrices for methylene blue or triamcinolone acetonide because of a lack of currently commercially available carriers that could adhere to the mucous. METHODS The study was designed as a 12-week single-blind prospective randomized clinical trial with 30 patients, full contralateral split-mouth design. Matrices for steroid and photosensitizer and laser device were fabricated. Fractal and texture analysis of photographs, taken in 405, 450, 405 + 450 nm wavelength, of lesions was performed to increase the objectivity of the assessment of treatment. RESULTS We achieved two total responses for treatment in case of steroid therapy and one in the case of PDT. Partial response was noted in 17 lesions treated using local steroid therapy and 21 in the case of PDT. No statistically significant differences were found between the effectiveness of both used methods. Statistically significant differences in fractal dimension before and after treatment were observed only in the analysis of photographs taken in 405 + 450 nm wavelength. CONCLUSIONS Photodynamic therapy and topical steroid therapy are effective methods for treating OLP. Using a carrier offers the possibility of a more predictable and effective method of drug delivery into the mucous membrane. Autofluorescence enables the detection of lesions especially at the early stage of their development.
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Parvathala P, Baghirath PV, Reddy CN, Vinay BH, Krishna AB, Naishadham PP. Horoscopic role of CD105 (Endoglin) in progression of oral lichen planus: An immunohistochemical study. J Oral Maxillofac Pathol 2021; 25:37-45. [PMID: 34349409 PMCID: PMC8272491 DOI: 10.4103/jomfp.jomfp_82_20] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2020] [Revised: 10/19/2020] [Accepted: 01/19/2021] [Indexed: 11/04/2022] Open
Abstract
Context Role of CD105(Endoglin) in Pathogenesis and progression of OLP. Aim To assess the role of neoangiogenesis in the progression of OLP by determining the expression of CD105 in OLP and normal mucosa. Settings and Design The present study includes a total of 70 formalin-fixed paraffin-embedded blocks of which the study group comprises 50 tissue sections histopathologically confirmed as OLP. They were subdivided into two groups - Group I (Reticular OLP) and Group II (Erosive OLP) - 25 each. The control group (designated as Group III) included 20 sections of normal mucosa. Materials and Methods All the sections were 4 μm thick and stained with CD105 antibodies. After identifying areas of highest vascularity (hot spots) in low power (×10) magnification, individual microvessels were counted manually at high power (×40) magnification. Statistical Analysis Used Analysis of variance test was used to determine the difference of microvessel density (MVD) between variants of OLP and normal mucosa and Cohen's kappa statistic was used to check interobserver variability. Results CD105 staining showed a mean MVD of 1.31 ± 1.8 in the normal mucosa compared to 1.68 ± 1.4 and 4.14 ± 2.7 in the reticular and erosive variants, respectively, with a P = 0.000*, which is statistically significant (*P < 0.05 is statistically significant). Conclusion Based on our observations, it is evident that compared to normal mucosa, MVD is greater in lichen planus. Within the two variants of OLP, MVD is higher in Erosive variant compared with Reticular variant, foreshadowing the role of neoangiogenesis in the progression of OLP and its possible malignant transformation.
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Affiliation(s)
- Poornima Parvathala
- CKS Theja Institute of Dental Sciences and Research, Tirupati, Andhra Pradesh, India
| | - P Venkat Baghirath
- Panineeya Mahavidyalaya Institute of Dental Sciences and Research Centre, Hyderabad, Telangana, India
| | - C Narendra Reddy
- Department of Surgical Oncology, SVIMS, Tirupati, Andhra Pradesh, India
| | - B Hari Vinay
- Panineeya Mahavidyalaya Institute of Dental Sciences and Research Centre, Hyderabad, Telangana, India
| | - A Bhargavi Krishna
- Panineeya Mahavidyalaya Institute of Dental Sciences and Research Centre, Hyderabad, Telangana, India
| | - Parameshwar P Naishadham
- Panineeya Mahavidyalaya Institute of Dental Sciences and Research Centre, Hyderabad, Telangana, India
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Akama MSK, Teixeira LR, Innocentini LMAR, Gallo CDB, Pinheiro TN, Ribeiro-Silva A, Motta ACF. Laminin-332 expression in oral lichen planus: Preliminary results of a cross-sectional study. Oral Dis 2021; 27:942-946. [PMID: 32790894 DOI: 10.1111/odi.13612] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2020] [Revised: 07/22/2020] [Accepted: 08/09/2020] [Indexed: 12/19/2022]
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Marques LC, Santos LR, da Silva NC, Cunha KS, Junior AS, Conde DC. Oral Lichen Planus Associated With Lichen Planus Pigmentosus and Lichen Sclerosus in Monozygotic Twins. Am J Dermatopathol 2021; 43:368-372. [PMID: 33395041 DOI: 10.1097/dad.0000000000001847] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
ABSTRACT Lichen planus (LP) is a mucocutaneous immune-mediated disease of unknown etiology. It is more prevalent in women and usually occurs between the third and sixth decades of life. Oral lesions may or may not be associated with skin and genital lesions. Although the role of genetic factors is still undetermined, reports of LP in more than one family member are not uncommon. However, the occurrence of LP in monozygotic twins is rare. We report a rare case of 42-year-old female monozygotic twins presenting oral LP. This report is even rarer because one of the patients had cutaneous lesions of an unusual variant of LP (LP pigmentosus) and the other had an uncommon association with lichen sclerosus. The etiology and pathogenesis of LP are still uncertain. However, despite being rare, its occurrence in family members and monozygotic twins suggests that genetic factors are involved in its development.
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Affiliation(s)
- Letícia Côgo Marques
- Postgraduate Program in Pathology, School of Medicine, Fluminense Federal University, Niterói, RJ, Brazil
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Wang XS, Sun Z, Liu LW, Du QZ, Liu ZS, Yang YJ, Xue P, Zhao HY. Potential Metabolic Biomarkers for Early Detection of Oral Lichen Planus, a Precancerous Lesion. Front Pharmacol 2020; 11:603899. [PMID: 33240093 PMCID: PMC7677577 DOI: 10.3389/fphar.2020.603899] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2020] [Accepted: 10/05/2020] [Indexed: 12/31/2022] Open
Abstract
Background: Oral lichen planus (OLP) is a T-cell-mediated chronic inflammatory disorder and precancerous oral lesion with high incidence. The current diagnostic method of OLP is very limited and metabolomics may provide a new approach for quantitative evaluation. Methods: The Ultra-Performance Liquid Chromatography-Quadrupole/Orbitrap High Resolution Mass Spectrometry (UHPLC-Q-Orbitrap HRMS) was applied to analyze the change of metabolites in serum of patients with OLP. A total of 115 OLP patients and 124 healthy controls were assigned to either a training set (n = 160) or a test set (n = 79). The potential biomarkers and the change of serum metabolites were profiled and evaluated by multivariate analysis. Results: Totally, 23 differential metabolites were identified in the training set between OLP group and healthy group. Three prominent metabolites in receiver operating characteristic (ROC) were selected as a panel to distinguish OLP or healthy individuals in the test set, and the diagnostic accuracy was 86.1%. Conclusions: This study established a new method for the early detection of OLP by analyzing serum metabolomics using UHPLC-Q-Orbitrap HRMS, which will help in understanding the pathological processes of OLP and identifying precancerous lesions in oral cavity.
