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Shalaby R, Nawawy ME, Selim K, Bahaa S, Refai SE, Maksoud AE, Sayed ME, Essawy A, Elshaer A, ElShaer M, Kamel MM, Gamil Y. The role of vitamin D in amelioration of oral lichen planus and its effect on salivary and tissue IFN-γ level: a randomized clinical trial. BMC Oral Health 2024; 24:813. [PMID: 39020381 DOI: 10.1186/s12903-024-04239-0] [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: 11/28/2023] [Accepted: 04/09/2024] [Indexed: 07/19/2024] Open
Abstract
BACKGROUND AND OBJECTIVES Oral lichen planus (OLP) is a common, prevalent, immune-mediated, inflammatory disease affecting both the skin and oral mucosa and is considered one of the potentially malignant diseases. Since OLP is regarded as an immunologically mediated disease, some studies suggest the use of vitamin D (VD) for its management as it exhibits immune-modulatory, anti-inflammatory, and antimicrobial properties, as well as anti-proliferative, pro-differentiative, and anti-angiogenic effects. VD has demonstrated a suppressive effect on TH1 pro-inflammatory cytokines, including IFN-γ while augmenting the secretion of anti-inflammatory cytokines. At the same time, VD deficiency is a prevalent public issue. Therefore, the present study aimed to investigate the role of VD as an adjunct to steroids in the management of VD-deficient OLP patients as well as its inhibitory effect on IFN-γ through measurement of salivary and tissue IFN-γ levels in OLP patients. METHODS A total of 40 patients with ulcerative or erythematous OLP, diagnosed according to the World Health Organization's (WHO) modified criteria for OLP, were randomly allocated into one of the two study groups to receive either systemic steroids in addition to VD supplements (Group A) or systemic steroids only (Group B). Blood samples were collected for the measurement of serum VD level (SVDL) using the enzyme-linked immunosorbent assay (ELISA) to involve only patients with VD deficiency or insufficiency (≤ 30 ng/ml). Clinical evaluation of the lesion involved objective signs and subjective symptoms. Also, changes in salivary and tissue INF-γ levels (in pg/mL and pg/mg, respectively) were determined using the ELISA technique. All parameters were measured at baseline and after 4 weeks of treatment. The clinical pharmacy team devised a checklist to record all team interventions. The interventions were categorized into six domains, including drug interactions and/or adverse reactions, medication dose issues, drug selection issues, support with medication history, patient-related concerns, and suggestions for dental medication. RESULTS After one month of treatment, a significantly greater number of patients in group A showed complete pain relief and resolution of clinical lesions, as well as a greater number of patients showing a reduction in the clinical severity of lesions than in group B (P = 0.005). Also, there was a statistically significant reduction in average VAS pain scores and clinical scores in group A compared to group B after 1 month of treatment (P = 0.001 and 0.002, respectively). Furthermore, there was a statistically significant greater reduction in salivary and tissue IFN-γ levels in group A than in group B (P ≤ 0.001 and 0.029, respectively) after 1 month of treatment. CONCLUSION Current evidence suggests a significant preventive and therapeutic role for VD as an adjunct to standard therapies indicated for OLP lesions. These protective and therapeutic functions are achieved through the suppressive effect of VD on pro-inflammatory cytokines, particularly IFN-γ. Also, salivary IFN-γ appears to be a valuable prognostic marker for monitoring the progression of OLP. In addition, the inter-professional collaboration between dentists and clinical pharmacists helped to deliver complete, patient-centered primary care and ensured the quality of the medications included in patient kits, thus improving patient treatment and management. Nevertheless, further studies with larger sample sizes, longer follow-ups, and standardized designs may still be needed.
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Affiliation(s)
- Rania Shalaby
- Oral Medicine, Diagnosis, and Periodontology, Faculty of Dentistry, Fayoum University, Fayoum, Egypt.
