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Zisis V, Giannakopoulos NN, Schmitter M, Poulopoulos A, Andreadis D. A Novel Approach to Differentiating Erosive and Reticular Lichen Planus Based on the Percentage of Dental Surfaces With Metal Restorations. Cureus 2023; 15:e44782. [PMID: 37809260 PMCID: PMC10558055 DOI: 10.7759/cureus.44782] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/06/2023] [Indexed: 10/10/2023] Open
Abstract
Introduction Oral lichen planus (OLP) and oral lichenoid reaction (OLR) constitute clinical entities with strong but unclear etiologic relation to dental materials. The aim of this study was to evaluate a correlation between the clinical form of OLP/OLR and the number of dental metal restorations in the oral cavity thus utilizing an exposure to metal (EM) index. Material and methods The study type is experimental, and the study design is characterized as semiquantitative research that belongs to the branch of experimental research. Twenty-nine patients were chosen based on clinical (either reticular or erosive clinical forms) and histologic findings suggestive of OLP/OLR. The files of patients were retrieved from the archives of the Department of Oral Medicine/Pathology, School of Dentistry, Aristotle University of Thessaloniki, Greece, during the period 2009-2019. The medical history of the patients did not include any disorder or medication associated with lichenoid lesions and the measurements took place concurrently with the establishment of the diagnosis, thus no treatment for the lichen planus had been administered prior to the measurements. Quantitative measurement of the percentage of dental surfaces restored through metal restorations and correlation with the clinical and histologic findings of OLP/OLR was evaluated. The EM index was evaluated on a scale of 1-3, which corresponds to the percentage of dental surfaces restored through metal restorations. The statistical analysis was performed with the Pearson chi-square test and the significance level was set at p≤0.05. Results The EM index was measured by dividing each tooth into five surfaces (occlusal, mesial, distal, buccal, lingual), subsequently multiplying the number of available teeth with the number 5 to calculate the total number of surfaces, and then counting the number of surfaces with metal restorations - both fillings and crowns (in case of metal-ceramic crowns, the respective dental surface is taken into account only in case of macroscopically exposed metal), dividing the number of surfaces with metal restorations with the total number of surfaces and multiply by 100 so that the results take the form of percentages (%) and finally classifying the percentages into three groups: 1: 0% metal restorations, 2: 1-25% metal restorations, 3: >26% metal restorations). The percentage in female patients ranged from 0% to 100%, whereas it ranged from 0% to 60% in male patients. According to the clinical form of the lichenoid lesion, the percentage ranged from 0% to 60% in reticular lichen planus cases and from 0% to 100% in erosive lichen planus cases. There was no statistical difference between lichen planus cases, in total, and in normal oral epithelium. However, the levels of EM were marginally similar between the reticular lichen planus and the erosive lichen planus (Fisher's exact test, p = 0.056). Therefore, it may be the case that the EM index is higher in erosive lichenoid lesions. Conclusion In our study, the EM index was higher in female patients and in erosive lichenoid lesions. These findings should be tested and supported by larger samples of patients since the aforementioned Fisher's Exact Test, p = 0.056 could fall below the threshold of 0.05 if more patients were included. This is the first attempt to establish a novel approach to differentiating erosive and reticular lichen planus based on the percentage of dental surfaces with metal restorations.