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Affiliation(s)
- Xiao-Shuang Wang
- Stomatological Hospital of Henan Province, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China.,School and Hospital of Stomatology of Zhengzhou University, Zhengzhou, China
| | - Zhi Sun
- Department of Pharmacy, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China.,Henan Key Laboratory of Precision Clinical Pharmacy, Zhengzhou, China
| | - Li-Wei Liu
- Department of Pharmacy, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China.,Henan Key Laboratory of Precision Clinical Pharmacy, Zhengzhou, China
| | - Qiu-Zheng Du
- Department of Pharmacy, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China.,Henan Key Laboratory of Precision Clinical Pharmacy, Zhengzhou, China
| | - Zhang-Suo Liu
- Department of Nephrology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Yan-Jie Yang
- Stomatological Hospital of Henan Province, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China.,School and Hospital of Stomatology of Zhengzhou University, Zhengzhou, China
| | - Peng Xue
- Health Management Centre, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Hong-Yu Zhao
- Stomatological Hospital of Henan Province, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China.,School and Hospital of Stomatology of Zhengzhou University, Zhengzhou, China
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Rotaru DI, Sofineti D, Bolboacă SD, Bulboacă AE. Diagnostic Criteria of Oral Lichen Planus: A Narrative Review. Acta Clin Croat 2020; 59:513-522. [PMID: 34177062 PMCID: PMC8212651 DOI: 10.20471/acc.2020.59.03.16] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2018] [Accepted: 11/27/2018] [Indexed: 01/29/2023] Open
Abstract
Oral lichen planus (OLP) is a disease with unclear etiology or pathogenesis, categorized by the World Health Organization as oral lichenoid lesions (OLL; interface mucositis or lichenoid mucositis) into a group of potentially malignant disorders. The diagnosis of OLP is challenging because the clinical and histopathologic features are frequently seen in OLP, OLL and/or other mucosal diseases with lichenoid characteristics. Furthermore, OLP has a dynamic nature. Finally, an early and precise diagnosis can play a decisive role, allowing timely treatment and thus improving the patient quality of life. This article summarizes the state-of-the-art regarding OLP and OLL and discusses the challenges faced on making an accurate diagnosis, aiming to provide a practical guideline for the postgraduates and oral physicians in reaching the diagnosis of these lesions.
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Abstract
Chronic oral mucosal lesions can be associated with several mucocutaneous diseases. This article reviews the autoimmune and immune-mediated, reactive, genetic, and infectious diseases that may present with chronic oral and/or cutaneous manifestations and provides a rational approach to diagnosis and management.
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Kitkhajornkiat A, Rungsiyanont S, Talungchit S, Jirawechwongsakul P, Taebunpakul P. The expression of Cathepsin L in oral lichen planus. J Oral Biol Craniofac Res 2020; 10:281-286. [PMID: 32612918 DOI: 10.1016/j.jobcr.2020.06.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2020] [Revised: 05/21/2020] [Accepted: 06/14/2020] [Indexed: 11/19/2022] Open
Abstract
Background Malignant transformation of oral lichen planus (OLP) was reported particularly in erosive type, however, it remains inconclusive. Cathepsin L was shown to promote tumor growth and invasion in many cancers. Therefore, cathepsin L expression in erosive and non-erosive OLP compared with oral epithelial dysplasia and oral squamous cell carcinoma (OSCC) were investigated. Methods Thirty specimens of OLP (15 cases each of erosive and non-erosive OLP), 10 cases of oral epithelial dysplasia and 10 cases of OSCC were included. Ten healthy gingiva specimens were served as controls. All specimens were stained with cathepsin L antibody using immunohistochemistry technique. Results Cathepsin L was expressed in all OLP and OSCC cases. In oral epithelial dysplasia and healthy gingiva, the expression was found at 90% and 50% respectively. The percentage of positive cells was the highest in erosive OLP (27.26 ± 12.09%), followed by non-erosive OLP (20.85 ± 7.43%), OSCC (20.15 ± 15.70%), oral epithelial dysplasia (9.24 ± 7.00%) and healthy gingiva (2.27 ± 5.65%). Most of non-erosive OLP cases showed mild staining intensity while erosive OLP and OSCC showed moderate staining intensity. Cathepsin L was mainly expressed at basement membrane zone and inflammatory cells of OLP. In OSCC, the expression was found in tumor islands and keratin pearls. In oral epithelial dysplasia and normal gingiva, cathepsin L expressions were low and presented in scattered pattern in both epithelium and connective tissue. Conclusion According to the patterns of expression in this study, cathepsin L could be implicated in pathogenesis and severity of OLP.
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Affiliation(s)
- Athip Kitkhajornkiat
- Department of Oral Surgery and Oral Medicine, Faculty of Dentistry, Srinakharinwirot University, Bangkok, Thailand
| | - Sorasun Rungsiyanont
- Department of Oral Surgery and Oral Medicine, Faculty of Dentistry, Srinakharinwirot University, Bangkok, Thailand
| | - Sineepat Talungchit
- Department of Oral Surgery and Oral Medicine, Faculty of Dentistry, Srinakharinwirot University, Bangkok, Thailand
| | - Pimporn Jirawechwongsakul
- Department of Oral Surgery and Oral Medicine, Faculty of Dentistry, Srinakharinwirot University, Bangkok, Thailand
| | - Patrayu Taebunpakul
- Department of Oral Surgery and Oral Medicine, Faculty of Dentistry, Srinakharinwirot University, Bangkok, Thailand
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14
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Ahn MY, Kang JK, Kwon SM, Yoon HE, Yoon JH. Expression of nucleotide-binding oligomerization domain 1 and 2 in oral lichen planus. J Dent Sci 2020; 15:1-8. [PMID: 32256993 PMCID: PMC7109494 DOI: 10.1016/j.jds.2019.12.005] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2019] [Revised: 11/28/2019] [Indexed: 11/16/2022] Open
Abstract
Background/purpose Oral lichen planus (OLP) is a chronic inflammatory disease of oral mucosa. The present study investigated the expression of nucleotide-binding oligomerization domain (NOD), a pivotal sensor protein of the innate immune system, in OLP. Materials and methods Oral mucosal biopsies were collected from 20 patients with OLP and 6 individuals with normal oral mucosa (NOM). The expression of NOD1 and NOD2 was determined using RT-PCR and immunohistochemistry in OLP and NOM samples. Results The mRNA expression of NOD1 and NOD2 was significantly higher in the OLP group than in the NOM group. The protein expression of NOD1 was marginally upregulated in all mucosal layers in the OLP group compared with that of the NOM group; however, the differences were not significant. The expression of NOD2 was elevated in infiltrating lymphocytes of the submucosal layer in the OLP group compared with the NOM group, but was undetected in other inflammatory disease, inflammatory fibrous hyperplasia (IFH). This study revealed the upregulation of NOD2 mRNA and protein in the OLP group, but not in the NOM group. Conclusion These findings suggest that NOD2 may play an important role in the pathogenesis of OLP and represents a new diagnostic and treatment target.