| | - Marwa El Nawawy
- Oral Medicine, Diagnosis, and Periodontology, Faculty of Dentistry, Cairo University, Cairo, Egypt
| | - Khaled Selim
- Oral Medicine, Diagnosis, and Periodontology, Faculty of Dentistry, Cairo University, Cairo, Egypt
| | - Samah Bahaa
- Oral Medicine, Diagnosis, and Periodontology, Faculty of Dentistry, Cairo University, Cairo, Egypt
| | - Sahar El Refai
- Oral Pathology, College of Dentistry, Princess Nourah Bint Abdulrahman University, Riyadh, Saudi Arabia
| | | | - Mahitab El Sayed
- Clinical Pharmacy Department, Faculty of Pharmacy, Modern University for Technology and Information, Cairo, Egypt
| | - Aya Essawy
- Clinical Pharmacy Department, Faculty of Pharmacy, Modern University for Technology and Information, Cairo, Egypt
| | - Asmaa Elshaer
- Clinical Pharmacology Department, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | - Mohamed ElShaer
- Clinical Pharmacology Department, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | - Moataz Maher Kamel
- Medical Biochemistry and Molecular Biology, Faculty of Medicine, Cairo University, Giza, Egypt
| | - Yasmine Gamil
- Department of Oral Medicine, Diagnosis, and Periodontology, Faculty of Oral and Dental Surgery, Modern University for Technology and Information, MTI University, Cairo, Egypt
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Rahman A, Haider MF. A comprehensive review on glucocorticoids induced osteoporosis: A medication caused disease. Steroids 2024; 207:109440. [PMID: 38754651 DOI: 10.1016/j.steroids.2024.109440] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/27/2024] [Revised: 05/11/2024] [Accepted: 05/13/2024] [Indexed: 05/18/2024]
Abstract
Glucocorticoids (GCs) are steroid hormones that are extensively used in the treatment of autoimmune diseases, inflammation, and cancer. The major ill effect of administering GCs is that it has a deleterious effect on bone, which leads to GC-induced osteoporosis. GC therapy induces bone loss and is associated with the risk of nonvertebral and vertebral fractures, as it works in combination by increasing bone reabsorption and suppressing bone formation during the initial phase of therapy. It is seen and established that GC in excess or in low dose for 3 months or more can be a risk factor for fracture, and the risk increases with an increase in dose and duration of usage. The most common cause of secondary osteoporosis is the administration of GC inside the body to treat various diseases. The degree of bone loss is directly proportional to the GC dose and the exposure duration. The first step is to evaluate the patients' risk factors for the development of glucocorticoids that induce osteoporosis, which include the dose, duration of use, patient age, sex, previous fractures, and other medical conditions.
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Affiliation(s)
- Asim Rahman
- Faculty of Pharmacy, Integral University, Lucknow 226026, India
| | - Md Faheem Haider
- Faculty of Pharmacy, Integral University, Lucknow 226026, India.
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Nicolas-Rodriguez E, Pons-Fuster E, López-Jornet P. Diagnostic Infrared Thermography of the Tongue and Taste Perception in Patients with Oral Lichen Planus: Case-Control Study. J Clin Med 2024; 13:435. [PMID: 38256569 PMCID: PMC10816281 DOI: 10.3390/jcm13020435] [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: 12/08/2023] [Revised: 12/31/2023] [Accepted: 01/10/2024] [Indexed: 01/24/2024] Open
Abstract
Oral lichen planus (OLP) is a chronic inflammatory disease of autoimmune origin that affects the skin and mucous membranes. The aim of this study was to assess the effectiveness of infrared thermography (IRT) as a diagnostic tool in patients with oral lichen planus (OLP), as well as disturbances in taste perception, in cases with and without tongue involvement. A case-control study was carried out in a sample of 87 patients divided into three groups: healthy individuals (controls; n = 43), OLP patients without involvement of the tongue (n = 24), and OLP patients with involvement of the tongue (n = 20). The patient symptoms and the clinical characteristics of the lesions were assessed. Four thermal images of the tongue were obtained using IRT: dorsum, right and left lateral surface, and tip of the tongue. General taste perception capacity and subjective sweet, acid, salty, and bitter sensation were evaluated in all three groups. There were no statistically significant differences in the IRT values among the three groups (p ≥ 0.05). In the OLP patients with involvement of the tongue, significantly higher values were observed in the mixed forms of the disease (p = 0.032). The OLP patients with and without involvement of the tongue showed no significant alterations in taste sensation (p = 0.69). IRT may serve as a complementary tool for assessing the activity of OLP with involvement of the tongue. However, more research is needed in this field.