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Affiliation(s)
- Vasileios Zisis
- Prosthodontics, Julius-Maximilians-Universität Würzburg, Würzburg, DEU
- Oral Medicine/Pathology, Aristotle University of Thessaloniki, Thessaloniki, GRC
| | | | - Marc Schmitter
- Prosthodontics, Julius-Maximilians-Universität Würzburg, Würzburg, DEU
| | | | - Dimitrios Andreadis
- Oral Medicine/Pathology, Aristotle University of Thessaloniki, Thessaloniki, GRC
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Childhood oral lichen planus: a case series with review of literature. Eur Arch Paediatr Dent 2022; 23:341-353. [PMID: 35094367 DOI: 10.1007/s40368-021-00690-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2021] [Accepted: 12/14/2021] [Indexed: 01/12/2023]
Abstract
BACKGROUND Oral Lichen Planus (OLP) is a chronic autoimmune mucocutaneous condition, the exact etiology of which is still unknown. It is known to occur chiefly in adults and has a reported prevalence of 0.5-2% in general population and < 2-3% of total in pediatric population. OLP is considered as Oral Potentially Malignant Disorder with a malignant transformation rate of 1-2% in adults. Its occurrence in children is a rare finding with few cases reported in the literature. As a result, it gets misdiagnosed by the general practitioner and hence, there is a need to consider OLP in differential diagnosis of white lesions of oral cavity even in children. Therefore, in this paper, we present six cases of childhood OLP along with their management and follow-up. CASE SERIES We present here six patients aged between 11 and 13 years who presented either as incidental finding or as symptomatic lesions and were diagnosed with OLP. Symptomatic patients were treated with topical steroid ointment and both the symptomatic and asymptomatic patients were followed-up. We have also presented literature review of childhood OLP reported in PubMed, Medline and google scholar from 1980 till December 2020. CONCLUSION OLP is unusual in children and is often left untreated due to low awareness among the patients. Can be often misdiagnosed and should be considered in differential diagnosis of any white lesion of oral cavity. Any such lesions must be correctly diagnosed in time to institute appropriate management and follow-up.
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Singh S, Singh J, Biradar BC, Sonam M, Chandra S, Samadi FM. Evaluation of salivary oxidative stress in oral lichen planus using malonaldehyde. J Oral Maxillofac Pathol 2022; 26:26-30. [PMID: 35571312 PMCID: PMC9106263 DOI: 10.4103/jomfp.jomfp_333_21] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2021] [Revised: 12/04/2021] [Accepted: 01/13/2022] [Indexed: 11/26/2022] Open
Abstract
Background: Oral lichen planus is a chronic, mucocutaneous, inflammatory disease, with an unknown etiology. Reactive oxygen species and oxidative damage to the tissues might be the cause. Malonaldehyde (MDA), a low molecular weight end product of lipid peroxidation reaction is a suitable biomarker of endogenous DNA damage. monitoring the oxidant-antioxidant status of saliva may serve as an efficient marker of disease development in oral lichen planus patients. Aim and Objectives: To evaluate salivary oxidative stress in oral lichen planus subject using MDA and compare it with control subjects. Furthermore, to compare MDA levels in erosive and hypertrophic lichen planus. Materials and Methods: The current study is case–control study. Unstimulated salivary samples in the morning hours were taken from oral lichen planus subjects (n = 25) and controls subjects without any oral disease (n = 25). The saliva was centrifuged at 900 g for 10 min at a temperature of 4°C. Then, the entire filtrate was transferred to Eppendorf test tubes and frozen at–80°C until analysis. Salivary MDA was done through thiobarbituric acid reactive substance assay as per the protocol laid down by the manufacturer (Sigma Aldrich Lipid Peroxidation Assay Kit). Results: The data were expressed as the mean ± standard deviation and the statistical analysis was done using Student's t-test using SPSS version 21 IBM software. The salivary level of MDA was significantly higher than that of controls (P < 0.05). Conclusion: The higher level of MDA in patients with oral lichen planus suggests that free radicals and the resulting oxidative damage may be important in the pathogenesis of oral lichen planus lesions.
