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Lichen Planus and Hepatitis C Virus Infection: A clinical Evaluation of 168 Cases. SERBIAN JOURNAL OF DERMATOLOGY AND VENEREOLOGY 2018. [DOI: 10.2478/sjdv-2018-0006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Abstract
Introduction. Hepatitis C virus (HCV) infection is one of the factors which can lead to a chronic liver disease and hepatocellular carcinoma. There have been several reports on the association of oral lichen planus with hepatic disorders, i.e. hepatitis C infection in particular. Considering the controversies about the association of lichen planus with HCV infection on one hand and considerable impact of hepatitis C on the occurrence of chronic liver disease on the other hand, we investigated the association between lichen planus and HCV infection in Sanandaj City. Methods. This cross sectional study included 168 patients with lichen planus, who were referred to the Dermatology Clinic of Besat Hospital between 2014 and 2016. The diagnosis of lichen planus was made by our dermatologist and HCV antibody titer was determined for every patient. Results. Mean age of the patients was 39.7±13.3 years and mean duration of the disease was 14.8 months. 107 (63.7%) patients were men. The highest frequency of lichen planus was recorded in the housewives (30.4%). In 52 (31%) patients the genital area was involved and it was the most common site. In 6 (3.6%) patients the oral mucosa was involved and it was the least common site in our study. Only 4 (2.7%) patients had family history of lichen planus. None of 168 patients included in this study was found to have HCV infection. Conclusion. In this study, we found no relationship between lichen planus and HCV infection. Yet, the exact mechanism underlying the occurrence of lichen planus in the patients with HCV infection has not been determined. Therefore more studies on this subject are recommended.
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Abstract
Oral lichen planus (OLP) is a common T cell-mediated mucocutaneous disease of unknown etiology. A great number of factors have been suggested as relevant to the etiology of this disease. In this article, the authors assemble recent knowledge about the pathogenesis of OLP, discuss some proposed hypotheses, and compare OLP with oral lichenoid lesions.
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Affiliation(s)
- Patrícia A Nogueira
- Sector of Dermatology, School of Medicine, Federal University of Rio de Janeiro, Rio de Janeiro, RJ, Brazil
| | - Sueli Carneiro
- Sector of Dermatology, School of Medicine, Federal University of Rio de Janeiro, Rio de Janeiro, RJ, Brazil
| | - Marcia Ramos-e-Silva
- Sector of Dermatology, School of Medicine, Federal University of Rio de Janeiro, Rio de Janeiro, RJ, Brazil
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Pouralibaba F, Babaloo Z, Pakdel F, Aghazadeh M. Serum Level of Interleukin 17 in Patients with Erosive and Non erosive Oral Lichen Planus. J Dent Res Dent Clin Dent Prospects 2013; 7:91-4. [PMID: 23875087 PMCID: PMC3713867 DOI: 10.5681/joddd.2013.016] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2012] [Accepted: 02/21/2013] [Indexed: 12/30/2022] Open
Abstract
Background and aims Oral lichen planus is a relatively common chronic oral mucosal disease of unknown etiology. Regarding numerous studies on the immunologic factors involved in the etiology of lichen planus, the present study evaluated the serum interleukin-17 (IL-17) level in patients with erosive and non-erosive oral lichen planus.
Materials and methods This descriptive analytical study included 24 patients with erosive oral lichen planus (EOLP), 24 patients with non-erosive oral lichen planus (NEOLP) and 24 healthy volunteered as control. Blood samples of the subjects underwent ELISA, using special kits, to determine serum interleukin-17 levels. Data was analyzed using with descriptive statistic, chi-square test, and one-way ANOVA and Tukey post-hoc test with SPSS 16 software.
Results EOLP patients showed a high level of serum IL-17 compared with NEOLP patents and control groups (EOLP=184.16 ± 12.41 pg/mL, NEOLP=106.09±10.78 pg/mL, control=15.50 ± 4.34 pg/mL, P - 0.001).
Conclusion High level of serum IL-17 in erosive oral lichen planus patients compared to the non-erosive type and healthy individuals may be the reason for higher inflammation and atrophy in the erosive type.