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Affiliation(s)
- Mee-Young Ahn
- Major in Pharmaceutical Engineering, Division of Bio-industry, College of Medical and Life Sciences, Silla University, Busan, Republic of Korea
| | - Jin-Kyu Kang
- Department of Oral Medicine and Orofacial Pain, College of Dentistry, Daejeon Dental Hospital, Wonkwang University, Daejeon, Republic of Korea
| | - Seong-Min Kwon
- Department of Oral and Maxillofacial Pathology, College of Dentistry, Wonkwang Bone Regeneration Research Institute, Daejeon Dental Hospital, Wonkwang University, Daejeon, Republic of Korea
| | - Hyo-Eun Yoon
- Department of Oral and Maxillofacial Pathology, College of Dentistry, Wonkwang Bone Regeneration Research Institute, Daejeon Dental Hospital, Wonkwang University, Daejeon, Republic of Korea
| | - Jung-Hoon Yoon
- Department of Oral and Maxillofacial Pathology, College of Dentistry, Wonkwang Bone Regeneration Research Institute, Daejeon Dental Hospital, Wonkwang University, Daejeon, Republic of Korea
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15
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de Lima SLG, de Arruda JAA, Abreu LG, Mesquita RA, Ribeiro-Rotta RF, Mendonça EF, Arantes DAC, Batista AC. Clinicopathologic data of individuals with oral lichen planus: A Brazilian case series. J Clin Exp Dent 2019; 11:e1109-e1119. [PMID: 31824590 PMCID: PMC6894913 DOI: 10.4317/jced.56379] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2019] [Accepted: 11/04/2019] [Indexed: 11/13/2022] Open
Abstract
Background The aim of the present series was to analyze the sociodemographic characteristics, clinicopathologic features, and oral health-related quality of life of 41 individuals with oral lichen planus (OLP). Material and Methods In a retrospective analysis (1998-2018), individuals with a clinical diagnosis of OLP from a referral service of Oral Medicine of Brazil were invited for follow-up. The individuals were assessed using the Oral Health Impact Profile-14 (OHIP-14) form. Histopathological data were reviewed according to the latest criteria proposed by the American Academy of Oral and Maxillofacial Pathology (AAOMP/2016). Results This series mainly consisted of females (70.7%) in their forties (31.7%). The buccal mucosa (68.2%) was the most commonly affected site. Reticular (56.1%) and erosive (34.3%) appearances were the most frequent. According to OHIP-14, individuals with OLP at multiple sites in the oral cavity showed worse values in the handicap domain and those who did not respond to corticosteroids showed a higher score on the psychological discomfort domain. Conclusions The findings of the present study, using the AAOMP/2016 criteria, agree with case series and retrospective studies reported in the literature. Besides, OLP in its more severe clinical forms had an influence on patient quality of life. Key words:Diagnosis, epidemiology, oral lichen planus, oral mucosa, quality of life.
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Affiliation(s)
- Sara-Lia-Gonçalves de Lima
- DDS, MSc Student, Department of Stomatology (Oral Medicine and Oral Pathology), School of Dentistry, Universidade Federal de Goiás, Goiânia, GO, Brazil
| | - José-Alcides-Almeida de Arruda
- DDS, MSc, PhD Student, Department of Oral Surgery and Pathology, School of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil
| | - Lucas-Guimarães Abreu
- DDS, PhD, Department of Pediatric Dentistry and Orthodontics, School of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil
| | - Ricardo-Alves Mesquita
- DDS, PhD, Department of Oral Surgery and Pathology, School of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil
| | - Rejane-Faria Ribeiro-Rotta
- DDS, PhD, Department of Stomatology (Oral Medicine and Oral Pathology), School of Dentistry, Universidade Federal de Goiás, Goiânia, GO, Brazil
| | - Elismauro-Francisco Mendonça
- DDS, PhD, Department of Stomatology (Oral Medicine and Oral Pathology), School of Dentistry, Universidade Federal de Goiás, Goiânia, GO, Brazil
| | - Diego-Antônio-Costa Arantes
- DDS, PhD, Department of Stomatology (Oral Medicine and Oral Pathology), School of Dentistry, Universidade Federal de Goiás, Goiânia, GO, Brazil
| | - Aline-Carvalho Batista
- DDS, PhD, Department of Stomatology (Oral Medicine and Oral Pathology), School of Dentistry, Universidade Federal de Goiás, Goiânia, GO, Brazil
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Maymone MB, Greer RO, Kesecker J, Sahitya PC, Burdine LK, Cheng AD, Maymone AC, Vashi NA. Premalignant and malignant oral mucosal lesions: Clinical and pathological findings. J Am Acad Dermatol 2019; 81:59-71. [DOI: 10.1016/j.jaad.2018.09.060] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2018] [Revised: 09/13/2018] [Accepted: 09/19/2018] [Indexed: 01/20/2023]
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Xu N, Li B, Liu Z, Gao R, Wu S, Dong Z, Li H, Yu F, Zhang F. Role of mammary serine protease inhibitor on the inflammatory response in oral lichen planus. Oral Dis 2019; 25:1091-1099. [PMID: 30737971 DOI: 10.1111/odi.13054] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2018] [Revised: 01/06/2019] [Accepted: 01/24/2019] [Indexed: 02/05/2023]
Abstract
OBJECTIVES Oral lichen planus (OLP) is a chronic inflammatory condition with an unclear pathological mechanism. IκB kinase α (IKKα)-regulated mammary serine protease inhibitor (MASPIN) has been shown to mediate inflammation, particularly in cancers. Here, we explored the expression of MASPIN in OLP and its role in the inflammatory response. MATERIALS AND METHODS Immunohistochemistry staining and reverse transcription-polymerase chain reaction assays were used to detect the subcellular localization and expression of MASPIN and IKKα in OLP and healthy control tissues. Levels of the inflammatory factors were compared with enzyme-linked immunosorbent assays. MASPIN and IKKα were overexpressed and silenced, respectively, in an inflammation model of human oral keratinocytes (HOKs) stimulated with lipopolysaccharide (LPS). RESULTS Mammary serine protease inhibitor expression was down-regulated, whereas IKKα expression was up-regulated in OLP tissues (p < 0.01). The levels of tumour necrosis factor-alpha and interleukin-6 in OLP tissues were increased compared to those of healthy controls (p < 0.01). MASPIN overexpression in LPS-stimulated HOK cells inhibited the levels of IKKα and the secretion of inflammatory cytokines. By contrast, IKKα silencing promoted the expression of MASPIN and inhibited the secretion of inflammatory cytokines. CONCLUSION Both MASPIN and IKKα are involved in the inflammatory process of OLP, suggesting potential therapeutic targets.