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Affiliation(s)
- Shruti Singh
- Department of Oral Pathology and Microbiology, King George's Medical University, Lucknow, Uttar Pradesh, India
| | - Jaya Singh
- Department of Oral Pathology and Microbiology, Faculty of Dental Sciences, Banaras Hindu University, Varanasi, Uttar Pradesh, India
| | - Basavaprabhu C Biradar
- Department of Oral Pathology and Microbiology, HKES SN Dental College, Kalaburagi, Karnataka, India
| | - Manjari Sonam
- Department of Oral Pathology and Microbiology, Sardar Patel Post Graduate Institute of Dental and Medical Sciences, Lucknow, Uttar Pradesh, India
| | - Shaleen Chandra
- Department of Oral Pathology and Microbiology, King George's Medical University, Lucknow, Uttar Pradesh, India
| | - Fahad M Samadi
- Department of Oral Pathology and Microbiology, King George's Medical University, Lucknow, Uttar Pradesh, India
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Bansal D, Kamboj M, Anand R, Pandiar D, Narwal A, Sivakumar N, Devi A. Association of childhood vaccination with pediatric lichen planus: A systematic review. Int J Dermatol 2021; 62:22-31. [PMID: 34870853 DOI: 10.1111/ijd.15974] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/03/2021] [Revised: 09/21/2021] [Accepted: 10/23/2021] [Indexed: 12/23/2022]
Abstract
Lichen planus (LP) is a chronic T-cell-mediated mucocutaneous inflammatory disease, largely recognized in adults. It is uncommon in children, and the literature present still lacks comprehensive understanding mainly due to underreporting of such cases. LP shows atypical clinical features, when seen in children, mainly affecting the flexor aspect of the wrists, legs, and the oral and genital mucosae. It is largely considered an autoimmune response of the body with various etiologic factors. Its association with vaccination is still an interesting field for research. The focus of the present systematic review was to discover the link of vaccine in the pathogenesis of juvenile LP. An electronic search was carried out using MEDLINE by PubMed, Google Scholar, and Web of Science databases. Articles that reported LP in children with prior records for vaccination were selected for the present systematic review. Twenty-three published articles in the English language were included for the quantitative and qualitative syntheses. The demographic data, specific vaccine history, and clinical details of the lesions were recorded. The existing evidence supports that vaccines could play an important role in etiopathogenesis of pediatric LP.
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Affiliation(s)
- Deepty Bansal
- Department of Oral and Maxillofacial Pathology and Microbiology, Post Graduate Institute of Dental Sciences, Pt B.D. Sharma University of Health Sciences, Rohtak, India
| | - Mala Kamboj
- Department of Oral and Maxillofacial Pathology and Microbiology, Post Graduate Institute of Dental Sciences, Pt B.D. Sharma University of Health Sciences, Rohtak, India
| | - Rahul Anand
- Department of Oral and Maxillofacial Pathology and Microbiology, Post Graduate Institute of Dental Sciences, Pt B.D. Sharma University of Health Sciences, Rohtak, India
| | - Deepak Pandiar
- Department of Oral and Maxillofacial Pathology, Saveetha Dental College and Hospitals, Saveetha University (Tamil Nadu), Chennai, India
| | - Anjali Narwal
- Department of Oral and Maxillofacial Pathology and Microbiology, Post Graduate Institute of Dental Sciences, Pt B.D. Sharma University of Health Sciences, Rohtak, India
| | - N Sivakumar
- Department of Oral and Maxillofacial Pathology and Microbiology, Post Graduate Institute of Dental Sciences, Pt B.D. Sharma University of Health Sciences, Rohtak, India
| | - Anju Devi
- Department of Oral and Maxillofacial Pathology and Microbiology, Post Graduate Institute of Dental Sciences, Pt B.D. Sharma University of Health Sciences, Rohtak, India
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Merhy R, Sarkis AS, Assaf J, Afiouni R, Zeinaty P, Kechichian E, Tomb R, Helou J. Pediatric lichen planus: a systematic review of 985 published cases. Int J Dermatol 2021; 61:416-421. [PMID: 34370874 DOI: 10.1111/ijd.15678] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/10/2020] [Revised: 04/26/2021] [Accepted: 05/02/2021] [Indexed: 11/27/2022]
Abstract
BACKGROUND Lichen planus (LP) is a chronic inflammatory disorder usually occurring in middle-aged adults. Data are scarce in the pediatric population. OBJECTIVE To describe the patients' characteristics, clinical presentation, and management of pediatric LP. METHODS A systematic literature review of pediatric LP was performed in the Medline and Cochrane databases up to February 1, 2020. Demographic and clinical data were extracted for analysis, in addition to laboratory and histology findings, treatments used, and response to treatment. LP pemphigoides (LPP) was further pooled for a subcategory analysis. RESULTS One hundred and sixty-four articles were included representing 985 patients. The most common country of origin was India. The most common clinical signs were flat-topped papules (51%); the linear variant was present in 9%. Oral involvement was present in 22%. The most commonly used treatment was topical corticosteroids followed by systemic corticosteroids. The mean duration of treatment was 124.4 days. LPP patients had a short disease duration before diagnosis (4.1 months, P < 0.001) and failed previous treatment more frequently (P < 0.001). Systemic corticosteroids were more often prescribed in this subgroup (75%, P < 0.001) with more recurrence after treatment (31%, P = 0.048). LIMITATIONS Lack of randomized controlled studies, in addition to publication bias. CONCLUSION In children, LP had a wide polymorphous clinical presentation, and the reported cases were mostly from India. The linear variant was more common and the oral mucosa was less affected in children. LPP, a rare subtype in children, was treated with systemic corticosteroids and recurred more frequently.
