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Polizzi A, Santonocito S, Distefano A, De Pasquale R, Alibrandi A, Alanazi AM, Li Volti G, Isola G. Analysis of oral lichen planus severity on micro-RNA linked with malignant transformation risks. Oral Dis 2024; 30:2918-2928. [PMID: 37837187 DOI: 10.1111/odi.14758] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2023] [Revised: 09/03/2023] [Accepted: 09/19/2023] [Indexed: 10/15/2023]
Abstract
OBJECTIVE The present study evaluated the oral tissue expression of micro-RNA (miRNAs) linked to the potential malignant evolution of oral lichen planus (OLP). Furthermore, the correlation between OLP severity and miRNAs expression was assessed, and possible predictors of miRNAs in OLP patients were identified. METHODS The present study enrolled 41 patients with OLP (median age 58 years) and 42 healthy controls (median age 59 years). In each patient, miRNA levels (miR-7a-3p,-7a2-3p,-7a-5p,-21-3p,-21-5p,-100-3p,-100-5p,-125b-2-3p,-125b-5p,-200b-3p,-200b-5p) were assessed and analyzed through reverse transcription polymerase chain reaction. Clinical parameters and the eventual presence of OLP symptoms, signs, and disease severity scores in each patient were reported using an anamnestic questionnaire. RESULTS In comparison with healthy controls, OLP patients showed significantly higher miR-7a-3p,-7a-2-3p,-21-3p, miR-21-5p and miR-100-5p levels (p < 0.05) and significantly lower miR-125b-2-3p,-125b-5p,-200b-3p, and -200b-5p levels (p < 0.05). Furthermore, OLP symptoms and signs and disease severity scores were significantly correlated and were also predictors of all analyzed miRNAs (p < 0.05). CONCLUSIONS In comparison with healthy subjects, OLP patients exhibited unbalanced oral miRNAs expression linked to the risk of potential malignant evolution of OLP. Furthermore, some miRNAs were correlated with OLP extent and were significant predictors of OLP symptoms, signs, and disease severity scores.
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Affiliation(s)
- Alessandro Polizzi
- Department of General Surgery and Surgical-Medical Specialties, Unit of Periodontology, School of Dentistry, University of Catania, Catania, Italy
| | - Simona Santonocito
- Department of General Surgery and Surgical-Medical Specialties, Unit of Periodontology, School of Dentistry, University of Catania, Catania, Italy
| | - Alfio Distefano
- Department of Biomedical and Biotechnological Sciences, University of Catania, Catania, Italy
| | - Rocco De Pasquale
- Department of General Surgery and Surgical-Medical Specialties, Unit of Periodontology, School of Dentistry, University of Catania, Catania, Italy
| | - Angela Alibrandi
- Department of Economics, Unit of Statistical and Mathematical Sciences, University of Messina, Messina, Italy
| | - Amer M Alanazi
- Pharmaceutical Biotechnology Laboratory, Department of Pharmaceutical Chemistry, College of Pharmacy, King Saud University, Riyadh, Saudi Arabia
| | - Giovanni Li Volti
- Department of Biomedical and Biotechnological Sciences, University of Catania, Catania, Italy
| | - Gaetano Isola
- Department of General Surgery and Surgical-Medical Specialties, Unit of Periodontology, School of Dentistry, University of Catania, Catania, Italy
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Czerninski R, Awadieh Z, Feldman S, Keshet N, Zlotogorski A, Ramot Y. Familial oral lichen planus: A new risk group for oral cancer? Oral Dis 2024; 30:3018-3027. [PMID: 37983887 DOI: 10.1111/odi.14805] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2023] [Revised: 10/10/2023] [Accepted: 10/29/2023] [Indexed: 11/22/2023]
Abstract
OBJECTIVE The familial type of oral lichen planus (OLP) is rare, with a paucity of data regarding its clinical significance. Our objective was to characterize patients with familial OLP. METHODS Families with at least two members diagnosed with OLP were included. Clinical and demographic data and medical history were recorded. RESULTS Twenty families, 19 Jewish and 1 Arab, were identified. Of the Jewish families, 57.8% were non-Ashkenazi, originating mainly from central Asia. Of those with OLP there were 14 males and 23 females with an average age of 49.1. Dyslipidemia, cardiovascular, and thyroid disorders (27.7%, 22.2%, and 16.6%, respectively) were the most common comorbidities. Five patients from five distinct families had oral cancer, two with second primary. CONCLUSIONS To the best of our knowledge, this is the largest study describing familial OLP. The predominant and common ethnicity of the families with multiple members diagnosed with OLP may imply an ethnic tendency. The higher tendency of hypothyroidism and the high percentage of OSCC among familial OLP patients might be connected to familial OLP and the latter suggests that this population is predisposed to malignant transformation. Thus, this group should be considered as a high-risk group.
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Affiliation(s)
- Rakefet Czerninski
- Department of Oral Medicine, Sedation and Imaging, Hadassah Medical Center, Faculty of Dental Medicine, Hebrew University of Jerusalem, Jerusalem, Israel
| | - Zinat Awadieh
- Department of Oral Medicine, Sedation and Imaging, Hadassah Medical Center, Faculty of Dental Medicine, Hebrew University of Jerusalem, Jerusalem, Israel
| | - Svetlana Feldman
- Department of Oral Medicine, Sedation and Imaging, Hadassah Medical Center, Faculty of Dental Medicine, Hebrew University of Jerusalem, Jerusalem, Israel
| | - Naama Keshet
- Department of Oral Medicine, Sedation and Imaging, Hadassah Medical Center, Faculty of Dental Medicine, Hebrew University of Jerusalem, Jerusalem, Israel
| | - Abraham Zlotogorski
- Department of Dermatology, Hadassah Medical Center, Jerusalem, Israel
- Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel
| | - Yuval Ramot
- Department of Dermatology, Hadassah Medical Center, Jerusalem, Israel
- Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel
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Pérez-Sayáns M, Chamorro-Petronacci CM, Bravo SB, Padín-Iruegas ME, Guitián-Fernández E, Barros-Angueira F, Quintas-Rey R, García-García A. Genetic linkage analysis of head and neck cancer in a Spanish family. Oral Dis 2024; 30:1032-1039. [PMID: 37026679 DOI: 10.1111/odi.14572] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2023] [Revised: 03/15/2023] [Accepted: 03/17/2023] [Indexed: 04/08/2023]
Abstract
OBJECTIVES To describe the genetic variants that may be associated with the development of head and neck cancer (HNC) and functionally validating the molecular implications. MATERIALS AND METHODS A prospective observational study was carried out on a family of 3 generations in which 3 members had developed HNC. Peripheral blood sample was taken in a routine procedure for exome sequencing in one relative and genotyping in the remaining twelve relatives. For the functional analysis all-trans retinoic acid (atRA) was extracted from saliva and serum and measured using ultra-performance liquid chromatography-tandem mass spectrometry (UPLC-MS/MS). The presence of HPV-DNA. RESULTS None of the patients smoked or consumed alcohol. The presence of HPV DNA was not detected in any of the biopsied samples. A total amount of 6 members out of 13 (46.15%) carried out the same mutation of CYP26B1 (2p13.2; G>T). The mean plasma concentration of atRA was 3.3109 ± 1.4791 pg/mL for the study family and 4.7370 ± 1.5992 pg/mL for the controls (p = 0.042). CONCLUSION Lower levels of atRA were confirmed in the study family, which may open the way to the possible relationship between the polymorphism CYP26B1 (2p13.2; G>T) and HNC.