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Affiliation(s)
- Na Xu
- Department of Oral Medicine, Shanxi Medical University School and Hospital of Stomatology, Taiyuan, China
| | - Baoyin Li
- Jilin University School and Hospital of Stomatology, Changchun, China
| | - Zhuanzhuan Liu
- Department of Oral Medicine, Shanxi Medical University School and Hospital of Stomatology, Taiyuan, China
| | - Ruifang Gao
- Department of Oral Medicine, Shanxi Medical University School and Hospital of Stomatology, Taiyuan, China
| | - Shujuan Wu
- Department of Oral Medicine, Shanxi Medical University School and Hospital of Stomatology, Taiyuan, China
| | - Ziyu Dong
- Department of Oral Medicine, Shanxi Medical University School and Hospital of Stomatology, Taiyuan, China
| | - Huifang Li
- Department of Oral Medicine, Shanxi Medical University School and Hospital of Stomatology, Taiyuan, China
| | - Feiyan Yu
- Department of Oral Medicine, Shanxi Medical University School and Hospital of Stomatology, Taiyuan, China
| | - Fang Zhang
- Department of Oral Medicine, Shanxi Medical University School and Hospital of Stomatology, Taiyuan, China
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18
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Zucoloto ML, Shibakura MEW, Pavanin JV, Garcia FT, da Silva Santos PS, Maciel AP, de Barros Gallo C, Souza NV, Innocentini LMAR, Humberto JSM, Motta ACF. Severity of oral lichen planus and oral lichenoid lesions is associated with anxiety. Clin Oral Investig 2019; 23:4441-4448. [PMID: 30989337 DOI: 10.1007/s00784-019-02892-2] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2018] [Accepted: 04/02/2019] [Indexed: 12/21/2022]
Abstract
OBJECTIVES Oral lichen planus (OLP) and oral lichenoid lesions (OLL) are chronic inflammatory diseases whose symptoms can impair patient's quality of life (QoL). Psychological factors seem to play an important role in these diseases. This study aimed to determine the impact of oral health and anxiety levels on the QoL of patients with OLP and OLL. PATIENTS AND METHODS This was a cross-sectional study composed of OLP and OLL patients and a control group matched by age and sex with no autoimmune/inflammatory or malignant oral lesions. Anxiety levels and oral health impact on QoL were assessed using the Hamilton Anxiety Scale (HAM-A) and the Oral Health Impact Profile-14 (OHIP-14), respectively. The instruments were filled through personal interview before starting the treatment for oral lesions. RESULTS A total of 87 patients diagnosed with OLP (n = 45) and OLL (n = 42), and 87 controls were included in the study. Statistical differences were observed for the psychic and somatic anxiety dimensions between severities of diseases. Patients with OLP or OLL had higher scores for the OHIP-14 dimensions physiological discomfort and social limitation compared with controls. In addition, higher scores for physical pain, physical disability, social disability, and handicap were detected among patients with greater severity. CONCLUSION Greater severity of OLP and OLL seems to be associated with increased levels of anxiety, higher scores of oral health impact profile, and decreased QoL. CLINICAL RELEVANCE Patients with severe OLP/OLL may benefit from additional therapeutic treatments, such as psychological and/or psychiatric management, concomitant to treatment specific to oral lesions.
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Affiliation(s)
- Miriane Lucindo Zucoloto
- Department of Social Medicine, Ribeirão Preto School of Medicine, University of São Paulo, Ribeirão Preto, SP, Brazil
| | - Matheus Eiji Warikoda Shibakura
- Department of Stomatology, Public Oral Health and Forensic Dentistry, Division of Oral Diagnosis, School of Dentistry of Ribeirão Preto, University of São Paulo, Av. do Café, s/n, Ribeirão Preto, SP, 14040-904, Brazil
| | - Jefferson Veronezi Pavanin
- Department of Stomatology, Public Oral Health and Forensic Dentistry, Division of Oral Diagnosis, School of Dentistry of Ribeirão Preto, University of São Paulo, Av. do Café, s/n, Ribeirão Preto, SP, 14040-904, Brazil
| | - Fernanda Teixeira Garcia
- Department of Stomatology, Public Oral Health and Forensic Dentistry, Division of Oral Diagnosis, School of Dentistry of Ribeirão Preto, University of São Paulo, Av. do Café, s/n, Ribeirão Preto, SP, 14040-904, Brazil
| | - Paulo Sérgio da Silva Santos
- Department of Surgery, Stomatology, Pathology and Radiology, Bauru School of Dentistry, University of São Paulo, Bauru, SP, Brazil
| | - Aloizio Premoli Maciel
- Department of Surgery, Stomatology, Pathology and Radiology, Bauru School of Dentistry, University of São Paulo, Bauru, SP, Brazil
| | - Camila de Barros Gallo
- Department of Stomatology, School of Dentistry, University of São Paulo, São Paulo, SP, Brazil
| | - Nathalia Vilela Souza
- Department of Stomatology, School of Dentistry, University of São Paulo, São Paulo, SP, Brazil
| | - Lara Maria Alencar Ramos Innocentini
- Department of Stomatology, Public Oral Health and Forensic Dentistry, Division of Oral Diagnosis, School of Dentistry of Ribeirão Preto, University of São Paulo, Av. do Café, s/n, Ribeirão Preto, SP, 14040-904, Brazil.,Division of Dentistry and Stomatology, Ribeirão Preto Clinical Hospital, Ribeirão Preto School of Medicine, University of São Paulo, Ribeirão Preto, SP, Brazil
| | - Janaina Silva Martins Humberto
- Department of Stomatology, Public Oral Health and Forensic Dentistry, Division of Oral Diagnosis, School of Dentistry of Ribeirão Preto, University of São Paulo, Av. do Café, s/n, Ribeirão Preto, SP, 14040-904, Brazil
| | - Ana Carolina Fragoso Motta
- Department of Stomatology, Public Oral Health and Forensic Dentistry, Division of Oral Diagnosis, School of Dentistry of Ribeirão Preto, University of São Paulo, Av. do Café, s/n, Ribeirão Preto, SP, 14040-904, Brazil.