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Affiliation(s)
- Reine Merhy
- Department of Dermatology, Faculty of Medicine Saint Joseph University, Beirut, Lebanon
| | - Anne-Sophie Sarkis
- Department of Dermatology, Faculty of Medicine Saint Joseph University, Beirut, Lebanon
| | - Joy Assaf
- Department of Dermatology, Faculty of Medicine Saint Joseph University, Beirut, Lebanon
| | - Rym Afiouni
- Department of Dermatology, Faculty of Medicine Saint Joseph University, Beirut, Lebanon
| | - Perla Zeinaty
- Department of Dermatology, Faculty of Medicine Saint Joseph University, Beirut, Lebanon
| | - Elio Kechichian
- Department of Dermatology, Faculty of Medicine Saint Joseph University, Beirut, Lebanon
| | - Roland Tomb
- Department of Dermatology, Faculty of Medicine Saint Joseph University, Beirut, Lebanon
| | - Josiane Helou
- Department of Dermatology, Faculty of Medicine Saint Joseph University, Beirut, Lebanon
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Gholizadeh N, Sheykhbahaei N. Micronutrients Profile in Oral Lichen Planus: a Review Literature. Biol Trace Elem Res 2021; 199:912-924. [PMID: 32533293 DOI: 10.1007/s12011-020-02221-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/28/2020] [Accepted: 05/25/2020] [Indexed: 01/31/2023]
Abstract
Oral lichen planus (OLP) is a relatively common chronic inflammatory disease. The micronutrients are critical factors in health of oral mucous and proper function of immune system. There have not been any review articles for evaluating trace element levels before and after standard treatments of OLP. The purpose of this study is to provide complete review of the association of micronutrients with OLP. Databases including PubMed, Google Scholar, Scopus, and Embase (Ovid) with keywords of oral lichen planus, OLP, oral disorder, micronutrients, trace element, nutrient element, antioxidant, oxidative stress, malnutrition, and essential trace elements, without time limitation (1900-2019) were searched to collect data on related articles. Total number of 58 original articles including 12 randomized clinical trials, 41 case-control, 4 case reports, and 1 cell line research were reviewed in this study. Lower levels of iron and its associated markers, such as hemoglobin and ferritin, increased levels of TIBC; reduced levels of zinc, calcium, vitamin D, vitamin B12, folic acid, and antioxidants such as vitamins C and E; and increased levels of oxidants and homocysteine, have been reported in OLP patients.
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Affiliation(s)
- Narges Gholizadeh
- Department of Oral & Maxillofacial Medicine, School of Dentistry, Tehran University of Medical Science, Tehran, Iran
| | - Nafiseh Sheykhbahaei
- Department of Oral & Maxillofacial Medicine, School of Dentistry, Tehran University of Medical Science, Tehran, Iran.