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Affiliation(s)
- Mario Pérez-Sayáns
- Oral Medicine, Oral Surgery and Implantology Unit, Faculty of Medicine and Dentistry, Santiago de Compostela University, Santiago de Compostela, Spain
- Institute of Health Research Institute of Santiago (IDIS), Santiago de Compostela, Spain
| | - Cintia M Chamorro-Petronacci
- Oral Medicine, Oral Surgery and Implantology Unit, Faculty of Medicine and Dentistry, Santiago de Compostela University, Santiago de Compostela, Spain
- Institute of Health Research Institute of Santiago (IDIS), Santiago de Compostela, Spain
| | - Susana B Bravo
- Proteomic Unit, Health Research Institute of Santiago de Compostela (IDIS), University Clinical Hospital of Santiago de Compostela, Santiago de Compostela, Spain
| | - María E Padín-Iruegas
- Department of Functional Biology and Health Sciences, Faculty of Physiotherapy, Human Anatomy and Embryology Area, Vigo University, Pontevedra, Spain
| | - Esteban Guitián-Fernández
- Mass Spectrometry and Proteomics Unit, University of Santiago de Compostela, Santiago de Compostela, Spain
| | - Francisco Barros-Angueira
- Molecular Medicine Unit - Galician Public Foundation of Genomic Medicine, Consultation Building, Floor -2, University Hospital Complex of Santiago, Santiago de Compostela, Spain
| | - Rita Quintas-Rey
- Molecular Medicine Unit - Galician Public Foundation of Genomic Medicine, Consultation Building, Floor -2, University Hospital Complex of Santiago, Santiago de Compostela, Spain
| | - Abel García-García
- Oral Medicine, Oral Surgery and Implantology Unit, Faculty of Medicine and Dentistry, Santiago de Compostela University, Santiago de Compostela, Spain
- Institute of Health Research Institute of Santiago (IDIS), Santiago de Compostela, Spain
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Kirtschig G, Kinberger M. [Genital lichen sclerosus and lichen planus]. DERMATOLOGIE (HEIDELBERG, GERMANY) 2024; 75:22-29. [PMID: 38133692 DOI: 10.1007/s00105-023-05267-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 11/09/2023] [Indexed: 12/23/2023]
Abstract
Lichen sclerosus (LS) and lichen planus (LP) are chronic inflammatory dermatoses of unknown aetiology. They pose the most important differential diagnoses of inflammatory dermatoses in the genital area. There is often a delay in diagnosing LS and LP and subsequently treatment is initiated late in the course of the disease, which will lead to scarring and a decreased quality of life. There is an increased risk of the development of malignancies in the genital area in both diseases; however, early and continuous treatment with potent topical steroids will decrease this risk.
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Affiliation(s)
- Gudula Kirtschig
- Medbase Gesundheitszentrum, Unterer Graben 1, 8500, Frauenfeld, Schweiz.
| | - Maria Kinberger
- Klinik für Dermatologie, Venerologie und Allergologie, Division of Evidence-Based Medicine (dEBM), Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Deutschland
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Radu AM, Carsote M, Nistor C, Dumitrascu MC, Sandru F. Crossroads between Skin and Endocrine Glands: The Interplay of Lichen Planus with Thyroid Anomalies. Biomedicines 2023; 12:77. [PMID: 38255184 PMCID: PMC10813575 DOI: 10.3390/biomedicines12010077] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2023] [Revised: 12/15/2023] [Accepted: 12/23/2023] [Indexed: 01/24/2024] Open
Abstract
In this narrative review, we aimed to overview the interplay between lichen planus (LP) and thyroid conditions (TCs) from a dual perspective (dermatologic and endocrine), since a current gap in understanding LP-TC connections is found so far and the topic is still a matter of debate. We searched PubMed from Inception to October 2023 by using the key terms "lichen planus" and "thyroid", (alternatively, "endocrine" or "hormone"). We included original clinical studies in humans according to three sections: LP and TC in terms of dysfunction, autoimmunity, and neoplasia. Six studies confirmed an association between the thyroid dysfunction (exclusively hypothyroidism) and LP/OL (oral LP); of note, only one study addressed cutaneous LP. The sample size of LP/OLP groups varied from 12-14 to 1500 individuals. Hypothyroidism prevalence in OLP was of 30-50%. A higher rate of levothyroxine replacement was identified among OLP patients, at 10% versus 2.5% in controls. The highest OR (odd ratio) of treated hypothyroidism amid OLP was of 2.99 (p < 0.005). Hypothyroidism was confirmed to be associated with a milder OLP phenotype in two studies. A single cohort revealed a similar prevalence of hypothyroidism in LP versus non-LP. Non-confirmatory studies (only on OLP, not cutaneous LP) included five cohorts: a similar prevalence of hypothyroidism among OLP versus controls, and a single cohort showed that the subjects with OLP actually had a lower prevalence of hypothyroidism versus controls (1% versus 4%). Positive autoimmunity in LP/OLP was confirmed in eight studies; the size of the cohorts varied, for instance, with 619 persons with LP and with 76, 92, 105, 108, 192, 247, and 585 patients (a total of 1405) with OLP, respectively; notably, the largest control group was of 10,441 individuals. Four clusters of approaches with respect to the autoimmunity in LP/OLP were found: an analysis of HT/ATD (Hashimoto's thyroiditis/autoimmune thyroid diseases) prevalence; considerations over the specific antibody levels; sex-related features since females are more prone to autoimmunity; and associations (if any) with the clinical aspects of LP/OLP. HT prevalence in OLP versus controls was statistically significantly higher, as follows: 19% versus 5%; 12% versus 6%; and 20% versus 9.8%. A single study addressing LP found a 12% rate of ATDs. One study did not confirm a correlation between OLP-associated clinical elements (and OLP severity) and antibody values against the thyroid, and another showed that positive TPOAb (anti-thyroperoxidase antibodies) was more often found in erosive than non-erosive OLP (68% versus 33%). Just the reverse, one cohort found that OLP subjects had a statistically significantly lower rate of positive TPOAb versus controls (9% versus 15%). Five case-control studies addressed the issue of levothyroxine replacement for prior hypothyroidism in patients that were diagnosed with OLP (no study on LP was identified); three of them confirmed a higher rate of this treatment in OLP (at 8.9%, 9.7%, and 10.6%) versus controls. In conclusion, with regard to LP/OLP-TC, we note several main aspects as practical points for multidisciplinary practitioners: OLP rather than LP requires thyroid awareness; when it comes to the type of thyroid dysfunction, mostly, hypothyroidism should be expected; female patients are more prone to be associated with ATDs; a potential higher ratio of OLP subjects taking levothyroxine was found, thus a good collaboration with an endocrinology team is mandatory; and so far, OLP individuals have not been confirmed to be associated with a higher risk of thyroid nodules/cancer.
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Affiliation(s)
- Andreea-Maria Radu
- Department of Dermatovenerology, Elias University Emergency Hospital, 011461 Bucharest, Romania
| | - Mara Carsote
- Department of Endocrinology, Carol Davila University of Medicine and Pharmacy, 050474 Bucharest, Romania
- Department of Clinical Endocrinology V, C.I. Parhon National Institute of Endocrinology, 020021 Bucharest, Romania
| | - Claudiu Nistor
- Department 4—Cardio-Thoracic Pathology, Thoracic Surgery II Discipline, Carol Davila University of Medicine and Pharmacy, 050474 Bucharest, Romania
- Thoracic Surgery Department, Dr. Carol Davila Central Military Emergency University Hospital, 010242 Bucharest, Romania
| | - Mihai Cristian Dumitrascu
- Department of Obstetrics and Gynaecology, C. Davila University of Medicine and Pharmacy & University Emergency Hospital, 050474 Bucharest, Romania;
| | - Florica Sandru
- Department of Dermatovenerology, Carol Davila University of Medicine and Pharmacy & Elias University Emergency Hospital, 011461 Bucharest, Romania;
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Wang X, Li S, Song H, Ding Y, Gao R, Shi X, Li R, Ge X. METTL14-upregulated miR-6858 triggers cell apoptosis in keratinocytes of oral lichen planus through decreasing GSDMC. Commun Biol 2023; 6:976. [PMID: 37741915 PMCID: PMC10517968 DOI: 10.1038/s42003-023-05360-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2023] [Accepted: 09/15/2023] [Indexed: 09/25/2023] Open
Abstract
Oral lichen planus (OLP), a chronic inflammatory disorder, is characterized by the massive cell apoptosis in the keratinocytes of oral mucosa. However, the mechanism responsible for triggering oral keratinocyte apoptosis is not fully explained. Here, we identify that Gasdermin C (GSDMC) downregulation contributes to apoptosis in human oral keratinocytes. Mechanistically, we describe that activated nuclear factor kappa B (NF-κB) pathway induces overexpression of methyltransferase-like 14 (METTL14), which increases N6-adenosine methylation (m6A) levels in the epithelial layer of OLP. m6A modification is capable of regulating primary miR-6858 processing and alternative splicing, leading to miR-6858 increases. miR-6858 can bind and promote GSDMC mRNA degradation. Forced expression of GSDMC is able to rescue cell apoptosis in human oral keratinocyte models resembling OLP. Collectively, our data unveil that m6A modification regulates miR-6858 production to decrease GSDMC expression and to trigger keratinocyte apoptosis in the context of OLP.