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Flores-Hidalgo A, Murrah V, Fedoriw Y, Padilla RJ. Relationship of infiltrating intraepithelial T lymphocytes in the diagnosis of oral lichen planus versus oral epithelial dysplasia: a pilot study. Oral Surg Oral Med Oral Pathol Oral Radiol 2019; 127:e123-e135. [PMID: 30928328 DOI: 10.1016/j.oooo.2019.02.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2018] [Revised: 01/17/2019] [Accepted: 02/07/2019] [Indexed: 12/30/2022]
Abstract
OBJECTIVE The aim of this study was to identify the type and distribution of CD4+ and CD8+ T lymphocytes in oral mucosal specimens to potentially distinguish between underlying alterations or patterns in oral epithelial dysplasia and oral lichen planus. STUDY DESIGN This pilot study included 10 archived tissue samples that were received at the University of North Carolina Oral and Maxillofacial Pathology Laboratory and were diagnosed as oral lichen planus and moderate to severe epithelial dysplasia. Dual staining with CD4 and CD8 antibodies was carried out on each case. Slides were scanned in the Aperio ScanScope FL (Leica Biosystems, Wetzlar, Germany) and archived. Histomorphometric analysis was performed to detect inflammatory cells expressing CD4 and CD8 biomarkers in the epithelial and connective tissue regions. RESULTS No differences were found in the amount and ratio of CD4+/CD8+ lymphocytes among the 3 groups analyzed; however, the intraepithelial CD8+ lymphocyte distribution was strikingly different between lichen planus and moderate to severe epithelial dysplasia. CONCLUSIONS The localization of CD8+ cells can be potentially useful as an adjunctive diagnostic procedure to distinguish oral epithelial dysplasia from other inflammatory entities, such as lichen planus.
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Affiliation(s)
- Andres Flores-Hidalgo
- Clinical Assistant Professor, Oral and Maxillofacial Pathology, Department of Surgical Sciences, East Carolina University, School of Dental Medicine, 1851 MacGregor Downs Rd, Greenville, NC 27834-4354, USA.
| | - Valerie Murrah
- Professor and Chair, Oral and Maxillofacial Pathology, Department of Diagnostic Sciences, University of North Carolina at Chapel Hill, School of Dentistry, Chapel Hill, NC, USA
| | - Yuri Fedoriw
- Associate Professor, Director of Hematopathology UNC Hospitals, Department of Pathology and Laboratory Medicine, Hematopathology Laboratory, NC Cancer Hospital C3162, Chapel Hill, NC, USA
| | - Ricardo J Padilla
- Kaneda Family Distinguished Associate Professor, Oral and Maxillofacial Pathology, Department of Diagnostic Sciences, University of North Carolina at Chapel Hill, School of Dentistry, 101 Manning Drive, Chapel Hill, NC, USA
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Abstract
Reticular oral lichen planus is a common clinical finding, often found incidentally on routine oral examination. Patients rarely complain of symptoms and the condition does not require treatment, as a result, biopsies and ancillary laboratory evaluation are seldom performed. We present a case of reticular oral lichen planus with a classic clinical presentation and characteristic histologic findings.
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Affiliation(s)
- Teresa Cox
- Department of Anatomic Pathology, Naval Medical Center San Diego, San Diego, CA USA ,Department of Pathology, Naval Medical Center San Diego, 34800 Bob Wilson Drive, San Diego, CA 92134-5000 USA
| | - Jamie Woodhead
- Laboratory Department, Naval Medical Center San Diego, San Diego, CA USA
| | - Brenda L. Nelson
- Department of Anatomic Pathology, Naval Medical Center San Diego, San Diego, CA USA
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Humberto JSM, Pavanin JV, Rocha MJAD, Motta ACF. Cytokines, cortisol, and nitric oxide as salivary biomarkers in oral lichen planus: a systematic review. Braz Oral Res 2018; 32:e82. [PMID: 30110084 DOI: 10.1590/1807-3107bor-2018.vol32.0082] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2018] [Accepted: 05/05/2018] [Indexed: 12/11/2022] Open
Abstract
The etiopathogenesis of oral lichen planus (OLP) is still not fully elucidated, and it is believed that its development could involve a neuro-immune-endocrine profile. This systematic review investigated the relationship between cytokines, cortisol, and nitric oxide (NO) in the saliva of OLP patients. An electronic search was conducted in Pubmed/Medline, Scopus, LIVIVO, and Web of Science databases with no restriction of language to identify studies published up to December 2017. Data extraction was performed using the Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA) guidelines. A total of 140 articles were retrieved, and 32 articles fulfilled the inclusion criteria (cytokines = 17; cortisol = 9; NO = 6). The most studied cytokines in the saliva of OLP patients were interleukins IL-4, IL-6, IL-8, IFN-ү, and TNF-α, which were higher in OLP patients than in healthy controls (HC). Salivary cortisol was found to be higher in OLP than in HC in most (55.5%) of the selected studies, and all studies related to NO found higher levels of this marker in OLP than in HC. Despite controversial results, our review suggests that OLP patients have an increased inflammatory response, as indicated by the proinflammatory profile of salivary cytokines. In addition, we conclude that salivary cytokine and NO measurements may have significant diagnostic and prognostic potential for monitoring disease activity and therapeutic responses in OLP.
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Affiliation(s)
- Janaina Silva Martins Humberto
- Universidade de São Paulo - USP, School of Dentistry of Ribeirão Preto, Department of Morphology, Physiology, and Basic Pathology, Ribeirão Preto, SP, Brazil
| | - Jefferson Veronezi Pavanin
- Universidade de São Paulo - USP, School of Dentistry of Ribeirão Preto, Department of Stomatology, Ribeirão Preto, SP, Brazil
| | - Maria José Alves da Rocha
- Universidade de São Paulo - USP, School of Dentistry of Ribeirão Preto, Department of Morphology, Physiology, and Basic Pathology, Ribeirão Preto, SP, Brazil
| | - Ana Carolina Fragoso Motta
- Universidade de São Paulo - USP, School of Dentistry of Ribeirão Preto, Department of Stomatology, Ribeirão Preto, SP, Brazil
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22
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LPS-induced Vitamin D Receptor Decrease in Oral Keratinocytes Is Associated With Oral Lichen Planus. Sci Rep 2018; 8:763. [PMID: 29335479 PMCID: PMC5768778 DOI: 10.1038/s41598-018-19234-z] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2017] [Accepted: 12/28/2017] [Indexed: 01/06/2023] Open
Abstract
The suppressive function of vitamin D on oral lichen planus (OLP) have been documented previously. Vitamin D receptor (VDR) expression is down-regulated in OLP, but the molecular mechanism of its decrease and the related anti-inflammatory contributor of epithelial VDR signaling is unclear. Herein, we demonstrated that lipopolysaccharide (LPS) remarkedly down-regulated VDR expression of keratinocytes, and the reduced regulation was dependent on tumor necrosis factor alpha (TNFα)-miR-346 pathway. In human specimen studies, VDR levels of oral mucosal epithelia from OLP patients decreased substantially accompanied with robust TNFα and miR-346 induction, compared to the normal tissues. In addition, vitamin D/VDR signaling inhibited LPS-induced p53-upregulated modulator of apoptosis (PUMA) induction in keratinocytes via impeding nuclear factor-κB (NF-κB) activation, resulting in keratinocytes apoptosis reduction. Importantly, PUMA activity was up-regulated strongly in diseased epithelium, reversely correlated with VDR expression. Totally, our data indicate that LPS is responsible for VDR downregulation in oral keratinocytes, which is associated with OLP development.