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Affiliation(s)
- Elena Nicolas-Rodriguez
- Faculty of Medicine and Odontology, Hospital Morales Meseguer, Clínica Odontológica, Marqués del Los Vélez s/n, 30008 Murcia, Spain;
| | - Eduardo Pons-Fuster
- Departamento de Anatomía Humana y Psicobiología, Faculty of Medicine and Odontology, Biomedical Research Institute (IMIB-Arrixaca), University of Murcia Spain, 30100 Murcia, Spain;
| | - Pia López-Jornet
- Faculty of Medicine and Odontology, Hospital Morales Meseguer, Clínica Odontológica, Marqués del Los Vélez s/n, 30008 Murcia, Spain;
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Ting S, Nguyen J, Palmer A, Rosemary Nixon AM. Contact sensitisation in oral lichen planus: An Australian perspective. Contact Dermatitis 2023; 89:335-344. [PMID: 37311568 DOI: 10.1111/cod.14366] [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: 03/24/2023] [Revised: 05/30/2023] [Accepted: 06/05/2023] [Indexed: 06/15/2023]
Abstract
BACKGROUND The role of contact sensitisation in the pathogenesis of oral lichen planus (OLP) has not been clearly defined. OBJECTIVE We aimed to evaluate relevant contact sensitisers in OLP. METHODS A retrospective study was conducted on OLP patients who underwent patch testing from 1 January 2006 to 31 December 2020 at an Australian tertiary dermatology institution, compared to cheilitis patients patch tested over the same time period. RESULTS Ninety-six OLP patients and 152 cheilitis patients were patch tested during the 15-year period. Seventy-one (73.9%) OLP patients and 100 (65.8%) cheilitis patients recorded one or more relevant reactions. Forty-three (44.8%), 22 (22.9%), 21 (21.9%) and 17 (17.7%) OLP patients had relevant reactions to mercury-related chemicals, amalgam, spearmint and carvone, respectively, compared to 6 (3.9%), 3 (2.0%), 4 (2.6%) and 0 (0%) cheilitis patients, respectively (p-value <0.001 each). Four (4.2%) OLP patients had relevant positive reactions to sodium metabisulfite, compared to none in the cheilitis group (p-value 0.021). CONCLUSION While dental amalgam is used less frequently these days, we report that mercury (found in amalgam) and additionally spearmint and carvone are relevant sensitisers in OLP in Australia. Sodium metabisulfite may also be a relevant sensitiser in OLP, which has not previously been reported.
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Affiliation(s)
- Sarajane Ting
- Occupational Dermatology Research and Education Centre, Skin Health Institute, Carlton, Victoria, Australia
| | - Jennifer Nguyen
- Occupational Dermatology Research and Education Centre, Skin Health Institute, Carlton, Victoria, Australia
| | - Amanda Palmer
- Occupational Dermatology Research and Education Centre, Skin Health Institute, Carlton, Victoria, Australia
| | - A M Rosemary Nixon
- Occupational Dermatology Research and Education Centre, Skin Health Institute, Carlton, Victoria, Australia
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Alsoghier A, AlMadan N, Alali M, Alshagroud R. Clinicohistological Characteristics of Patients with Oral Lichenoid Mucositis: A Retrospective Study for Dental Hospital Records. J Clin Med 2023; 12:6383. [PMID: 37835027 PMCID: PMC10573176 DOI: 10.3390/jcm12196383] [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: 09/07/2023] [Revised: 09/26/2023] [Accepted: 10/02/2023] [Indexed: 10/15/2023] Open
Abstract
Oral lichenoid mucositis (OLM) of the oral mucosa is a histological diagnosis mainly characterised by a band of inflammatory infiltrate in lamina propria and basal cell degeneration. These features describe oral lichen planus or oral lichenoid reaction. However, it could be seen in oral dysplasia. The study aimed to assess the demographics and clinicohistological characteristics of patients with OLM and their relevance to dysplastic changes in the oral mucosa. This was a cross-sectional and retrospective study of archived and electronic records of individuals with histological confirmation of OLM at King Saud University Medical City, Saudi Arabia. The descriptive and correlation assessments were used to describe the demographics and clinicohistological characteristics and their associations, respectively [p < 0.05]. The analysis included 140 records of patients with histological confirmation of OLM with a mean age of 47 (±13), and 57% (n = 81) were females. Notably, 40% of patients had at least one medical condition, mainly diabetes mellitus, 74% were asymptomatic, and 52% had lesions in the buccal mucosa. Dysplasia was seen in 18 (12%) of the 140 reviewed records. Regarding the associations between study variables, dysplastic changes were associated with the male gender [p = 0.024] and were of no significance with increased age [p = 0.594]. Moreover, having oral symptoms was associated with older age [p < 0.001], medical history of diabetes [p = 0.0132] and hypertension [p < 0.001]. The present study findings could help indicate the individuals with histologically confirmed OLM who suffer the most from the clinical disease and have an increased risk of dysplastic changes. Therefore, symptomatic management and long-term follow-up can be planned accordingly.