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Affiliation(s)
- Xiangyu Wang
- Shanxi Province Key Laboratory of Oral Diseases Prevention and New Materials, Shanxi Medical University School and Hospital of Stomatology, Taiyuan, Shanxi, China
- Department of Child Dental and Preventive Dentistry, Shanxi Medical University School and Hospital of Stomatology, Taiyuan, Shanxi, China
- Department of Oral Medicine, Shanxi Medical University School and Hospital of Stomatology, Taiyuan, Shanxi, China
| | - Shuangting Li
- Shanxi Province Key Laboratory of Oral Diseases Prevention and New Materials, Shanxi Medical University School and Hospital of Stomatology, Taiyuan, Shanxi, China
| | - Huimin Song
- Shanxi Province Key Laboratory of Oral Diseases Prevention and New Materials, Shanxi Medical University School and Hospital of Stomatology, Taiyuan, Shanxi, China
- Department of Child Dental and Preventive Dentistry, Shanxi Medical University School and Hospital of Stomatology, Taiyuan, Shanxi, China
- Department of Oral Medicine, Shanxi Medical University School and Hospital of Stomatology, Taiyuan, Shanxi, China
| | - Yan Ding
- Department of Dermatology, Hainan Provincial Hospital of Skin Disease, Haikou, Hainan, China
- Department of Dermatology, Skin Disease Hospital of Hainan Medical University, Haikou, Hainan, China
| | - Ruifang Gao
- Shanxi Province Key Laboratory of Oral Diseases Prevention and New Materials, Shanxi Medical University School and Hospital of Stomatology, Taiyuan, Shanxi, China
| | - Xiaotong Shi
- Shanxi Province Key Laboratory of Oral Diseases Prevention and New Materials, Shanxi Medical University School and Hospital of Stomatology, Taiyuan, Shanxi, China
- Department of Child Dental and Preventive Dentistry, Shanxi Medical University School and Hospital of Stomatology, Taiyuan, Shanxi, China
- Department of Oral Medicine, Shanxi Medical University School and Hospital of Stomatology, Taiyuan, Shanxi, China
| | - Ran Li
- Shanxi Province Key Laboratory of Oral Diseases Prevention and New Materials, Shanxi Medical University School and Hospital of Stomatology, Taiyuan, Shanxi, China
| | - Xuejun Ge
- Shanxi Province Key Laboratory of Oral Diseases Prevention and New Materials, Shanxi Medical University School and Hospital of Stomatology, Taiyuan, Shanxi, China.
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Patigaroo SA, Ali I, Maqbool T, Qadri H, Showkat SA, Latoo MA. Reticular Oral Lichen Planus: A Clinical Experience of ENT Surgeons. Indian J Otolaryngol Head Neck Surg 2023; 75:390-396. [PMID: 37275004 PMCID: PMC10235395 DOI: 10.1007/s12070-022-03267-y] [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: 01/19/2022] [Accepted: 10/26/2022] [Indexed: 11/11/2022] Open
Abstract
Reticular Oral lichen planus (OLP) is a chronic autoimmune disease that presents as fine, white, linear and lace like lesions of the oral cavity referred to as Wickham striae. The clinical characteristics of 30 patients with reticular oral lichen planus is presented so that cases are not missed/misdiagnosed by ENT surgeons. The clinical records noted for each patient were gender, age and clinical presentation of reticular OLP (site affected, presence of symptoms and extraoral manifestations of the disease, smoking habit, and consumption of alcoholic beverages). Twenty patients were females (66.7%) and 10 (33.3%) were males giving a female to male ratio of 2:1. Majority of patients (50%) among both males and females were in the age group of 31-40 years followed by 41-50 years (20%). Oral discomfort/burning sensation was the chief symptom in 24 (80%) patients followed by asymptomatic oral white patches in 5 (16.6%).The buccal (cheek) mucosa was the site most affected (76.8%) followed by the buccal mucosa plus retromolar trigone mucosa (10%) and tongue (6.6%), Extraoral lesions were observed in 2 (6.6%) of patients at presentation with oral lesions and were on the nails in 1 patient and wrist in 1 patient. Tobacco smoking, alcohol use, diabetes and hypertension were reported in 3 (10%), 0%, 2 (6.7%) and 4 (13.3%) patients respectively. ENT surgeons routinely see patients with oral discomfort/oral ulcerations and as such they should be well versed with classical clinical characteristics of reticular oral lichen planus.
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Affiliation(s)
| | - Ihsan Ali
- Department of ENT, Government Medical College, Srinagar, J&K India
| | - Tabish Maqbool
- Department of ENT, Government Medical College, Srinagar, J&K India
| | - Haris Qadri
- Department of ENT, Government Medical College, Srinagar, J&K India
| | | | - Manzoor A. Latoo
- Department of ENT, Government Medical College, Srinagar, J&K India
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Polizzi A, Santonocito S, Lo Giudice A, Alibrandi A, De Pasquale R, Isola G. Analysis of the response to two pharmacological protocols in patients with oral lichen planus: A randomized clinical trial. Oral Dis 2023; 29:755-763. [PMID: 34252252 DOI: 10.1111/odi.13960] [Citation(s) in RCA: 23] [Impact Index Per Article: 23.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2021] [Revised: 06/10/2021] [Accepted: 07/08/2021] [Indexed: 02/07/2023]
Abstract
OBJECTIVE To evaluate the effectiveness of two different therapies on oral lichen planus (OLP) treatment through the analysis of OLP symptoms and signs and to analyze the risk of side effects related to the adopted protocols. METHODS Thirty-eight patients with OLP were selected according to van der Meij and van der Waal clinical and histopathological criteria. Through a randomized design, 19 patients received Tacrolimus 0.1% ointment (T group) and 19 an anti-inflammatory mouthwash (M group) composed of calcium hydroxide 10%, hyaluronic acid 0.3%, umbelliferone, and oligomeric proanthocyanidins. The patients were examined on a regular basis for OLP symptoms, signs, and disease severity score changes over a 3-month follow-up period. RESULTS Both treatments were effective in the reduction of OLP signs and symptoms. However, at 3 months (T3), in comparison with the M group, T group patients showed significantly lower mean values of OLP signs (p = 0.035), symptoms (p = 0.045), and disease severity scores (p = 0.041). Moreover, the Spearman test showed that there was a significant correlation between OLP signs and symptoms at each follow-up session in all patients. CONCLUSIONS Both treatments demonstrated a significant approach to control OLP. However, tacrolimus determined a more effective improvement in OLP signs and symptoms compared to anti-inflammatory mouthwash at 3-month follow-up.