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23
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Du J, Li R, Yu F, Yang F, Wang J, Chen Q, Wang X, Zhao B, Zhang F. Experimental study on 1,25(OH) 2 D 3 amelioration of oral lichen planus through regulating NF-κB signaling pathway. Oral Dis 2017; 23:770-778. [PMID: 28231625 DOI: 10.1111/odi.12659] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2016] [Revised: 02/05/2017] [Accepted: 02/17/2017] [Indexed: 12/14/2022]
Abstract
OBJECTIVE To explore the protective function of vitamin D (VD)/vitamin D receptor (VDR) on the development of oral lichen planus (OLP) and elaborate the underling mechanism of it. METHODS H&E staining, myeloid peroxidase (MPO) assays, quantitative PCR (qPCR), Western blotting, and Elisa were used to test the human biopsies and serum. QPCR, Western blotting, Elisa, and siRNA transfection were also performed in LPS-induced keratinocytes to observe the functions of vitamin D and VDR. RESULTS The lack of VDR in the diseased biopsies from OLP patients was associated with activated helper T-cell type 1 (Th1)-driven inflammatory response. Importantly, the status of serum 25-hydroxyvitamin D of OLP patients was reduced consistently. In a cultured cell model, 1,25(OH)2 D3 could downregulate excessive production of pro-inflammatory factors induced by lipopolysaccharide (LPS) in keratinocyte HaCat cells. Mechanistically, even though LPS-induced cytokines in keratinocytes were inhibited both by nuclear factor-κB (NF-κB) inhibitor and by activator protein 1 (AP-1) inhibitor, VDR-dependent 1,25(OH)2 D3 blocked the activation of phosphorylated-NF-κB p65 rather than c-Jun/c-Fos in the presence of LPS stimulation. CONCLUSION These results suggest that 1,25(OH)2 D3 plays an anti-inflammatory role in OLP by mediating NF-κB signaling pathway but not AP-1 signaling pathway with a VDR-dependent manner, predicting vitamin D supplement may be a potential strategy for the OLP management.
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Affiliation(s)
- J Du
- Department of Stomatology, Shanxi Medical University, Taiyuan, Shanxi, China
| | - R Li
- Department of Stomatology, Shanxi Medical University, Taiyuan, Shanxi, China
| | - F Yu
- Department of Stomatology, Shanxi Medical University, Taiyuan, Shanxi, China
| | - F Yang
- Department of Stomatology, Shanxi Medical University, Taiyuan, Shanxi, China
| | - J Wang
- Department of Stomatology, Shanxi Medical University, Taiyuan, Shanxi, China
| | - Q Chen
- Department of Stomatology, Shanxi Medical University, Taiyuan, Shanxi, China
| | - X Wang
- Department of Stomatology, Shanxi Medical University, Taiyuan, Shanxi, China
| | - B Zhao
- Department of Stomatology, Shanxi Medical University, Taiyuan, Shanxi, China
| | - F Zhang
- Department of Stomatology, Shanxi Medical University, Taiyuan, Shanxi, China
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Yang Q, Guo B, Sun H, Zhang J, Liu S, Hexige S, Yu X, Wang X. Identification of the key genes implicated in the transformation of OLP to OSCC using RNA-sequencing. Oncol Rep 2017; 37:2355-2365. [PMID: 28259920 DOI: 10.3892/or.2017.5487] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2016] [Accepted: 01/02/2017] [Indexed: 11/06/2022] Open
Abstract
Oral lichen planus (OLP) is a chronic inflammatory disease that may transform to oral squamous cell carcinoma (OSCC), while its carcinogenesis mechanisms are not entirely clear. This study was designed to identify the important genes involved in the malignant transformation of OLP to OSCC. After RNA-sequencing, the differently expressed genes (DEGs) in OLP vs. normal and OSCC vs. normal groups, respectively, were identified by limma package in R language, and then clustering analysis were conducted by Pheatmap package in R language. Weighed gene co-expression network analysis (WGCNA) was performed for the DEGs to screen disease-associated modules. Using Cytoscape software, co-expression networks were constructed for the genes involved in the modules. Enrichment analysis was conducted for the genes involved in the co-expression networks using GOstat package in R language. Finally, quantitative real-time PCR (qRT-PCR) experiments were conducted to validate the key genes. There were, respectively, 223 and 548 DEGs in OLP vs. normal and OSCC vs. normal groups. WGCNA identified the blue modules for the DEGs in the two groups as disease-associated modules. Moreover, 19 common DEGs (including upregulated BCL9L, PER2 and TSPAN33, and downregulated GMPS and HES1) associated with both OLP and OSCC were identified. In the co-expression networks, BCL9L, HES1, PER2 and TSPAN33 might function in OLP via interactions (such as BCL9L-TSPAN33 and HES1-PER2). qRT-PCR analysis showed that BCL9L, PER2 and TSPAN33 were significantly upregulated, and GMP and HES1 were downregulated. These findings indicated that BCL9L, GMPS, HES1, PER2 and TSPAN33 affected the transformation of OLP to OSCC.