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Affiliation(s)
- Abdullah Alsoghier
- Department of Oral Medicine and Diagnostic Sciences, College of Dentistry, King Saud University, Riyadh 12372, Saudi Arabia;
- King Saud University Medical City, King Saud University, Riyadh 12372, Saudi Arabia; (N.A.); (M.A.)
| | - Nasser AlMadan
- King Saud University Medical City, King Saud University, Riyadh 12372, Saudi Arabia; (N.A.); (M.A.)
- Dental Center, Prince Sultan Military Medical City, Riyadh 12233, Saudi Arabia
| | - Mohammed Alali
- King Saud University Medical City, King Saud University, Riyadh 12372, Saudi Arabia; (N.A.); (M.A.)
- Dental Center, Prince Sultan Military Medical City, Riyadh 12233, Saudi Arabia
| | - Rana Alshagroud
- Department of Oral Medicine and Diagnostic Sciences, College of Dentistry, King Saud University, Riyadh 12372, Saudi Arabia;
- King Saud University Medical City, King Saud University, Riyadh 12372, Saudi Arabia; (N.A.); (M.A.)
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Xie F, Dasari S, Deschaine M, Gleue CA, Sartori-Valinotti JC, Torgerson RR, Davis MD, Charlesworth MC, Meves A, Lehman JS. Differential proteomic expression profiles in vulvar lichen planus as compared to normal vulvar tissue, vulvar lichen sclerosus, or oral lichen planus: An exploratory study. Exp Dermatol 2023; 32:1498-1508. [PMID: 37317627 PMCID: PMC10527766 DOI: 10.1111/exd.14854] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2023] [Revised: 05/13/2023] [Accepted: 05/15/2023] [Indexed: 06/16/2023]
Abstract
Vulvar lichen planus (VLP) is a chronic inflammatory disease which adversely affects patients' quality of life. The pathogenesis of VLP is unknown although Th1 immune response has been implicated. We aimed to discover specific tissue-based protein biomarkers in VLP compared to normal vulvar tissue (NVT), vulvar lichen sclerosus (VLS) and oral lichen planus (OLP). We used laser capture microdissection-liquid chromatography- tandem mass spectrometry to assess protein expression in fixed lesional mucosal specimens from patients with VLP (n = 5). We then compared proteomic profiles against those of NVT (n = 4), VLS (n = 5), OLP (n = 6) and normal oral mucosa (n = 5), previously published by our group. IL16, PTPRC, PTPRCAP, TAP1 and ITGB2 and were significantly overexpressed in VLP compared to NVT. Ingenuity pathway analysis identified antigen presentation and integrin signalling pathways. Proteins overexpressed in both VLP versus NVT and OLP versus NOM included IL16, PTPRC, PTPRCAP, TAP1, HLA-DPB1, HLA-B and HLA-DRA. This proteomic analysis revealed several overexpressed proteins in VLP that relate to Th1 autoimmunity, including IL16. Overlapping pathways, including those involving IFNγ and Th1 signalling, were observed between VLP, VLS, and OLP.