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Hasan S, Mansoori S, Ansari MI, Siddiqui S. Oral lichen planus in an 8-year-old child: A case report with a brief literature review. J Oral Maxillofac Pathol 2020; 24:S128-S134. [PMID: 32189921 PMCID: PMC7069139 DOI: 10.4103/jomfp.jomfp_343_19] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2019] [Accepted: 01/16/2020] [Indexed: 11/04/2022] Open
Abstract
Lichen planus (LP) is a chronic autoimmune condition of uncertain etiopathogenesis and usually affects the skin, oro-genital mucosa, nail and scalp appendages. LP is primarily seen in middle-aged individuals, and oral lesions of LP in children are relatively uncommon. Herewith, we report a case of oral LP in an 8-year-old boy, which regressed well with the treatment modality.
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Affiliation(s)
- Shamimul Hasan
- Department of Oral Medicine and Radiology, Faculty of Dentistry, Jamia Millia Islamia, New Delhi, India
| | - Shahnaz Mansoori
- Department of Oral Medicine and Radiology, Faculty of Dentistry, Jamia Millia Islamia, New Delhi, India
| | - Mohd Irfan Ansari
- Department of Conservative Dentistry and Endodontics, Faculty of Dentistry, Jamia Millia Islamia, New Delhi, India
| | - Safia Siddiqui
- Department of Oral Pathology, Sardar Patel Institute of Dental and Medical Sciences, Lucknow, Uttar Pradesh, India
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8
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Olczak-Kowalczyk D, Krasuska-Sławińska E, Gozdowski D, Kowalczyk W, Pawłowska J. Oral mucosa lesions and gingival bleeding can indicate the progression of liver disease in children and adolescents aged two to 18 years. Acta Paediatr 2018; 107:886-892. [PMID: 29297940 DOI: 10.1111/apa.14213] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/28/2017] [Revised: 09/13/2017] [Accepted: 12/28/2017] [Indexed: 12/20/2022]
Abstract
AIM This study assessed correlations between systemic disturbances of paediatric chronic liver diseases (CLD) and oral symptoms in subjects aged 2-18 years. METHODS It was carried out during outpatient appointments at the Children's Memorial Health Institute, Warsaw, Poland, from 2010 to 2015 and comprised 52 CLD patients with a mean age of 12.3 ± 4.6. We also recruited 54 generally healthy controls with a mean age of 12.0 ± 3.7 from the Department of Paediatric Dentistry at the Medical University of Warsaw. The study used various measures, including the Child-Pugh score, which assesses CLD prognosis. We also assessed the causes of liver disease and the medication taken by the patients with CLD. RESULTS A total of 24 patients received a Child-Pugh score of seven or more points, while 28 patients were awarded five or six points. More severe cases of gingivitis and a greater prevalence of oral lesions were evident in patients suffering from liver disease. Oral candidiasis, telangiectasia, bald tongue, cracked strawberry lip, yellowish-brown gum discoloration, petechiae and gingival bleeding all correlated with the severity of liver dysfunction, coagulopathy, protein, bilirubin and creatinine levels and portal hypertension. CONCLUSION This study found that oral lesions and gingival bleeding may indicate the progression of liver failure.