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Affiliation(s)
- Firoz Pouralibaba
- Dntal and Periodontal Research Center, Tabriz University of Medical Sciences, Tabriz, Iran ; Assistant Professor, Department of Oral Medicine, Faculty of Dentistry, Tabriz University, Tabriz, Iran
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Hassan M, Selimovic D, El-Khattouti A, Ghozlan H, Haikel Y, Abdelkader O. Hepatitis C virus-host interactions: Etiopathogenesis and therapeutic strategies. World J Exp Med 2012; 2:7-25. [PMID: 24520529 PMCID: PMC3905577 DOI: 10.5493/wjem.v2.i2.7] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/04/2012] [Revised: 04/16/2012] [Accepted: 04/18/2012] [Indexed: 02/06/2023] Open
Abstract
Hepatitis C virus (HCV) is a significant health problem facing the world. This virus infects more than 170 million people worldwide and is considered the major cause of both acute and chronic hepatitis. Persons become infected mainly through parenteral exposure to infected material by blood transfusions or injections with nonsterile needles. Although the sexual behavior is considered as a high risk factor for HCV infection, the transmission of HCV infection through sexual means, is less frequently. Currently, the available treatment for patients with chronic HCV infection is interferon based therapies alone or in combination with ribavirin and protease inhibitors. Although a sustained virological response of patients to the applied therapy, a great portion of patients did not show any response. HCV infection is mostly associated with progressive liver diseases including fibrosis, cirrhosis and hepatocellular carcinoma. Although the focus of many patients and clinicians is sometimes limited to that problem, the natural history of HCV infection (HCV) is also associated with the development of several extrahepatic manifestations including dermatologic, rheumatologic, neurologic, and nephrologic complications, diabetes, arterial hypertension, autoantibodies and cryglobulins. Despite the notion that HCV-mediated extrahepatic manifestations are credible, the mechanism of their modulation is not fully described in detail. Therefore, the understanding of the molecular mechanisms of HCV-induced alteration of intracellular signal transduction pathways, during the course of HCV infection, may offer novel therapeutic targets for HCV-associated both hepatic and extrahepatic manifestations. This review will elaborate the etiopathogenesis of HCV-host interactions and summarize the current knowledge of HCV-associated diseases and their possible therapeutic strategies.
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Affiliation(s)
- Mohamed Hassan
- Mohamed Hassan, Denis Selimovic, Youssef Haikel, National Institute of Health and Medical Research, U 977, Faculty of Medicine, and Dental Faculty, 11 Rue Humann, 67085 Strasbourg Cedex, France
| | - Denis Selimovic
- Mohamed Hassan, Denis Selimovic, Youssef Haikel, National Institute of Health and Medical Research, U 977, Faculty of Medicine, and Dental Faculty, 11 Rue Humann, 67085 Strasbourg Cedex, France
| | - Abdelouahid El-Khattouti
- Mohamed Hassan, Denis Selimovic, Youssef Haikel, National Institute of Health and Medical Research, U 977, Faculty of Medicine, and Dental Faculty, 11 Rue Humann, 67085 Strasbourg Cedex, France
| | - Hanan Ghozlan
- Mohamed Hassan, Denis Selimovic, Youssef Haikel, National Institute of Health and Medical Research, U 977, Faculty of Medicine, and Dental Faculty, 11 Rue Humann, 67085 Strasbourg Cedex, France
| | - Youssef Haikel
- Mohamed Hassan, Denis Selimovic, Youssef Haikel, National Institute of Health and Medical Research, U 977, Faculty of Medicine, and Dental Faculty, 11 Rue Humann, 67085 Strasbourg Cedex, France
| | - Ola Abdelkader
- Mohamed Hassan, Denis Selimovic, Youssef Haikel, National Institute of Health and Medical Research, U 977, Faculty of Medicine, and Dental Faculty, 11 Rue Humann, 67085 Strasbourg Cedex, France
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Lodi G, Pellicano R, Carrozzo M. Hepatitis C virus infection and lichen planus: a systematic review with meta-analysis. Oral Dis 2010; 16:601-12. [DOI: 10.1111/j.1601-0825.2010.01670.x] [Citation(s) in RCA: 143] [Impact Index Per Article: 10.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
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Thongprasom K, Youngnak-Piboonratanakit P, Pongsiriwet S, Laothumthut T, Kanjanabud P, Rutchakitprakarn L. A multicenter study of oral lichen planus in Thai patients. ACTA ACUST UNITED AC 2010; 1:29-36. [DOI: 10.1111/j.2041-1626.2010.00005.x] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Taghavi Zenouz A, Mehdipour M, Gholizadeh N, Naghili B, Jafari Heydarlou M. Evaluation of Relationship between Lichen Planus and HCV Antibody. J Dent Res Dent Clin Dent Prospects 2010; 4:10-3. [PMID: 22991587 PMCID: PMC3429952 DOI: 10.5681/joddd.2010.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2009] [Accepted: 08/06/2009] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND AND AIMS Lichen planus is a relatively common chronic mucocutaneaous disease with an unknown cause, and is considered a manifestation of cell-mediated immune response. Hepatitis C virus (HCV) and its subgroups have been associated with lichen planus in different geographic locations. The present study was undertaken to evaluate the prevalence of HCV antibody in patients with lichen planus in northwest Iran. MATERIALS AND METHODS This descriptive analytical study included 30 patients with cutaneous lichen planus, 30 pa-tients with oral lichen planus, and 30 healthy individuals as controls. Anti-HCV test was run for all the subjects. Descriptive statistics as well as chi-square test, to compare means in the three study groups, were applied to the data using SPSS 14.0 computer software. RESULTS Age and sex differences between the groups were not significant. No statistically significant differences were ob-served in anti-HCV test results between the groups (P = 0.50). CONCLUSION No statistically significant relationships were observed between lichen planus and HCV antibody in the studied samples.
