New-onset oral lichen planus and granulomatous cheilitis in a 66-year-old woman

Lichenoid lesions of the upper labial mucosa: a systematic review and a report of a new case with extensive follow-up

OBJECTIVES

The paper reports the demographic characteristics of patients with lichenoid lesions affecting only the upper labial mucosa, with or without associated lesions in the maxillary anterior gingiva, alongside the lesions' clinical and histopathological features, treatment, follow-up and prognosis. Also, a new case with lengthy follow-up is presented.

MATERIALS AND METHODS

A systematic review was performed in line with PRISMA guidelines. The literature search sources were PubMed, Scopus and Web of Science.

RESULTS

In all, 26 patients (21 women, 5 men) were included in the review. 80.8% (n = 21) of the labial lesions were clinically erythematous and 19.2% (n = 5) were accompanied by white striations. The gingiva was affected in 46.2% of cases. All patients (100%, n = 24) reported symptoms. All of the lesions presented histological features of lichenoid inflammation. Granulomas were noted in 65.4% (n = 17) of the lesions. Topical corticosteroid was the most frequent therapy (89.5%, n = 17).

CONCLUSIONS

Lichenoid lesions found solely in the upper labial mucosa, with or without adjacent gingival lesions, are rarely reported in the literature, and the reporting is often incomplete. A definitive aetiology could not be established for the lesions. Likewise, there is little information about this condition's long-term prognosis.

Nivolumab‑induced lichenoid granulomatous stomatitis in a patient with advanced melanoma: A case report

Lichenoid granulomatous reactions (LGR) are granulomatous inflammations of the skin and oral mucosa, also sharing features of lichenoid lesions. Thus, the present study refers to lichenoid granulomatous dermatitis (LGD) and lichenoid granulomatous stomatitis (LGS). LGR is a condition that can be triggered by drugs, diseases or environmental causes. In the present case study, anti-PD1 (nivolumab) medication had a detrimental effect on the oral mucosa, which clinicaly and histologicaly proved to be LGS. Checkpoint inhibitors consitute a cornerstone in the current treatment of several types of cancer, of which cutaneous melanoma is the best example. Oral lichenoid responses following anti-PD-1 therapy have been recorded in few case reports and small case series. To the best of our knowledhe, this is the first case of LGS being reported as a side effect of immune checkpoint inhibitor treatment.

Assessment of cases of lichenoid granulomatous stomatitis in respect to demographics, histological features, and subcategories in known population

Introduction: Lichenoid granulomatous dermatitis (LGD) is widely encountered lesions with both oral as well as dermal manifestation. Present study was done to evaluate lichenoid granulomatous stomatitis cases. Materials and methods: 226 biopsies were exposed to special stains such as acid-fast bacilli (AFB), immunohistochemical staining for CD 68 and Grocott methenamine-silver (GMS), and periodic acid‐Schiff (PAS) stains. Results: Out of 226 patients, males were 84 and females were 142. Maximum cases were seen in age group 40–60 years (122) followed by >60 years (56) and 20–40 years (48). The common site was buccal mucosa seen in 128 (56.6%) cases followed by vestibule in 30 (13.2%), gingiva in 26 (11.5%), tongue in 20 (8.8%), lip in 12 (5.3%) and palate in 10 (4.4%). The common lesion was oral lichen planus seen in 142 (62.8%), carcinoma in situ in 12 (5.3%), squamous cell carcinoma in 8 (3.53%), pemphigus vulgaris in 10 (4.42%), leukoplakia in 24 (10.6%) and pemphigoid in 30 (13.2%) cases. Most lesions were of type I seen in 117 (51.7%) cases. Conclusion: Lichenoid granulomatous dermatitis poses variety of clinical as well as oral features. A long standing follows up and consideration of differential diagnosis is mandatory for better management of patients.

Lichenoid reaction with granulomatous stomatitis: A retrospective histologic study of 47 patients

OBJECTIVES

Lichenoid granulomatous reaction can be subcategorized into lichenoid granulomatous dermatitis or lichenoid granulomatous stomatitis. It is described in the literature as demonstrating a band-like lichenoid infiltration with clusters of histiocytic or granuloma formation. In this study, we presented a large case series of lichenoid granulomatous stomatitis including demographics, histological features, and subcategories and compared findings with current literature.

METHODS AND MATERIALS

We retrieved all cases diagnosed with lichenoid reaction with granulomatous inflammation between January 1, 2000, and August 1, 2016, from the University of Florida Oral Pathology Biopsy Service Archives.

RESULTS

A total of 47 patients with tissue from 50 biopsy sites were included. The majority of the cases were noted in females (64%) with a mean age of 59 years (range 30-88). Most patients were Caucasian, and the most common sites in descending order were: gingiva, buccal mucosa, vestibule, tongue, lip, palate, and occasional multifocal involvement. Clinical impressions by the treating clinicians included leukoplakia, dysplasia, carcinoma in situ, squamous cell carcinoma, lichen planus, vesiculobullous disease, trauma, and allergy. The histologic features of these cases ranged from lichenoid mucositis with numerous aggregates of histiocytes to well-formed granulomas, in accordance with previous classifications of similar dermatologic lesions. All cases revealed positive CD 68 in the histiocytic infiltrates and were negative for microorganisms utilizing acid-fast bacilli, Grocott methenamine-silver, and periodic acid-Schiff stains.

CONCLUSION

Lichenoid granulomatous disease may be more common than previously reported; however, its etiology remains unknown and patients should be kept under long-term clinical follow-up.

Oral lichenoid lesions of the upper lip and gingiva: What we know so far

The clinical presentation of oral lichen planus and oral lichenoid lesions is diverse. A special category of patients presents with lichenoid lesions affecting only the mucosa of their upper lip and the anterior upper gingiva. This is a concise review summarizing the specific characteristics of these patients.

Oral lichenoid lesions of the upper lip

BACKGROUND

Oral lichen planus is a chronic inflammatory disease of unknown etiology. It is characterized by notable heterogeneity in clinical presentation and behavior.

MAIN OBSERVATIONS

We describe 3 patients with lichenoid lesions of the upper lip and upper anterior gingiva. These cases probably represent a clinical subtype of lichenoid lesions associated with microbial antigenicity and are characterized by persistency. All three patients had a long history of previous ineffective treatments and all three showed an excellent response to a combination of clarithromycin (2 x 250 mg/day) and prednisolone (15 mg/day).

CONCLUSION

The combination of clarithromycin and prednisolone may be considered as an alternative intervention in patients with lichenoid lesions of the upper lip and upper anterior gingiva.