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Affiliation(s)
| | - Ewa Krasuska-Sławińska
- Department of Paediatric Oral Surgery; Children's Memorial Health Institute; Warsaw Poland
| | - Dariusz Gozdowski
- Department of Experimental Statistics and Bioinformatics; Warsaw University of Life Sciences; Warsaw Poland
| | | | - Joanna Pawłowska
- Department of Gastroenterology, Hepatology, Nutritional Disorders and Pediatrics; Children's Memorial Health Institute; Warsaw Poland
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Agel M, Al-Chihabi M, Zaitoun H, Thornhill MH, Hegarty AM. Lichen planus in children. ACTA ACUST UNITED AC 2018. [DOI: 10.12968/denu.2018.45.3.227] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Mona Agel
- Specialty Dentist in Paediatric Dentistry, Charles Clifford Dental Hospital, Sheffield, UK
| | - Mamdouh Al-Chihabi
- Specialty Trainee in Paediatric Dentistry, Charles Clifford Dental Services, Sheffield, UK
| | - Halla Zaitoun
- Consultant in Paediatric Dentistry, Charles Clifford Dental Services, Sheffield, UK
| | - Martin H Thornhill
- Professor of Translational Research in Dentistry, School of Clinical Dentistry, University of Sheffield, UK
| | - Anne M Hegarty
- Consultant in Oral Medicine, Charles Clifford Dental Services, Sheffield, UK
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Bakhtiari S, Taheri JB, Toossi P, Azimi S, Kawosi Nezhad S. Prevalence of oral lichen planus in Iranian children and adolescents: a 12-year retrospective study. Eur Arch Paediatr Dent 2017; 18:419-422. [PMID: 29139037 DOI: 10.1007/s40368-017-0315-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2017] [Accepted: 09/22/2017] [Indexed: 10/18/2022]
Abstract
AIM To investigate the prevalence of oral lichen planus in patients younger than 18 years, referred to a dermatology centre in Iran during 2002-2014. Lichen planus is a chronic inflammatory, immune-mediated disease that could affect the oral mucosa and is a pre-cancerous condition. The disease usually develops in middle age with female predominance and is rare in children. METHODS In this retrospective study, cases with definitive histopathologic diagnosis of lichen planus, over a 12-year period from 2002 to 2014 from a dermatologic hospital archive were evaluated. The prevalence of both cutaneous and oral lichen planus, the male:female ratio and site of involvement were calculated using SPSS version 21. RESULTS Thirty-six of 564 patients younger than 18 years old diagnosed with lichen planus. Two females (0.4%) had oral lichen planus. One patient had erosive, and one had bullous, oral lichen planus. CONCLUSION Oral lichen planus had a very low frequency in Iranian population younger than 18 years old, identifying these patients is recommended for long-term follow-up.
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Affiliation(s)
- S Bakhtiari
- Department of Oral Medicine, Dental School, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - J B Taheri
- Department of Oral Medicine, Dental School, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - P Toossi
- Department of Dermatology, Skin Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - S Azimi
- International Research Collaborative, Oral Health and Equity, School of Human Sciences, The University of Western Australia, Perth, WA, 6009, Australia. .,School of Human Science, The University of Western Australia, 35 Stirling Highway, Crawley, WA, 6009, Australia.
| | - Sh Kawosi Nezhad
- Dental School, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Cascone M, Celentano A, Adamo D, Leuci S, Ruoppo E, Mignogna MD. Oral lichen planus in childhood: a case series. Int J Dermatol 2017; 56:641-652. [PMID: 28256018 DOI: 10.1111/ijd.13571] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/17/2015] [Revised: 11/09/2016] [Accepted: 01/10/2017] [Indexed: 11/28/2022]
Abstract
BACKGROUND Although the exact incidence of pediatric oral lichen planus (OLP) is unknown, the oral mucosa seems to be less commonly involved, and the clinical presentation is often atypical. The aim of the study is to present a case series of OLP in childhood. METHODS From our database, we retrospectively selected and analyzed the clinical data of OLP patients under the age of 18 where the diagnosis had been confirmed by histopathological analysis. RESULTS The case series from our database shows eight patients, four males and four females. The mean (±SD) age at the time of diagnosis of the disease was 13.5 (±2.73) years, ranging in age from 9 to 17. Clinically, a reticular pattern was present in six patients (75%), and the tongue was the most commonly involved oral site (six cases, 75%). We also report the first case of OLP in a 9-year-old girl affected by autoimmune polyendocrinopathy-candidiasis-ectodermal dystrophy. CONCLUSIONS We report the largest case series of pediatric OLP published in literature thus far. Differences in the disease between adults and pediatric patients have been detected, but further investigation and a larger case series are needed to establish any detailed differences in clinical outcomes.