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Affiliation(s)
- Qiaozhen Yang
- Department of Stomatology, Huashan Hospital, Fudan University, Shanghai 200040, P.R. China
| | - Bin Guo
- State Key Laboratory of Genetic Engineering, Institute of Genetics, School of Life Sciences, Fudan University, Shanghai 200433, P.R. China
| | - Hongying Sun
- Department of Stomatology, Huashan Hospital, Fudan University, Shanghai 200040, P.R. China
| | - Jie Zhang
- Department of Stomatology, Huashan Hospital, Fudan University, Shanghai 200040, P.R. China
| | - Shangfeng Liu
- Department of Stomatology, Huashan Hospital, Fudan University, Shanghai 200040, P.R. China
| | - Saiyin Hexige
- State Key Laboratory of Genetic Engineering, Institute of Genetics, School of Life Sciences, Fudan University, Shanghai 200433, P.R. China
| | - Xuedi Yu
- Department of Stomatology, Huashan Hospital, Fudan University, Shanghai 200040, P.R. China
| | - Xiaxia Wang
- Department of Stomatology, Huashan Hospital, Fudan University, Shanghai 200040, P.R. China
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Gong C, Sun S, Liu B, Wang J, Chen X. Identification of potential therapeutic target genes, key miRNAs and mechanisms in oral lichen planus by bioinformatics analysis. Arch Oral Biol 2017; 78:122-128. [PMID: 28237528 DOI: 10.1016/j.archoralbio.2017.02.013] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2016] [Revised: 02/07/2017] [Accepted: 02/08/2017] [Indexed: 11/16/2022]
Abstract
The study aimed to identify the potential target genes and key miRNAs as well as to explore the underlying mechanisms in the pathogenesis of oral lichen planus (OLP) by bioinformatics analysis. The microarray data of GSE38617 were downloaded from Gene Expression Omnibus (GEO) database. A total of 7 OLP and 7 normal samples were used to identify the differentially expressed genes (DEGs) and miRNAs. The DEGs were then performed functional enrichment analyses. Furthermore, DEG-miRNA network and miRNA-function network were constructed by Cytoscape software. Total 1758 DEGs (598 up- and 1160 down-regulated genes) and 40 miRNAs (17 up- and 23 down-regulated miRNAs) were selected. The up-regulated genes were related to nuclear factor-Kappa B (NF-κB) signaling pathway, while down-regulated genes were mainly enriched in the function of ribosome. Tumor necrosis factor (TNF), caspase recruitment domain family, member 11 (CARD11) and mitochondrial ribosomal protein (MRP) genes were identified in these functions. In addition, miR-302 was a hub node in DEG-miRNA network and regulated cyclin D1 (CCND1). MiR-548a-2 was the key miRNA in miRNA-function network by regulating multiple functions including ribosomal function. The NF-κB signaling pathway and ribosome function may be the pathogenic mechanisms of OLP. The genes such as TNF, CARD11, MRP genes and CCND1 may be potential therapeutic target genes in OLP. MiR-548a-2 and miR-302 may play important roles in OLP development.
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Affiliation(s)
- Cuihua Gong
- Department of General Emergency, Dalian Hospital of Stomatology, Dalian, Liaoning, 116021, China
| | - Shangtong Sun
- Department of Periodontal Mucosa, Dalian Hospital of Stomatology, Dalian, Liaoning, 116021, China
| | - Bing Liu
- Department of Orthopedic Trauma, the First Affiliated Hospital of Dalian Medical University, Dalian, Liaoning, 116011, China
| | - Jing Wang
- Department of Cosmetic Surgery, The First Affiliated Hospital of Dalian Medical University, Dalian, Liaoning, 116011, China.
| | - Xiaodong Chen
- Department of Reconstruction Surgery, Dalian Hospital of Stomatology, No. 935 Changjiang Rd, Shahekou District, Dalian, Liaoning, 116021, China.
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Oral lichenoid lesions: distinguishing the benign from the deadly. Mod Pathol 2017; 30:S54-S67. [PMID: 28060366 DOI: 10.1038/modpathol.2016.121] [Citation(s) in RCA: 56] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2016] [Revised: 05/31/2016] [Accepted: 06/02/2016] [Indexed: 12/25/2022]
Abstract
Oral lichen planus is a chronic inflammatory disease of unknown etiology or pathogenesis with varied disease severity that waxes and wanes over a long period of time. Although a common oral mucosal disease, accurate diagnosis is often challenging due to the overlapping clinical and histopathological features of oral lichen planus and other mucosal diseases. Other immune-mediated mucocutaneous diseases can exhibit lichenoid features including mucous membrane pemphigoid, chronic graft-versus-host disease, and discoid lupus erythematosus. Reactive changes to dental materials or to systemic medications can mimic oral lichen planus both clinically and histologically. In these situations the clinical presentation can be useful, as oral lichen planus presents as a multifocal process and is usually symmetrical and bilateral. Dysplasia of the oral cavity can exhibit a lichenoid histology, which may mask the potentially premalignant features. Proliferative verrucous leukoplakia, an unusual clinical disease, can often mimic oral lichen planus clinically, requiring careful correlation of the clinical and pathologic features.
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RIMKEVIČIUS A, ALEKSEJŪNIENĖ J, PŪRIENĖ A, ŠEININ D, RASTENIENĖ R. Oral lichen planus: a 4-year clinical follow-up study. Turk J Med Sci 2017; 47:514-522. [DOI: 10.3906/sag-1511-94] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2015] [Accepted: 09/11/2016] [Indexed: 11/03/2022] Open
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AbuHilal M, Walsh S, Shear N. Treatment of recalcitrant erosive oral lichen planus and desquamative gingivitis with oral apremilast. J Dermatol Case Rep 2016; 10:56-57. [PMID: 28400896 DOI: 10.3315/jdcr.2016.1232] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2016] [Accepted: 11/11/2016] [Indexed: 12/28/2022]
Abstract
BACKGROUND Erosive oral lichen planus and desquamative gingivitis are uncommon but severe debilitating variants of oral lichen planus. Treatment of these presentations is difficult and challenging. MAIN OBSERVATION A 44-year-old woman was referred to the dermatology clinic with chronic painful lichen planus-related gingivitis and buccal erosions. She has failed multiple treatments including topical clobetasol and tacrolimus, intralesional corticosteroids and several systemic and immunosuppressive agents. Following completion of three months of treatment with oral apremilast at a dose of 30 mg twice daily, significant improvement was noted in her disease activity. CONCLUSION Oral apremilast may be a safe and effective treatment for erosive oral lichen planus.
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Affiliation(s)
- Mohn'd AbuHilal
- Division of Dermatology, Department of Medicine, Sunnybrook Health Sciences Center and University of Toronto, Toronto, Canada
| | - Scott Walsh
- Division of Dermatology, Department of Medicine, Sunnybrook Health Sciences Center and University of Toronto, Toronto, Canada
| | - Neil Shear
- Division of Dermatology, Department of Medicine, Sunnybrook Health Sciences Center and University of Toronto, Toronto, Canada
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Stoopler ET, Alfaris S, Alomar D, Alawi F. Oral lichen planus preceding concomitant lichen planopilaris. Oral Surg Oral Med Oral Pathol Oral Radiol 2016; 122:e82-5. [PMID: 27544399 DOI: 10.1016/j.oooo.2016.05.022] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2016] [Revised: 05/17/2016] [Accepted: 05/24/2016] [Indexed: 12/19/2022]
Abstract
Lichen planus (LP) is an immune-mediated mucocutaneous disorder with a wide array of clinical presentations. Oral lichen planus (OLP) is characterized clinically by striae, desquamation, and/or ulceration. Lichen planopilaris (LPP), a variant of LP, affects the scalp, resulting in perifollicular erythema and scarring of cutaneous surfaces accompanied by hair loss. The association between OLP and LPP has been reported previously with scant information on concomitant or sequential disease presentation. We describe a patient with concomitant OLP and LPP, and to the best of our knowledge, this is the first report on OLP preceding the onset of LPP.