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Affiliation(s)
- Alessandro Polizzi
- Department of General Surgery and Surgical-Medical Specialties, School of Dentistry, University of Catania, Catania, Italy
| | - Simona Santonocito
- Department of General Surgery and Surgical-Medical Specialties, School of Dentistry, University of Catania, Catania, Italy
| | - Antonino Lo Giudice
- Department of General Surgery and Surgical-Medical Specialties, School of Dentistry, University of Catania, Catania, Italy
| | - Angela Alibrandi
- Department of Economical, Business and Environmental Sciences and Quantitative Methods, University of Messina, Messina, Italy
| | - Rocco De Pasquale
- Department of General Surgery and Surgical-Medical Specialties, Unit of Dermatology, University of Catania, Catania, Italy
| | - Gaetano Isola
- Department of General Surgery and Surgical-Medical Specialties, School of Dentistry, University of Catania, Catania, Italy
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Gururaj N, Hasinidevi P, Janani V, Divynadaniel T. Diagnosis and management of oral lichen planus - Review. J Oral Maxillofac Pathol 2021; 25:383-393. [PMID: 35281147 PMCID: PMC8859620 DOI: 10.4103/jomfp.jomfp_386_21] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2021] [Accepted: 11/24/2021] [Indexed: 12/15/2022] Open
Affiliation(s)
- N Gururaj
- Department of Oral and Maxillofacial Pathology, CSI College of Dental Sciences and Research, Madurai, Tamil Nadu, India
| | - P Hasinidevi
- Srinivas Dental Clinic and Oral Care, Madurai, Tamil Nadu, India
| | - V Janani
- Srinivas Dental Clinic and Oral Care, Madurai, Tamil Nadu, India
| | - T Divynadaniel
- Department of Oral and Maxillofacial Pathology, CSI College of Dental Sciences and Research, Madurai, Tamil Nadu, India
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Ramesh S, Nazeer SS, Thomas S, Vivek V, Jayasree RS. Optical diagnosis of oral lichen planus: A clinical study on the use of autofluorescence spectroscopy combined with multivariate analysis. SPECTROCHIMICA ACTA. PART A, MOLECULAR AND BIOMOLECULAR SPECTROSCOPY 2021; 248:119240. [PMID: 33310275 DOI: 10.1016/j.saa.2020.119240] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/31/2020] [Revised: 11/03/2020] [Accepted: 11/14/2020] [Indexed: 06/12/2023]
Abstract
Oral lichen planus (OLP) is a chronic mucocutaneous inflammatory condition of stratified squamous epithelia. OLP is a potentially malignant condition in oral mucosa. Patients with OLP have an increased risk of developing squamous cell carcinoma. Therefore an early and accurate diagnosis is necessary to avoid further damage to the oral mucosa. Biopsy followed by histopathological examination is the gold standard for the diagnosis of oral mucosal lesions including OLP. But this invasive procedure is traumatic and time consuming with limited statistical confidence level. Autofluorescence spectroscopy (AFS) has recently emerged as a potential tool to evaluate the biochemical changes associated with oral cavity disorders. In this study, we used AFS to differentiate the oral cavity tissue of 20 OLP patients from that of 16 normal volunteers. Spectra from oral mucosa were acquired at 280, 320 and 410 nm excitation wavelengths which correspond to the excitation energy of major endogenous fluorophores. Normalized spectral data at 320 nm excitation showed significant increase in the intensity of collagen peak for OLP. Optical redox ratio and total hemoglobin concentration estimated from the spectral data revealed significant increase and decrease respectively in OLP and normal patients. Principal component analysis followed by linear discriminant analysis (PCA-LDA) provided sensitivity and specificity of 71 and 80%, 80 and 90%, and 72 and 75% respectively for 280, 320 and 410 nm excited spectral datasets. Meanwhile, partial least square discriminant analysis (PLS-DA) provided sensitivity and specificity of 69 and 77%, 78 and 91% and 73 and 78.13% respectively for 280, 320 and 410 nm excited spectral datasets. From the results, it is concluded that AFS is an efficient tool for the non invasive diagnosis of OLP, with 320 nm light identified as the best wavelength for excitation.
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Affiliation(s)
- S Ramesh
- Department of Oral Medicine and Radiology, PMS College of Dental Sciences and Research, Trivandrum, Kerala, India; Department of Oral Medicine and Radiology, Government Dental College, Trivandrum, Kerala, India
| | - Shaiju S Nazeer
- Department of Chemistry, Indian Institute of Space Sciences and Technology, Trivandrum, Kerala, India; Division of Biophotonics and Imaging, Biomedical Technology Wing, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Kerala, India
| | - Sunila Thomas
- Department of Oral Medicine and Radiology, PMS College of Dental Sciences and Research, Trivandrum, Kerala, India
| | - V Vivek
- Department of Oral Medicine and Radiology, PMS College of Dental Sciences and Research, Trivandrum, Kerala, India
| | - Ramapurath S Jayasree
- Division of Biophotonics and Imaging, Biomedical Technology Wing, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Kerala, India.
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Wang F, Tan YQ, Zhang J, Zhou G. Familial oral lichen planus in a 3-year-old boy: a case report with eight years of follow-up. BMC Oral Health 2020; 20:341. [PMID: 33243193 PMCID: PMC7690117 DOI: 10.1186/s12903-020-01333-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2019] [Accepted: 11/17/2020] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Oral lichen planus (OLP) is a chronic mucocutaneous disease characterized by adult predominance and a prolonged course. However, it is rare in the pediatric population with familial aggregation. CASE PRESENTATION A 3-year-old boy presented with pain and irritation on the oral mucosa while contacting spicy food for 2 months. Oral examination showed widespread whitish reticular and papular lesions on the lips, the dorsum of the tongue, and bilateral buccal mucosa, with diffuse erosions covered with pseudomembrane on the buccal mucosa. The boy's parents were examined to exhibit white reticular and plaque-like lesions on their oral mucosa. The three patients were clinically diagnosed as affected by OLP and histopathologically confirmed. The boy underwent topical treatment with recombinant bovine basic fibroblast growth factor (rb-bFGF) gel, and oral lesions gradually resolved and healed. Neither of his parents received treatment. During the subsequent follow-ups, none of three patients underwent any medical treatment. Fortunately, their lesions had almost faded over 8 years. CONCLUSIONS Our case emphasizes that pediatric OLP should be recorded with family history. Besides, long-term periodic follow-up is recommended in pediatric patients with OLP for monitoring any changes in lesions.
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Affiliation(s)
- Fang Wang
- The State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOST) and Key Laboratory of Oral Biomedicine Ministry of Education, School and Hospital of Stomatology, Wuhan University, Luoyu Road, Wuhan, 237, China.,Department of Oral Medicine, School and Hospital of Stomatology, Wuhan University, Luoyu Road, Wuhan, 237, China
| | - Ya-Qin Tan
- The State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOST) and Key Laboratory of Oral Biomedicine Ministry of Education, School and Hospital of Stomatology, Wuhan University, Luoyu Road, Wuhan, 237, China.,Department of Oral Medicine, School and Hospital of Stomatology, Wuhan University, Luoyu Road, Wuhan, 237, China
| | - Jing Zhang
- The State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOST) and Key Laboratory of Oral Biomedicine Ministry of Education, School and Hospital of Stomatology, Wuhan University, Luoyu Road, Wuhan, 237, China.,Department of Oral Medicine, School and Hospital of Stomatology, Wuhan University, Luoyu Road, Wuhan, 237, China
| | - Gang Zhou
- The State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOST) and Key Laboratory of Oral Biomedicine Ministry of Education, School and Hospital of Stomatology, Wuhan University, Luoyu Road, Wuhan, 237, China. .,Department of Oral Medicine, School and Hospital of Stomatology, Wuhan University, Luoyu Road, Wuhan, 237, China.
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12
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Shavit E, Hagen K, Shear N. Oral lichen planus: a novel staging and algorithmic approach and all that is essential to know. F1000Res 2020; 9. [PMID: 32226613 PMCID: PMC7096219 DOI: 10.12688/f1000research.18713.1] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 03/19/2020] [Indexed: 01/04/2023] Open
Abstract
Lichen planus (LP) is a chronic autoimmune disease. Oral lesions may occur in isolation or in combination with other affected muco-cutaneous sites. Oral LP (OLP) may present as one of the various manifestations of LP or may present as a disease sui generis with a broad range of severity. Despite this disease targeting the oral mucosa, its great impact on quality of life is underrated. In this article, we provide an updated review of the pathophysiology and epidemiology of OLP and offer guidance for its diagnosis and management. We also propose an algorithmic approach to the clinical forms of OLP and a novel staging system to facilitate management decisions.
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Affiliation(s)
- Eran Shavit
- Division of Dermatology, Department of Medicine, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, ON, Canada.,Dermatology Unit, Barzilai University Medical Center, Ashkelon, Israel.,Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheba, Israel
| | - Klieb Hagen
- Department of Dentistry, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, ON, Canada.,Department of Anatomic Pathology, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, ON, Canada
| | - Neil Shear
- Division of Dermatology, Department of Medicine, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, ON, Canada.,Department of Medicine (Dermatology, Clinical Pharmacology, and Toxicology), Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario, Canada.,Department of Pharmacology, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, ON, Canada
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13
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Possible Mechanisms Involved in the Cooccurrence of Oral Lichen Planus and Hashimoto's Thyroiditis. Mediators Inflamm 2020; 2020:6309238. [PMID: 32089646 PMCID: PMC7024099 DOI: 10.1155/2020/6309238] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2019] [Accepted: 01/22/2020] [Indexed: 02/05/2023] Open
Abstract
Oral lichen planus (OLP) is a chronic inflammatory oral mucosal disorder mediated by T cells, with a multifactorial etiology. Hashimoto's thyroiditis (HT) is a common autoimmune disease characterized by hypothyroidism. Although many clinical studies conducted over the past several decades have reported the cooccurrence of OLP and HT, the underlying mechanism remains unclear. This review summarizes potential mechanisms that might be involved in the cooccurrence of OLP and HT. We find that OLP and HT share a common or overlapping pathogenesis in terms of immune, heredity, environmental, and hormonal factors, which might cause cooccurrence. Furthermore, considering the latency of HT, a routine screen for thyroid diseases, particularly HT, is suggested for confirmed OLP patients.