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Affiliation(s)
- Fangyi Xie
- Department of Dermatology, Mayo Clinic, Rochester, Minnesota
| | - Surendra Dasari
- Department of Quantitative Health Sciences, Mayo Clinic, Rochester, Minnesota
| | - Maria Deschaine
- Department of Dermatology, Florida State University, Pensacola, FL
| | - Casey A. Gleue
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, Minnesota
| | | | - Rochelle R. Torgerson
- Department of Dermatology, Mayo Clinic, Rochester, Minnesota
- Department of Obstetrics and Gynecology, Mayo Clinic, Rochester, Minnesota
| | - Mark D.P. Davis
- Department of Dermatology, Mayo Clinic, Rochester, Minnesota
| | | | - Alexander Meves
- Department of Dermatology, Mayo Clinic, Rochester, Minnesota
- Department of Biochemistry and Molecular Biology, Mayo Clinic, Rochester, Minnesota
| | - Julia S. Lehman
- Department of Dermatology, Mayo Clinic, Rochester, Minnesota
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, Minnesota
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Evaluation of the classification and clinical characteristics of oral lichen planus and its treatment effect in different clinical types: A retrospective study. ADVANCES IN ORAL AND MAXILLOFACIAL SURGERY 2022. [DOI: 10.1016/j.adoms.2022.100369] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
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Saeed S, Choudhury P, Ahmad SA, Alam T, Panigrahi R, Aziz S, Kaleem SM, Priyadarshini SR, Sahoo PK, Hasan S. Vitamin D in the Treatment of Oral Lichen Planus: A Systematic Review. Biomedicines 2022; 10:biomedicines10112964. [PMID: 36428531 PMCID: PMC9687323 DOI: 10.3390/biomedicines10112964] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2022] [Revised: 11/03/2022] [Accepted: 11/13/2022] [Indexed: 11/19/2022] Open
Abstract
Oral lichen planus (OLP) is a chronic mucocutaneous condition that affects up to 2% of the general population, and typically presents with long-standing, non-responsive lesions, with episodes of exacerbation and remissions. The etiopathogenesis of OLP is still unclear, although, it has been postulated that it is most likely a T-cell-mediated condition of an unknown antigen. The treatment remains a challenge with no defined treatment strategy. Vitamin D has anti-inflammatory and immunomodulatory properties, along with its regulatory effect on keratinocyte proliferation and differentiation; thus, suggesting its possible role in the treatment of OLP. This systematic review aims to evaluate the therapeutic role of vitamin D in OLP treatment. We searched PubMed/MEDLINE, and Google scholar search engines for studies evaluating vitamin D as a treatment modality in OLP from January 2000 to August 2022. Articles were searched with the combination of Medical Subject Heading (MeSH) terms. A web platform for visualizing risk-of-bias assessment was used in this review, and descriptive statistics were calculated. Out of the seventeen retrieved studies, five articles meeting the inclusion criteria were considered in this systematic review. All the included studies demonstrated significant amelioration in the OLP symptoms in patients who were given vitamin D supplements as an adjuvant to the conventional steroid therapy and or placebo. This systematic review signifies the role of vitamin D as adjuvant therapy for OLP. However, more studies with larger sample size are required to validate these results.
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Affiliation(s)
- Shazina Saeed
- Amity Institute of Public Health, Amity University, Noida 201303, India
| | | | - Syed Ansar Ahmad
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Jamia Millia Islamia, New Delhi 110025, India
| | - Tanveer Alam
- Department of DDS, College of Dentistry, King Khalid University, Abha 61413, Saudi Arabia
| | - Rajat Panigrahi
- Department of Oral Medicine and Radiology, Institute of Dental Sciences, Siksha ‘O’ Anusandhan University, Bhubaneswar 751003, India
| | - Shahid Aziz
- Department of Medicine, College of Medicine, King Khalid University, Abha 61413, Saudi Arabia
| | - Sultan Mohammed Kaleem
- Department of DDS, College of Dentistry, King Khalid University, Abha 61413, Saudi Arabia
| | - Smita R. Priyadarshini
- Department of Oral Medicine and Radiology, Institute of Dental Sciences, Siksha ‘O’ Anusandhan University, Bhubaneswar 751003, India
| | - Pradyumna Ku Sahoo
- Department of Prosthodontics, Institute of Dental Sciences, Siksha ‘O’ Anusandhan University, Bhubaneswar 751003, India
| | - Shamimul Hasan
- Department of Oral Medicine and Radiology, Faculty of Dentistry, Jamia Millia Islamia, New Delhi 110025, India
- Correspondence: ; Tel.: +91-99-5329-0676
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Wang R, Zhang X, Wang S. Differential genotypes of TNF-α and IL-10 for immunological diagnosis in discoid lupus erythematosus and oral lichen planus: A narrative review. Front Immunol 2022; 13:967281. [PMID: 35990645 PMCID: PMC9389012 DOI: 10.3389/fimmu.2022.967281] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2022] [Accepted: 07/18/2022] [Indexed: 01/24/2023] Open
Abstract
Discoid lupus erythematosus and oral lichen planus are chronic systemic immune system-mediated diseases with unclear etiology and pathogenesis. The oral mucosa is the common primary site of pathogenesis in both, whereby innate and adaptive immunity and inflammation play crucial roles. The clinical manifestations of discoid lupus erythematosus on the oral mucosa are very similar to those of oral lichen planus; therefore, its oral lesion is classified under oral lichenoid lesions. In practice, the differential diagnosis of discoid lupus erythematosus and oral lichen planus has always relied on the clinical manifestations, with histopathological examination as an auxiliary diagnostic tool. However, the close resemblance of the clinical manifestations and histopathology proves challenging for accurate differential diagnosis and further treatment. In most cases, dentists and pathologists fail to distinguish between the conditions during the early stages of the lesions. It should be noted that both are considered to be precancerous conditions, highlighting the significance of early diagnosis and treatment. In the context of unknown etiology and pathogenesis, we suggest a serological and genetic diagnostic method based on TNF-α and IL-10. These are the two most common cytokines produced by the innate and adaptive immune systems and they play a fundamental role in maintaining immune homeostasis and modulating inflammation. The prominent variability in their expression levels and gene polymorphism typing in different lesions compensates for the low specificity of current conventional diagnostic protocols. This new diagnostic scheme, starting from the immunity and inflammation of the oral mucosa, enables simultaneous comparison of discoid lupus erythematosus and oral lichen planus. With relevant supportive evidence, this information can enhance physicians’ understanding of the two diseases, contribute to precision medicine, and aid in prevention of precancerous conditions.