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Affiliation(s)
- Eric T Stoopler
- Associate Professor of Oral Medicine, Division of Oral Medicine, Department of Oral and Maxillofacial Surgery, University of Pennsylvania Health System, Philadelphia, PA, USA.
| | - Sausan Alfaris
- Resident, Division of Oral Medicine, Department of Oral and Maxillofacial Surgery, University of Pennsylvania Health System, Philadelphia, PA, USA
| | - Dalal Alomar
- Resident, Division of Oral Medicine, Department of Oral and Maxillofacial Surgery, University of Pennsylvania Health System, Philadelphia, PA, USA
| | - Faizan Alawi
- Associate Professor of Pathology, Section of Oral and Maxillofacial Pathology, Division of Dermatopathology, Department of Dermatology, University of Pennsylvania Health System, Philadelphia, PA, USA
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Cheng YSL, Gould A, Kurago Z, Fantasia J, Muller S. Diagnosis of oral lichen planus: a position paper of the American Academy of Oral and Maxillofacial Pathology. Oral Surg Oral Med Oral Pathol Oral Radiol 2016; 122:332-54. [PMID: 27401683 DOI: 10.1016/j.oooo.2016.05.004] [Citation(s) in RCA: 274] [Impact Index Per Article: 34.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2016] [Revised: 05/03/2016] [Accepted: 05/11/2016] [Indexed: 12/26/2022]
Abstract
Despite being one of the most common oral mucosal diseases and recognized as early as 1866, oral lichen planus (OLP) is still a disease without a clear etiology or pathogenesis, and with uncertain premalignant potential. More research is urgently needed; however, the research material must be based on an accurate diagnosis. Accurate identification of OLP is often challenging, mandating inclusion of clinico-pathological correlation in the diagnostic process. This article summarizes current knowledge regarding OLP, discusses the challenges of making an accurate diagnosis, and proposes a new set of diagnostic criteria upon which to base future research studies. A checklist is also recommended for clinicians to provide specific information to pathologists when submitting biopsy material. The diagnostic process of OLP requires continued clinical follow-up after initial biopsy, because OLP mimics can manifest, necessitating an additional biopsy for direct immunofluorescence study and/or histopathological evaluation in order to reach a final diagnosis.
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Affiliation(s)
- Yi-Shing Lisa Cheng
- Department of Diagnostic Sciences, Texas A&M University College of Dentistry, Dallas, TX, USA.
| | - Alan Gould
- Louisville Oral Pathology Laboratory, Louisville, KY, USA
| | - Zoya Kurago
- Department of Oral Health and Diagnostic Sciences, College of Dental Medicine, Augusta University, Augusta, GA, USA
| | - John Fantasia
- Department of Dental Medicine, Hofstra North Shore-Long Island Jewish Health System, New Hyde Park, NY, USA
| | - Susan Muller
- Professor Emeritus, Emory University School of Medicine, Atlanta, GA; Atlanta Oral Pathology, Decatur, GA, USA
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Dudhia BB, Dudhia SB, Patel PS, Jani YV. Oral lichen planus to oral lichenoid lesions: Evolution or revolution. J Oral Maxillofac Pathol 2016; 19:364-70. [PMID: 26980966 PMCID: PMC4774291 DOI: 10.4103/0973-029x.174632] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
The diagnosis between different diseases may be impaired by clinical and histopathologic similarities, as observed in the oral lichen planus (OLP) and oral lichenoid lesion (OLL). Inspite of similar clinicopathological features; etiology, diagnosis and prognosis differ which mandates separation of OLL from OLP. Hence, it is essential for the oral physician and oral pathologist to be familiarized with the individual variations among clinicopathological features of OLP and OLL as well as to obtain a thorough history and perform a complete mucocutaneous examination in addition to specific diagnostic testing. The difficulties faced to establish the diagnosis between these two pathologies are widely investigated in the literature with a lack of definite conclusion. This review is an attempt to throw some light on these clinicopathologic entities with the aim to resolve the diagnostic dilemma.
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Affiliation(s)
- Bhavin B Dudhia
- Department of Oral Medicine and Radiology, Ahmedabad Dental College and Hospital, Ahmedabad, Gujarat, India
| | - Sonal B Dudhia
- Department of Oral Medicine and Radiology, College of Dental Sciences and Research Centre, Ahmedabad, Gujarat, India
| | - Purv S Patel
- Department of Oral Medicine and Radiology, Ahmedabad Dental College and Hospital, Ahmedabad, Gujarat, India
| | - Yesha V Jani
- Department of Oral Medicine and Radiology, Ahmedabad Dental College and Hospital, Ahmedabad, Gujarat, India
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Qari H, Villasante C, Richert J, Rees T, Kessler H. The diagnostic challenges of separating chronic ulcerative stomatitis from oral lichen planus. Oral Surg Oral Med Oral Pathol Oral Radiol 2015; 120:622-7. [DOI: 10.1016/j.oooo.2015.07.018] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2015] [Revised: 07/03/2015] [Accepted: 07/13/2015] [Indexed: 11/16/2022]
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Abd El-Alim S, Kassem A, Basha M. Proniosomes as a novel drug carrier system for buccal delivery of benzocaine. J Drug Deliv Sci Technol 2014. [DOI: 10.1016/s1773-2247(14)50087-1] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Erosive vulval lichen planus—a diagnosis not to be missed: a clinical review. Eur J Obstet Gynecol Reprod Biol 2013; 171:214-9. [DOI: 10.1016/j.ejogrb.2013.09.038] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2013] [Revised: 08/31/2013] [Accepted: 09/28/2013] [Indexed: 01/03/2023]
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Mortazavi N. Role of oxidative stress in malignant transformation of oral lichen planus. Oral Oncol 2013; 49:e41-2. [PMID: 24084408 DOI: 10.1016/j.oraloncology.2013.09.004] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2013] [Accepted: 09/08/2013] [Indexed: 01/16/2023]
Affiliation(s)
- Nazanin Mortazavi
- Department of Oral Medicine, Dental School, Babol University of Medical Sciences, PO Box 47135-853, Babol, Iran.
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