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14
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Khurana A, Tandon S, Marfatia YS, Madnani N. Genital lichen planus: An underrecognized entity. Indian J Sex Transm Dis AIDS 2020; 40:105-112. [PMID: 31922099 PMCID: PMC6896385 DOI: 10.4103/ijstd.ijstd_45_19] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Abstract
Genital lichen planus (LP) is an underrecogonized dermatosis. The appearance is often unlike classical LP elsewhere, and hence, the condition goes undiagnosed in many. Vulvo-vaginal LP in particular, can be a distressing condition often leading to scarring and a poor quality of life. Treatment for most of the genital LP variants is similar to managing LP elsewhere; however, the erosive variant requires special attention as treatment outcomes are often disappointing and the disease runs a protracted course. Potential for development of malignancy also exists, as in oral LP, and hence close follow up is essential.
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Affiliation(s)
- Ananta Khurana
- Department of Dermatology, Venereology and Leprosy, Postgraduate Institute of Medical Education and Research, Dr. Ram Manohar Lohia Hospital, New Delhi, India
| | - Sidharth Tandon
- Department of Dermatology, Santosh Medical College, Gaziabad, Uttar Pradesh, India
| | - Yogesh S Marfatia
- Department of Dermatology, Government Medical College, Vadodara, Gujarat, India
| | - Nina Madnani
- Department of Dermatology, P. D. Hinduja National Hospital and Sir H. N. Reliance Foundation Hospital, Mumbai, Maharashtra, India
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15
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Hasan S, Ahmed S, Kiran R, Panigrahi R, Thachil JM, Saeed S. Oral lichen planus and associated comorbidities: An approach to holistic health. J Family Med Prim Care 2019; 8:3504-3517. [PMID: 31803644 PMCID: PMC6881968 DOI: 10.4103/jfmpc.jfmpc_749_19] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2019] [Revised: 09/08/2019] [Accepted: 09/23/2019] [Indexed: 02/06/2023] Open
Abstract
Lichen planus (LP) is a chronic inflammatory disorder with involvement of skin, oral and genital mucosa, scalp, and nail appendages. Oral lichen planus (OLP) lesions demonstrate a number of morphologic presentations, persist for a long time with rare self-resolution, and undergo malignant changes. OLP has been associated with numerous systemic connotations such as metabolic syndrome, diabetes mellitus, hypertension, thyroid diseases, psychosomatic ailments, chronic liver disease, gastrointestinal diseases, and genetic susceptibility to cancer. The oral health physician should be aware of these systemic associations and should work in close connect with the primary healthcare physicians to rule out the predisposing factors for the associated comorbidities. This article aims to highlight the various systemic associations of OLP and warrants the screening of these ailments in OLP for prevention and effective management.
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Affiliation(s)
- Shamimul Hasan
- Department of Oral Medicine and Radiology, Faculty of Dentistry, Jamia Millia Islamia, New Delhi, India
| | - Sameer Ahmed
- Department of Periodontology, Darshan Dental College and Hospitals Udaipur, Rajasthan, India
| | - Ravi Kiran
- Department of Periodontology, Darshan Dental College and Hospitals Udaipur, Rajasthan, India
| | - Rajat Panigrahi
- Department of Oral Medicine and Radiology, Institute of Dental Sciences, SOA University, Bhubaneswar, Odisha, India
| | | | - Shazina Saeed
- Amity Institute of Public Health, Amity University, Noida, Uttar Pradesh, India
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16
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Kaomongkolgit R, Daroonpan P, Tantanapornkul W, Palasuk J. Clinical profile of 102 patients with oral lichen planus in Thailand. J Clin Exp Dent 2019; 11:e625-e629. [PMID: 31516660 PMCID: PMC6730998 DOI: 10.4317/jced.55814] [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: 04/22/2019] [Accepted: 06/12/2019] [Indexed: 11/05/2022] Open
Abstract
Background Oral lichen planus (OLP) is a chronic inflammatory disease of the skin and mucous membrane presented with various clinical appearances. The aim of the present study was to elucidate the clinical profile of patients with OLP. Material and Methods The dental records of 102 patients who visited Oral Medicine Clinic, Dental Hospital, Naresuan University during 2002-2018 were retrospectively reviewed. Results There were 75 (73.5%) women and 27 (26.5%) men, giving a female to male ratio of 2.8:1. The age of OLP patients ranged 20-81 years old with the mean age of 56.4 ± 13.2 years old. Seventy-eight patients (76.5%) had the history of systemic diseases and hypertension was the predominantly one. Most patients were non-smokers (98%), non-drinkers (86.3%) and non-betel nut chewers (98%). The atrophic form (93.1%) was the most common OLP. The lesions were mainly symptomatic (92.2%) and involved multiple locations (67.6%) where the buccal mucosa (79.4%) primarily affected. Only 2% were extraoral lesions detected on the skin. Patients had no family history of OLP or malignant transformation. Ninety-one patients (89.2%) were treated with topical steroid and only 4 patients were prescribed a combination of tropical and systemic steroid. Conclusions The results of the study indicated that most of characteristics are in accordance with previous studies. Since, OLP is a chronic inflammatory oral mucosal disease with high recurrence rate, early detection, accurately diagnosis, and long-term follow-up are necessary to evaluate the exacerbation and malignant transformation. Key words:Clinical profile, demographic, oral lichen planus, retrospective study.
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Affiliation(s)
| | - Pissacha Daroonpan
- Department of Oral Diagnosis, Faculty of Dentistry, Naresuan University, Phitsanulok, Thailand
| | - Weeraya Tantanapornkul
- Department of Oral Diagnosis, Faculty of Dentistry, Naresuan University, Phitsanulok, Thailand
| | - Jadesada Palasuk
- Department of Restorative Dentistry, Faculty of Dentistry, Naresuan University, Phitsanulok, Thailand
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17
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Ibrahim ZAES, El-Ashmawy AA, Neinaa YMEH, Mohammad DAEA. Immunohistochemical Expression of Calmodulin in Cutaneous Lichen Planus: A Case-Control Study. Indian J Dermatol 2019; 64:338. [PMID: 31516153 PMCID: PMC6714185 DOI: 10.4103/ijd.ijd_91_18] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Background: Calmodulin (CaM) is a multifunctional intermediate messenger protein that plays important role in cell motility, proliferation, and apoptosis. Therefore, it is thought to be involved in various ways in the apoptotic processes which are implicated in the pathogenesis of lichen planus. Objective: The aim of this study was to evaluate the immunohistochemical expression of CaM in lichen planus lesions in comparison to normal control skin to throw light on its possible role in disease pathogenesis. Patients and Methods: This case–control study was conducted on 50 patients with lichen planus, in addition to 20 age- and sex-matched healthy individuals. Skin biopsy specimens were taken from lesional skin of lichen planus patients as well as normal skin of controls. All were examined for immunohistochemical expression of CaM antibody. Results: There was statistically significant increase of the immunohistochemical expression of CaM in lesional skin of lichen planus patients compared with normal skin of controls (Chi-square test, P < 0.001). No significant correlation could be detected between CaM expression in lesional skin and the studied clinical parameters of lichen planus patients. Limitations: Tha main limitation of this study is its small sample size. Conclusion: CaM is upregulated in cutaneous lichen planus lesions suggesting a possible role in disease pathogenesis. Targeting CaM is expected to be a novel strategy for treatment of lichen planus.