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Affiliation(s)
- Ruochong Wang
- Emergency Department, State Key Laboratory of Oral Diseases, National Center of Stomatology, National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Xuefeng Zhang
- Emergency Department, State Key Laboratory of Oral Diseases, National Center of Stomatology, National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Siyu Wang
- Department of Dermatology, Institute of Dermatology and Venereology, Sichuan Academy of Medical Sciences & Sichuan Provincial People’s Hospital, Chengdu, China
- *Correspondence: Siyu Wang,
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Lehner J, Agbo-Godeau S, Bertolus C. A Retrospective Study of 23 Cases: Are Lichenoid Lesions of the Labial Mucosa Induced? Cureus 2022; 14:e25012. [PMID: 35591890 PMCID: PMC9110071 DOI: 10.7759/cureus.25012] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/15/2022] [Indexed: 11/27/2022] Open
Abstract
Background Lichen planus (LP) is a pathology that affects the skin and the mucosa. The lips are rarely involved but represent a diagnostic challenge in those cases. Oral lichenoid lesions (OLL) are defined as lesions that resemble oral lichen planus (OLP) but do not fully meet the clinical and/or histologic criteria for OLP. This study aimed to present our case series and to study the correlation between the location of the lesion and the dental factor (resin composite, amalgams, crowns, abrasive teeth, and mandibular crossbite) that could cause the lesion. Methods We conducted a retrospective observational study of 23 patients with LP/OLL of the lips treated in the Department of Oral Mucosal Pathology of the Department of Stomatology and Maxillofacial Surgery of the Pitié-Salpêtrière Hospital in Paris between January 2017 and February 2021. We noted the location of the lesion (upper, lower, or both lips), medical history, treatments, smoking habits, and the aspect of the teeth facing the lesion. Patients received a local corticoid treatment and were monitored via follow-up. Results Sixteen patients had lesions on the upper lip, two on the lower lip, and five on both lips, and most patients (n = 14, 60.1%) had a dental factor facing the lesion (e.g., abrasive teeth, resin composites, dental crowns, and mandibular crossbite). Six patients received clobetasol propionate, and 15 patients received a preparation combining betamethasone and benzocaine (Orabase, ConvaTec, Deeside, UK). Fourteen patients returned for post-treatment follow-up consultations approximately two months after treatment. Seven patients saw clinical improvement, five had partial improvement, and two had no improvement. Conclusions Lesions of the labial mucosa appear to be a rare condition in LP/OLL. The difference between LP and OLL can be difficult, even with histological analysis. Its pathogenesis remains unknown, although some studies found evidence of lichenoid reactions of the lips in contact with dental composite restorations. In our study, 14 of our patients had a dental factor facing the lesions. However, our study failed to show a correlation between the presence of an inducing factor and the lesion. In a future study, the potential effect of dental inducing factor removal could be studied. This topic requires further investigations, particularly regarding the inducing factor and the optimal therapeutic approach.