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Affiliation(s)
- Ali Taghavi Zenouz
- Assistant Professor, Department of Oral Medicine, Faculty of Dentistry, Tabriz University of Medical Sciences, Tabriz, Iran
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Carrozzo M. Oral diseases associated with hepatitis C virus infection. Part 2: lichen planus and other diseases. Oral Dis 2008; 14:217-28. [PMID: 18221456 DOI: 10.1111/j.1601-0825.2007.01432.x] [Citation(s) in RCA: 50] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
Some of the most frequent extrahepatic manifestations of hepatitis C virus (HCV) infection involve the oral region predominantly or exclusively. Part 2 of this review discusses the current evidences regarding the association of lichen planus (LP) and other diseases frequently involving the oral cavity with HCV. Epidemiological data suggest that LP may be significantly associated with HCV infections especially in southern Europe and Japan but not in northern Europe. These geographical differences are possibly influenced by immunogenetic factors, the duration of the HCV infection and the design of the published studies. Because of the fact that most of the studies published are retrospective, it is impossible to establish whether the HCV exposure occurred earlier to or after the onset of disease and more prospective studies are clearly warranted. As the virus may replicate in the skin and oral mucosa and HCV-specific T lymphocytes can be found in the oral mucosa of patients with chronic hepatitis C and LP, HCV may be implicated in the pathogenesis of LP. However, little attention has been paid to the variable effect of therapy with interferon-alpha (IFN-alpha), with or without ribavirin for LP. Conversely, it is unlikely that other oral diseases such as oral carcinoma, pemphigus and Behcet disease are triggered by HCV.
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Affiliation(s)
- M Carrozzo
- Department of Oral Medicine, School of Dental Sciences, University of Newcastle upon Tyne, Newcastle upon Tyne, UK.
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Abstract
OBJECTIVE This is the largest UK patient group with oral lichen planus (OLP) to be studied in terms of the demographic and clinical characteristics. MATERIALS AND METHODS Data were taken from the medical records of 690 consecutive patients referred to Oral Medicine subsequently found to have clinical, and usually histopathological confirmatory features of OLP. Over two-thirds (68.7%) of the patients were Caucasians. RESULTS Eighty-two per cent of the patients had been referred to a specialist Oral Medicine service by general dental practitioners, 62% of the patients being referred as a consequence of oral mucosal and/or gingival pain. Reticular OLP was the most common intra-oral presentation, but 60% of such lesions were accompanied by other clinical types of OLP. 95% of lesions were bilateral. About 13% of patients reported symptoms or signs, or had a known history of lichen planus or possible lichen planus affecting non-oral epithelia. In only 13% of patients did all signs and symptoms of OLP resolve within 12-246 months (median 35 months). A malignant transformation rate of 1.9% was observed in the present group. CONCLUSIONS Oral lichen planus in UK persons almost always gives rise to bilateral reticular OLP, rarely resolves spontaneously, and has a low rate of malignant transformation.
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Affiliation(s)
- M Ingafou
- Oral Medicine, Division of Maxillofacial Diagnostic, Medical and Surgical Sciences, UCL, Eastman Dental Institute, London, UK
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Lodi G, Scully C, Carrozzo M, Griffiths M, Sugerman PB, Thongprasom K. Current controversies in oral lichen planus: Report of an international consensus meeting. Part 1. Viral infections and etiopathogenesis. ACTA ACUST UNITED AC 2005; 100:40-51. [PMID: 15953916 DOI: 10.1016/j.tripleo.2004.06.077] [Citation(s) in RCA: 261] [Impact Index Per Article: 13.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Despite recent advances in understanding the immunopathogenesis of oral lichen planus (LP), the initial triggers of lesion formation and the essential pathogenic pathways are unknown. It is therefore not surprising that the clinical management of oral LP poses considerable difficulties to the dermatologist and the oral physician. A consensus meeting was held in France in March 2003 to discuss the most controversial aspects of oral LP. Part 1 of the meeting report focuses on (1) the relationship between oral LP and viral infection with special emphasis on hepatitis C virus (HCV), and (2) oral LP pathogenesis, in particular the immune mechanisms resulting in lymphocyte infiltration and keratinocyte apoptosis. Part 2 focuses on patient management and therapeutic approaches and includes discussion on malignant transformation of oral LP.