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Affiliation(s)
| | - Amal Ahmad El-Ashmawy
- Department of Dermatology and Venereology, Faculty of Medicine, Tanta University, Tanta, Egypt
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18
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Cassol-Spanemberg J, Rodríguez-de Rivera-Campillo ME, Otero-Rey EM, Estrugo-Devesa A, Jané-Salas E, López-López J. Oral lichen planus and its relationship with systemic diseases. A review of evidence. J Clin Exp Dent 2018; 10:e938-e944. [PMID: 30386529 PMCID: PMC6203921 DOI: 10.4317/jced.55145] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2018] [Accepted: 08/06/2018] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND Oral lichen planus (OLP) is one of the most common dermatological diseases which are present in the oral cavity. It is a chronic autoimmune, mucocutaneous disease that affects the oral mucosa as well as the skin, genital mucosa and other sites. OBJECTIVE Review the relevant information to OLP and its relationship with systemic diseases. MATERIAL AND METHODS Searches were carried out in the Medline/PubMed, Lilacs, Bireme, BVS, and SciELO databases by using key-words. After an initial search that provided us with 243 papers, this number was reduced to 78 from the last seven years. One of the first criteria adopted was a selective reading of the abstracts of articles for the elimination of publications that presented less information regarding the subject proposed for this work. All the selected articles were read in their entirety by all of the authors, who came to a consensus about their level of evidence. The Scottish Intercollegiate Guidelines Network (SIGN) criteria were used as the criteria of methodological validation. RESULTS Only 9 articles showed an evidence level of 1+, 2+, 3 or 4, as well as a recommendation level of A, B, C or D. Three of them were non-systematic reviews, one was a cohort study and only one was a controlled clinical trial. Three of the studies were case series, with respective sample sizes of 45, 171 and 633 patients. CONCLUSIONS Several factors have been associated with OLP. Patients with OLP are carriers of a disease with systemic implications and may need the care of a multidisciplinary team. The correct diagnosis of any pathology is critical to making effective treatment and minimizes iatrogenic harm. For OLP is no different, taking into account its association with numerous systemic diseases that require special attention from health professionals. Periodic follow-up of all patients with OLP is recommended. Key words:Oral lichen planus, etiopathogenesis, systemic diseases.
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Affiliation(s)
- Juliana Cassol-Spanemberg
- PhD. Postdoctoral Research Fellow. Specialist in Stomatology and Public Health. Faculty of Medicine and Health Sciences (School of Dentistry), University of Barcelona, Spain
| | - María-Eugenia Rodríguez-de Rivera-Campillo
- MD, DDS, PhD, Dermatologist and Dentist. Professor of Oral Pathology, Faculty of Medicine and Health Sciences (School of Dentistry), University of Barcelona / Oral Health and Masticatory System Group (Bellvitge Biomedical Research Institute) IDIBELL, University of Barcelona, Spain
| | - Eva-María Otero-Rey
- DDS, PhD, Odontology. Professor of Master of Daily Practice Dentistry. Department of Stomatology. School of Dentistry. University of Santiago de Compostela, Spain
| | - Albert Estrugo-Devesa
- MD, DDS, PhD. Doctor, Specialist in Stomatology. Professor of Oral Pathology, Faculty of Medicine and Health Sciences (School of Dentistry), University of Barcelona / Oral Health and Masticatory System Group (Bellvitge Biomedical Research Institute) IDIBELL, University of Barcelona, Spain
| | - Enric Jané-Salas
- MD, DDS, PhD. Doctor, Specialist in Stomatology. Professor of Oral Pathology, Faculty of Medicine and Health Sciences (School of Dentistry), University of Barcelona / Oral Health and Masticatory System Group (Bellvitge Biomedical Research Institute) IDIBELL, University of Barcelona, Spain
| | - José López-López
- MD, DDS, PhD. Doctor, Specialist in Stomatology. Professor of Oral Pathology, Faculty of Medicine and Health Sciences (School of Dentistry), University of Barcelona - Head of the Medical Surgical Area and Medical Director of Dentistry Hospital Barcelona University / Oral Health and Masticatory System Group (Bellvitge Biomedical Research Institute) IDIBELL, University of Barcelona, Spain
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19
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Wei Z, Hou Q, Xu H, Jiang L, Chen Q. Evidence of genetic factors involved in oral lichen planus pathogenesis. Oral Dis 2017; 24:864-865. [PMID: 28736881 DOI: 10.1111/odi.12716] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Affiliation(s)
- Z Wei
- State Key Laboratory of Oral Diseases; National Clinical Research Center for Oral Diseases; West China Hospital of Stomatology; Sichuan University; Chengdu China
| | - Q Hou
- Department of Laboratory Medicine; Precision Medicine Key Laboratory of Sichuan Province; West China Hospital; Sichuan University; Chengdu China
| | - H Xu
- Department of Laboratory Medicine; Precision Medicine Key Laboratory of Sichuan Province; West China Hospital; Sichuan University; Chengdu China
| | - L Jiang
- State Key Laboratory of Oral Diseases; National Clinical Research Center for Oral Diseases; West China Hospital of Stomatology; Sichuan University; Chengdu China
| | - Q Chen
- State Key Laboratory of Oral Diseases; National Clinical Research Center for Oral Diseases; West China Hospital of Stomatology; Sichuan University; Chengdu China
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20
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Li D, Li J, Li C, Chen Q, Hua H. The Association of Thyroid Disease and Oral Lichen Planus: A Literature Review and Meta-analysis. Front Endocrinol (Lausanne) 2017; 8:310. [PMID: 29170653 PMCID: PMC5684121 DOI: 10.3389/fendo.2017.00310] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/30/2017] [Accepted: 10/25/2017] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND The objective of this study was to systemically evaluate the association between oral lichen planus (OLP) and thyroid disease. METHOD Eleven electronic databases were searched for any clinical study published up until August 2016 that explored an association between OLP and thyroid disease, complemented with manual searching. The titles and abstracts of all studies identified from the electronic searches were then assessed independently to determine inclusion of the study. The population of interest was patients with OLP, and the exposure was the presence of thyroid disease in OLP patients. Statistical analyses were conducted using Review Manager 5.2. The odds ratios (OR) and 95% confidence intervals (CIs) were calculated to evaluate the association between OLP and thyroid disease. RESULTS Eight studies were included for review, and of these, four case-control studies were included in the final meta-analysis. The mean Newcastle-Ottawa Scale score evaluating the methodological quality of the four studies was 6.5. The OR was 2.10 (95% CI: 1.47-3.01), indicating a statistically significant difference in the prevalence of thyroid disease between the OLP and control groups. Heterogeneity was satisfactory (I2 = 0%, <25%). An approximately symmetrical funnel plot suggested no obvious publication bias. Two articles showed a higher correlation between OLP and hypothyroidism (OR 1.83, 95% CI: 1.16-2.89), with satisfactory heterogeneity (I2 = 0%, <25%). CONCLUSION This meta-analysis indicated a significantly high prevalence of thyroid disease among OLP patients compared with controls, suggesting that routine screening for thyroid disease could be beneficial to OLP patients. However, due to the small number of studies included, further studies are needed to confirm the results.
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Affiliation(s)
- Dan Li
- Department of Oral Medicine, Peking University Hospital of Stomatology, Beijing, China
| | - Jin Li
- Department of Oral Medicine, Peking University Hospital of Stomatology, Beijing, China
| | - Chunlei Li
- Department of Oral Medicine, Peking University Hospital of Stomatology, Beijing, China
| | - Qianming Chen
- Department of Oral Medicine West China School of Stomatology, Sichuan University, Chengdu, China
| | - Hong Hua
- Department of Oral Medicine, Peking University Hospital of Stomatology, Beijing, China
- *Correspondence: Hong Hua,
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21
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Lu SL, Qi XM, Dong G, Chen SL, Guo DW, Wang YL, Yang PS. Clinical characteristics and analysis of familial oral lichen planus in eight Chinese families. Exp Ther Med 2016; 12:2281-2284. [PMID: 27698724 DOI: 10.3892/etm.2016.3597] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2015] [Accepted: 07/28/2016] [Indexed: 12/30/2022] Open
Abstract
Oral lichen planus (OLP) is one of the most common oral mucosa diseases; however, familial OLP is uncommon. The present study reported and analyzed patients with familial OLP (n=18) in eight different Chinese families between January 1, 2012 and December 31, 2013. Parameters analyzed include gender, age at diagnosis, lesion distribution and lesion type. The follow-up period for each patient was a minimum of 1 year. In this survey, 18/88 individuals in the eight families were affected. Females were more frequently affected, and the female to male ratio for familial OLP (2.2:1) was higher compared with that previously reported for nonfamilial OLP (1.4:1). The age at diagnosis, lesion distribution and lesion type showed consistency with reports concerning nonfamilial OLP, with the exception of family VI, in which 4/5 children had OLP/LP lesions and were of an early age at diagnosis. There were two families in which three generations had been affected by OLP. In addition, it appeared that patients of the same generation in the same family were of a similar age at diagnosis. No malignant or premalignant lesion was identified in the 18 individuals diagnosed with OLP from the eight families. The present study supports the hypothesis that genetic predisposition may serve a role in the etiology of OLP.