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Affiliation(s)
- Marco Cascone
- Department of Neurosciences, Reproductive and Odontostomatological Sciences, University Federico II of Naples, Naples, Italy
| | - Antonio Celentano
- Department of Neurosciences, Reproductive and Odontostomatological Sciences, University Federico II of Naples, Naples, Italy
| | - Daniela Adamo
- Department of Neurosciences, Reproductive and Odontostomatological Sciences, University Federico II of Naples, Naples, Italy
| | - Stefania Leuci
- Department of Neurosciences, Reproductive and Odontostomatological Sciences, University Federico II of Naples, Naples, Italy
| | - Elvira Ruoppo
- Department of Neurosciences, Reproductive and Odontostomatological Sciences, University Federico II of Naples, Naples, Italy
| | - Michele D Mignogna
- Department of Neurosciences, Reproductive and Odontostomatological Sciences, University Federico II of Naples, Naples, Italy
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12
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Lombardi N, Rossi V, Delia S, Tovaru S, Passera D, Munari A, Varacca A. Lesioni lichenoidi in età pediatrica: due casi clinici di pazienti in terapia ortodontica. DENTAL CADMOS 2014. [DOI: 10.1016/s0011-8524(14)70134-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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13
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Abstract
Lichen planus (LP) is a chronic inflammatory mucocutaneous condition which is relatively common in adults but rarely affects children. The present study is a report on an unusual case of ulcerative oral LP involving the dorsum of tongue in a 12-year-old boy. Patient complained of painful oral lesion on the tongue which was burning in nature and obstructing talking and eating spicy foods. On intraoral examination, a white ulcerative lesion on the dorsum of tongue was observed. Diagnosis was made based on clinical examination and histopathological features. We instituted local treatment and patient responded well to the treatment. Although rarely reported in childhood, lichen planus should be considered in a differential diagnosis of hyperkeratotic, reticular, and ulcerative lesions of the oral mucosa in children.
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14
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Khandelwal V, Nayak PA, Nayak UA, Gupta A. Oral lichen planus in a young Indian child. BMJ Case Rep 2013; 2013:bcr2013010516. [PMID: 23946513 PMCID: PMC3762147 DOI: 10.1136/bcr-2013-010516] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Lichen planus (LP) is one of the most distinct mucocutaneous diseases. It is common with the middle aged and elderly population but has rarely been described in children. Incidences of oral LP in children is most commonly reported amongst Asians. We present a 10-year-old Indian girl with the documented clinical aspects and histopathological studies.
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Affiliation(s)
- Vishal Khandelwal
- Modern Dental College and Research Center, Indore, Madhya Pradesh, India
| | - Prathibha Anand Nayak
- Department of Periodontics, Mahatma Gandhi Dental College & Hospital, Jaipur, Rajasthan, India
| | - Ullal Anand Nayak
- Department of Pedodontics, Mahatma Gandhi Medical and Dental College, Jaipur, Rajasthan, India
| | - Amit Gupta
- Department of Orthodontics, Modern Dental College & Research Centre, Indore, Madhya Pradesh, India
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15
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Chaitra TR, Telgi RL, Kishor A, Kulkarni AU. Juvenile oral lichen planus: a clinical rarity. BMJ Case Rep 2012; 2012:bcr-2012-006192. [PMID: 23131605 DOI: 10.1136/bcr-2012-006192] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Affiliation(s)
- T R Chaitra
- Department of Pediatric Dentistry, Kothiwal Dental College and Research Centre, Moradabad, Uttar Pradesh, India
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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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Abstract
Oral lichen planus which is one of the most common oral
mucosal diseases in adults, it has been rarely described in
children. There are very reports in the literature regarding
oral lichen planus in children, here we report a case of intraoral
lesions of lichen planus. Lichen planus should be
considered in the differential diagnosis of hyperkeratotic or
erosive lesions of the oral mucosa in children.
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Affiliation(s)
- Usha Mohan Das
- Professor and Head, Dean, Department of Pedodontics and Preventive Dentistry, VS Dental College and Hospital, KR Road VV Puram, Bengaluru, Karnataka, India
| | - Beena Jp
- Lecturer, Department of Pedodontics and Preventive Dentistry, VS Dental College and Hospital, KR Road, VV Puram, Bengaluru Karnataka, India
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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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