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Affiliation(s)
- Giovanni Lodi
- Department of Medicine, Surgery, and Dentistry, University of Milan, Italy.
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Carrozzo M, Gandolfo S. Oral diseases possibly associated with hepatitis C virus. CRITICAL REVIEWS IN ORAL BIOLOGY AND MEDICINE : AN OFFICIAL PUBLICATION OF THE AMERICAN ASSOCIATION OF ORAL BIOLOGISTS 2003; 14:115-27. [PMID: 12764074 DOI: 10.1177/154411130301400205] [Citation(s) in RCA: 60] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Morbidity associated with hepatitis C virus (HCV) infection can involve a variety of extrahepatic conditions, including lichen planus (LP) and sialadenitis, predominantly or exclusively involving the oral region, conditions which have been largely neglected in reviews. The literature suggests that HCV-infected patients may frequently have Sjögren-like sialadenitis with mild clinical symptoms, whereas oral LP may be significantly associated with HCV infections in Southern Europe and Japan but not in Northern Europe. These geographical differences could be related to immunogenetic factors such as the HLA-DR6 allele, significantly expressed in Italian patients with OLP and HCV. Analysis of experimental data suggests that HCV could be involved in the pathogenesis of both these diseases. Moreover, parotid lymphoma may arise in patients with sialadenitis, mainly with type II cryoglobulinemia. Little attention has been paid to oral health needs in HCV-infected patients and the variable effect of interferon-alpha therapy on oral tissues. Further research is needed, because of the potentially great influence of oral diseases possibly linked to HCV on the quality of life of millions of patients.
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Affiliation(s)
- M Carrozzo
- Department of Biomedical Sciences and Human Oncology, Oral Medicine Section, C. so Dogliotti 14, University of Turin, I-10126 Torino, Italy.
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Lodi G, Bez C, Porter SR, Scully C, Epstein JB. Infectious hepatitis C, hepatitis G, and TT virus: review and implications for dentists. SPECIAL CARE IN DENTISTRY 2002; 22:53-8. [PMID: 12109595 DOI: 10.1111/j.1754-4505.2002.tb01162.x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
In the past 10 years, hepatitis C and G viruses have been identified, and in the last two years a further parenterally transmitted agent, termed TT virus (TTV), has been discovered. These viruses have a worldwide distribution and frequently cause chronic infection. The purpose of this article was to promote an understanding of these viral agents and their relevance in dental practice. Infected patients may develop a chronic carrier state without clinical disease or may develop liver disease, and may have related oral conditions. Dental providers will see a growing number of patients with HCV/HGV and possibly TTV infection. All of these patients require appropriate infection control measures during dental treatment.
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Affiliation(s)
- Giovanni Lodi
- Department of Oral Medicine, Eastman Dental Institute for Oral Health Care Sciences, University of London, UK
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Abstract
OBJECTIVE This investigation was conducted to determine the possible association between oral lichen planus (OLP) and hepatitis C virus infection (HCV) in the population of São Paulo (Brazil). MATERIALS AND METHODS Three groups of patients were studied: group 1 was composed of 68 patients with OLP lesions; group 2 had 126 patients with HCV infection; and the control group consisted of 898 individuals seeking dental treatment at our school, used to determine the prevalence of lichen planus in the general population. The prevalence of HCV in group 1 was determined and compared with that of the population of São Paulo (Focaccia et al (1998) Brazilian J Infect Dis 2: 269), while the prevalence of OLP in group 2 was determined and compared with that of the control group. RESULTS The results showed that the frequency of HCV in OLP patients was 8.8%, significantly higher than in the general population of São Paulo, which is 1.4% (P = 0.002), and the frequency of OLP in HCV patients (4.7%) was also significantly higher (P = 0.0003) than that of the control group (0.6%). CONCLUSION These data suggest that, at least in São Paulo, there is an association between OLP and HCV infection.
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Affiliation(s)
- L C Figueiredo
- Department of Oral Diagnosis, University of São Paulo School of Dentistry, Brazil
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