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Affiliation(s)
- Shu-Lai Lu
- Department of Periodontology, School of Stomatology, Shandong University, Jinan, Shandong 250012, P.R. China; Oral Medical Center of Qingdao Municipal Hospital, Qingdao, Shandong 266071, P.R. China; Shandong Provincial Key Laboratory of Oral Biomedicine, Shandong University, Jinan, Shandong 250012, P.R. China
| | - Xiang-Min Qi
- Department of Periodontology, School of Stomatology, Shandong University, Jinan, Shandong 250012, P.R. China; Shandong Provincial Key Laboratory of Oral Biomedicine, Shandong University, Jinan, Shandong 250012, P.R. China
| | - Gang Dong
- Oral Medical Center of Qingdao Municipal Hospital, Qingdao, Shandong 266071, P.R. China
| | - Shu-Lan Chen
- Oral Medical Center of Qingdao Municipal Hospital, Qingdao, Shandong 266071, P.R. China
| | - Da-Wei Guo
- Oral Medical Center of Qingdao Municipal Hospital, Qingdao, Shandong 266071, P.R. China
| | - Yun-Long Wang
- Gout Laboratory, The Affiliated Hospital of Qingdao University, Qingdao, Shandong 266003, P.R. China
| | - Pi-Shan Yang
- Department of Periodontology, School of Stomatology, Shandong University, Jinan, Shandong 250012, P.R. China; Shandong Provincial Key Laboratory of Oral Biomedicine, Shandong University, Jinan, Shandong 250012, P.R. China
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22
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Alrashdan MS, Cirillo N, McCullough M. Oral lichen planus: a literature review and update. Arch Dermatol Res 2016; 308:539-51. [PMID: 27349424 DOI: 10.1007/s00403-016-1667-2] [Citation(s) in RCA: 227] [Impact Index Per Article: 28.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2016] [Revised: 03/16/2016] [Accepted: 06/17/2016] [Indexed: 12/22/2022]
Abstract
Lichen planus (LP) is a common chronic inflammatory condition that can affect skin and mucous membranes, including the oral mucosa. Because of the anatomic, physiologic and functional peculiarities of the oral cavity, the oral variant of LP (OLP) requires specific evaluations in terms of diagnosis and management. In this comprehensive review, we discuss the current developments in the understanding of the etiopathogenesis, clinical-pathologic presentation, and treatment of OLP, and provide follow-up recommendations informed by recent data on the malignant potential of the disease as well as health economics evaluations.
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Affiliation(s)
- Mohammad S Alrashdan
- Department of Oral Medicine and Surgery, Faculty of Dentistry, Jordan University of Science and Technology, Irbid, 22110, Jordan.
| | - Nicola Cirillo
- Melbourne Dental School, The University of Melbourne, Victoria, Australia
| | - Michael McCullough
- Melbourne Dental School, The University of Melbourne, Victoria, Australia
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23
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Krupaa RJ, Sankari SL, Masthan KMK, Rajesh E. Oral lichen planus: An overview. J Pharm Bioallied Sci 2015; 7:S158-61. [PMID: 26015696 PMCID: PMC4439656 DOI: 10.4103/0975-7406.155873] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2014] [Revised: 10/31/2014] [Accepted: 11/09/2014] [Indexed: 11/30/2022] Open
Abstract
Lichen planus is an immunologically mediated mucocutaneous disease that is triggered by varied etiological agents. The oral lichenoid reaction is considered a variant of the disease that needs to be clearly diagnosed as a separate entity from oral lichen planus and treated. They follow a strict cause-effector relationship, protocols that suggest the differentiation. Lichen planus has varied clinical forms in the oral mucosa and cutaneously that has different prognosis. This condition also arises in association with various other systemic conditions such as hypertension, diabetes mellitus. There have been cases reported in the esophagus, larynx, scalp, nail, cutaneous areas, especially arms and wrists, trunk. There is reported malignant transformation that essentiates careful examination, treatment protocol and regular follow-up sessions. This article throws light on the disease condition of oral lichen planus and oral lichenoid reaction that is essential for the differentiation and treatment.
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Affiliation(s)
- R Jayasri Krupaa
- Department of Oral Pathology and Microbiology, Sree Balaji Dental College and Hospital, Bharath University, Chennai, Tamil Nadu, India
| | - S Leena Sankari
- Department of Oral Pathology and Microbiology, Sree Balaji Dental College and Hospital, Bharath University, Chennai, Tamil Nadu, India
| | - K M K Masthan
- Department of Oral Pathology and Microbiology, Sree Balaji Dental College and Hospital, Bharath University, Chennai, Tamil Nadu, India
| | - E Rajesh
- Department of Oral Pathology and Microbiology, Sree Balaji Dental College and Hospital, Bharath University, Chennai, Tamil Nadu, India
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Payeras MR, Cherubini K, Figueiredo MA, Salum FG. Oral lichen planus: focus on etiopathogenesis. Arch Oral Biol 2013; 58:1057-69. [PMID: 23660124 DOI: 10.1016/j.archoralbio.2013.04.004] [Citation(s) in RCA: 145] [Impact Index Per Article: 13.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2012] [Revised: 03/09/2013] [Accepted: 04/11/2013] [Indexed: 02/07/2023]
Abstract
Lichen planus is a chronic mucocutaneous inflammatory disease, which frequently affects the oral mucosa of white females over 40 years old. Its aetiology remains uncertain and the pathogenesis is still the object of much speculation. The present paper presents the most well known antigens, and describes the action of different cells and proteins associated with the development of that disease, as well as the possible agents involved with its malignant transformation. Different external agents, especially virus, and internal agents, like stress, and the heat shock protein antigen expression, associated or not, can alter the basal keratinocytes of the oral mucosa making them susceptible to apoptosis by CD8(+) cytotoxic T cell as well as activate matrix metalloproteinase and mast cell degranulation, which produce a great range of inflammatory mediators and cytokines determining the clinical onset of the disease. Regarding carcinogenesis, since it is a complex process and presents multifactorial origin, it is believed that there may be a synergism between intrinsic, such as inflammation mediators, and extrinsic agents (tobacco, alcohol, viral infections) for the OLP malignant transformation to occur. However, further studies are needed to better understand the origin, pathogenesis and process of malignant transformation of OLP.
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Affiliation(s)
- Márcia Rodrigues Payeras
- Oral Medicine Division, Pontifical Catholic University of Rio Grande do Sol, Av. Ipiranga 6690, Porto Alegre, RS, Brazil.
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Wu D, Cheng S, Chen X, Sun M, Wang G, Fu S, Dong G, Wang L, Wu Y. Mitochondrial haplogroup B4 may be a protective factor to oral lichen planus susceptibility in Chinese. Oral Dis 2013; 20:62-8. [PMID: 23413987 DOI: 10.1111/odi.12074] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2012] [Revised: 12/20/2012] [Accepted: 01/15/2013] [Indexed: 11/27/2022]
Abstract
OBJECTIVE Oral lichen planus (OLP) is a common inflammatory disorder with a higher prevalence among women than men. The pathogenesis of OLP is still unclear, and its heredity is not well characterized. Maternal inheritance of mitochondrial DNA (mtDNA) indicates its importance in human ethnic group classification as well disease susceptibility. So, this study was conducted to find whether mtDNA haplogroup associates with OLP susceptibility in Chinese, and determine the influence of C-stretch structure of mtDNA on OLP susceptibility. SUBJECTS AND METHODS We sequenced three hypervariable regions of mtDNA from 242 patients with OLP and 237 healthy controls. The association between mtDNA haplogroups and OLP is tested by chi-square test. RESULTS Seventeen kinds of haplogroups were identified, and the frequency of haplogroup B4 was significantly higher in control group than that of the OLP group (P = 0.013, OR=0.429). In female samples, B4 declared even more significance (P = 0.003, OR=0.296). Meanwhile, the haplotypes of C-stretch in mtDNA did not have any significant difference between case-control groups. CONCLUSIONS Mitochondrial DNA haplogroup B4 might have a protective effect to OLP, and its protective effect resides predominantly in women. However, the association between C-stretch haplotype and OLP susceptibility still needs more patients for evaluation.
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Affiliation(s)
- D Wu
- Center for DNA Typing, Forth Military Medical University, Xi'an, China; Department of Biochemistry and Molecular Biology, Forth Military Medical University, Xi'an, China
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Agha-Hosseini F, Mirzaii-Dizgah I, Farmanbar N, Abdollahi M. Oxidative stress status and DNA damage in saliva of human subjects with oral lichen planus and oral squamous cell carcinoma. J Oral Pathol Med 2012; 41:736-40. [DOI: 10.1111/j.1600-0714.2012.01172.x] [Citation(s) in RCA: 66] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Wang Z, Yao H, Cui B, Ning G, Tang G. Genetic linkage analysis of oral lichen planus in a Chinese family. GENETICS AND MOLECULAR RESEARCH 2011; 10:1427-33. [DOI: 10.4238/vol10-3gmr1137] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Boorghani M, Gholizadeh N, Taghavi Zenouz A, Vatankhah M, Mehdipour M. Oral lichen planus: clinical features, etiology, treatment and management; a review of literature. J Dent Res Dent Clin Dent Prospects 2010; 4:3-9. [PMID: 22991586 PMCID: PMC3429956 DOI: 10.5681/joddd.2010.002] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2009] [Accepted: 02/22/2010] [Indexed: 01/16/2023] Open
Abstract
Lichen planus is a chronic inflammatory mucocutaneous disease. Mucosal lesions are classified into six clinical forms and there is malignant potential for two forms of OLP; therefore, follow-up should be considered. There are many un-established etiological factors for OLP and some different treatment modalities are based on etiology. The aims of current OLP therapy are to eliminate mucosal erythema and ulceration, alleviate symptoms and reduce the risk of oral cancer. We have used review papers, case reports, cohort studies, and case-and-control studies published from 1985 to 2010 to prepare this review of literature.
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Affiliation(s)
- Marzieh Boorghani
- Assistant Professor, Department of Oral Medicine, Faculty of Dentistry, Tabriz University of Medical Sciences, Tabriz, Iran
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Agha-Hosseini F, Mirzaii-Dizgah I, Mikaili S, Abdollahi M. Increased salivary lipid peroxidation in human subjects with oral lichen planus. Int J Dent Hyg 2009; 7:246-50. [DOI: 10.1111/j.1601-5037.2009.00365.x] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Bornstein MM, Hakimi B, Persson GR. Microbiological findings in subjects with asymptomatic oral lichen planus: a cross-sectional comparative study. J Periodontol 2009; 79:2347-55. [PMID: 19053926 DOI: 10.1902/jop.2008.080303] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
BACKGROUND The bacterial colonization of the oral mucosa was evaluated in patients with asymptomatic oral lichen planus (OLP) and compared to the microbiologic status in mucosally healthy subjects. METHODS Bacteria from patients with clinically and histopathologically diagnosed OLP from the Stomatology Service, Department of Oral Surgery and Stomatology, School of Dental Medicine, University of Bern, were collected with a non-invasive swab system. Samples were taken from OLP lesions on the gingiva and from non-affected sites on the contralateral side of the mouth. The control population did not have OLP and was recruited from the student clinic. All samples were processed with the checkerboard DNA-DNA hybridization method using well-defined bacterial species for the analysis. RESULTS Significantly higher bacterial counts of Bacteroides ureolyticus (P = 0.001), Dialister species (sp.) (P = 0.006), Staphylococcus haemolyticus (P = 0.007), and Streptococcus agalactiae (P = 0.006) were found in samples taken from OLP lesions compared to sites with no clinical evidence of OLP. Significantly higher bacterial counts were found for Capnocytophaga sputigena, Eikenella corrodens, Lactobacillus crispatus, Mobiluncus curtisii, Neisseria mucosa, Prevotella bivia, Prevotella intermedia, and S. agalactiae at sites with lesions in subjects with OLP compared to sites in control subjects (P <0.001). CONCLUSIONS Microbiologic differences were found between sites with OLP and sites in subjects without a diagnosis of OLP. Specifically, higher counts of staphylococci and S. agalactiae were found in OLP lesions.
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Affiliation(s)
- Michael M Bornstein
- Department of Oral Surgery and Stomatology, School of Dental Medicine, University of Bern, Bern, Switzerland.
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Ismail SB, Kumar SKS, Zain RB. Oral lichen planus and lichenoid reactions: etiopathogenesis, diagnosis, management and malignant transformation. J Oral Sci 2008; 49:89-106. [PMID: 17634721 DOI: 10.2334/josnusd.49.89] [Citation(s) in RCA: 312] [Impact Index Per Article: 19.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Lichen planus, a chronic autoimmune, mucocutaneous disease affects the oral mucosa (oral lichen planus or OLP) besides the skin, genital mucosa, scalp and nails. An immune mediated pathogenesis is recognized in lichen planus although the exact etiology is unknown. The disease most commonly affects middle-aged females. Oral lichenoid reactions (OLR) which are considered variants of OLP, may be regarded as a disease by itself or as an exacerbation of an existing OLP, by the presence of medication (lichenoid drug reactions) or dental materials (contact hypersensitivity). OLP usually presents as white striations (Wickham's striae), white papules, white plaque, erythema, erosions or blisters. Diagnosis of OLP is established either by clinical examination only or by clinical examination with histopathologic confirmation. Direct immunofluorescence examination is only used as an adjunct to the above method of diagnosis and to rule out specific autoimmune diseases such as pemphigus and pemphigoid. Histopathologic features of OLP and OLR are similar with suggestions of certain discriminatory features by some authors. Topical corticosteroids are the treatment of choice for OLP although several other medications have been studied including retinoids, tacrolimus, cyclosporine and photodynamic therapy. Certain OLP undergo malignant transformation and the exact incidence and mechanisms are still controversial. In this paper, etiopathogenesis, diagnosis, management and malignant transformation of OLP and OLR have been reviewed.
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Affiliation(s)
- Sumairi B Ismail
- Department of Oral Pathology, Oral Medicine and Periodontology, Faculty of Dentistry, University of Malaya, Kuala Lumpur, Malaysia
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Xavier GM, de Sá AR, Guimarães ALS, da Silva TA, Gomez RS. Investigation of functional gene polymorphisms interleukin-1β, interleukin-6, interleukin-10 and tumor necrosis factor in individuals with oral lichen planus. J Oral Pathol Med 2007; 36:476-81. [PMID: 17686006 DOI: 10.1111/j.1600-0714.2007.00560.x] [Citation(s) in RCA: 48] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
Oral lichen planus (OLP) is a chronic inflammatory oral mucosal disease. There are some studies in the literature demonstrating association between cytokines genes polymorphisms and susceptibility to develop some immune-mediate conditions. The purpose of this study was to investigate cytokine gene polymorphisms in a sample of Brazilian patients with OLP. Fifty-three patients with OLP (mean age = 43.1 years; range 20-68 years) and 53 healthy volunteers (mean age = 42.9 years; range 21-67) were genotyped for IL-1beta +3954 (C/T), IL-6-174 (G/C), IL-10-1082 (G/A) and TNFA-308 (G/A) gene polymorphisms. Statistical analysis was based on the use of logistic regression (P-values below 0.05 were considered as significant). IL-6 and TNFA homozygous genotypes were significantly more often detected in OLP patients. These genotypes were associated with an increased risk of OLP development (OR 6.89 and 13.04, respectively). IL-1beta and IL-10 gene polymorphisms were not related to OLP development. Our findings clearly demonstrate an association between inheritance of IL-6 and TNFA gene polymorphisms and OLP occurrence, thus giving additional support for genetic basis of this disease.
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Affiliation(s)
- Guilherme Machado Xavier
- Department of Oral Surgery and Pathology, School of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
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Transient liver hypoxia after liver hilus dearterialization. ScientificWorldJournal 1979; 2014:742826. [PMID: 24672362 PMCID: PMC3929580 DOI: 10.1155/2014/742826] [Citation(s) in RCA: 213] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2013] [Accepted: 10/20/2013] [Indexed: 02/06/2023] Open
Abstract
Lichen planus (LP) is a chronic inflammatory disorder that most often affects middle-aged adults. LP can involve the skin or mucous membranes including the oral, vulvovaginal, esophageal, laryngeal, and conjunctival mucosa. It has different variants based on the morphology of the lesions and the site of involvement. The literature suggests that certain presentations of the disease such as esophageal or ophthalmological involvement are underdiagnosed. The burden of the disease is higher in some variants including hypertrophic LP and erosive oral LP, which may have a more chronic pattern. LP can significantly affect the quality of life of patients as well. Drugs or contact allergens can cause lichenoid reactions as the main differential diagnosis of LP. LP is a T-cell mediated immunologic disease but the responsible antigen remains unidentified. In this paper, we review the history, epidemiology, and clinical subtypes of LP. We also review the histopathologic aspects of the disease, differential diagnoses, immunopathogenesis, and the clinical and genetic correlations.
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