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Faghihian E, Taghvaee R, Etemadi M, Ghalayani P. Comparison of clinical indices and therapeutic effect of a mucoadhesive system containing Melissa 1% and triamcinolone 0.1% on lichenoid reactions. Dent Res J (Isfahan) 2022; 19:2. [PMID: 35308455 PMCID: PMC8927956 DOI: 10.4103/1735-3327.336687] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2020] [Revised: 06/05/2021] [Accepted: 07/13/2021] [Indexed: 11/04/2022] Open
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Boch K, Langan EA, Kridin K, Zillikens D, Ludwig RJ, Bieber K. Lichen Planus. Front Med (Lausanne) 2021; 8:737813. [PMID: 34790675 PMCID: PMC8591129 DOI: 10.3389/fmed.2021.737813] [Citation(s) in RCA: 34] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2021] [Accepted: 10/11/2021] [Indexed: 12/17/2022] Open
Abstract
Lichen planus (LP) is a T cell-mediated disease affecting the stratified squamous epithelia of the skin and/or mucus membrane. Histologically, the disease is characterized by a lichenoid inflammatory infiltrate and vacuolar degeneration of the basal layer of the epidermis. LP has three major subtypes: Cutaneous, mucosal and appendageal LP. Rarely, it may affect the nails in the absence of skin and/or mucosal changes. LP may also be induced by several drugs, typically anti-hypertensive medication or be associated with infections, particularly viral hepatitis. The diagnosis is based on the clinical presentation and characteristic histological findings. Although the disease is often self-limiting, the intractable pruritus and painful mucosal erosions result in significant morbidity. The current first-line treatment are topical and/or systemic corticosteroids. In addition, immunosuppressants may be used as corticosteroid-sparing agents. These, however are often not sufficient to control disease. Janus kinase inhibitors and biologics (anti-IL-12/23, anti-IL17) have emerged as novel future treatment options. Thus, one may expect a dramatic change of the treatment landscape of LP in the near future.
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Affiliation(s)
- Katharina Boch
- Department of Dermatology, University of Lübeck, Lübeck, Germany
| | - Ewan A Langan
- Department of Dermatology, University of Lübeck, Lübeck, Germany.,Dermatological Sciences, University of Manchester, Manchester, United Kingdom
| | - Khalaf Kridin
- Lübeck Institute of Experimental Dermatology, University of Lübeck, Lübeck, Germany.,Azrieli Faculty of Medicine, Bar-Ilan University, Safed, Israel
| | - Detlef Zillikens
- Department of Dermatology, University of Lübeck, Lübeck, Germany
| | - Ralf J Ludwig
- Lübeck Institute of Experimental Dermatology, University of Lübeck, Lübeck, Germany
| | - Katja Bieber
- Lübeck Institute of Experimental Dermatology, University of Lübeck, Lübeck, Germany
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13
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Kan S, Ren H, Gao Z, Dai E, Liu Y, Yang L, Cai Q. Lichenoid drug eruption on the lower lip caused by anti-PD-1 monoclonal antibody: a case report and literature review. Immunotherapy 2021; 13:1373-1378. [PMID: 34632814 DOI: 10.2217/imt-2021-0234] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
Anti-PD-1/PD-L1 monoclonal antibodies result in a unique spectrum of side effects, widely known as immune-related adverse events. Toripalimab is an anti-PD-1 monoclonal antibody used for the treatment of some cancers. Here we report the first case, to our knowledge, of oral lichenoid drug reaction triggered by toripalimab. A 78-year-old man who was diagnosed with systemic metastatic prostate cancer presented with ulcers on the lower lip after the fifth cycle of toripalimab. We diagnosed him with oral lichenoid drug reaction based on clinical manifestation, histopathological findings and the history of anti-PD-1 therapy. The patient responded well to oral corticosteroids combined with helium-neon laser therapy. The anti-PD-1 therapy was not restarted because of stable disease, and the eruptions did not recur.
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Affiliation(s)
- Siyue Kan
- Shanghai Skin Disease Hospital, Department of Medical Mycology, Tongji University School of Medicine, Shanghai, 200443, China
| | - Hongjin Ren
- Shanghai Skin Disease Hospital, Department of Medical Mycology, Tongji University School of Medicine, Shanghai, 200443, China
| | - Zhiqin Gao
- Shanghai Skin Disease Hospital, Department of Medical Mycology, Tongji University School of Medicine, Shanghai, 200443, China
| | - Erhong Dai
- Shanghai Skin Disease Hospital, Department of Medical Mycology, Tongji University School of Medicine, Shanghai, 200443, China
| | - Yeqiang Liu
- Shanghai Skin Disease Hospital, Department of Pathology, Tongji University School of Medicine, Shanghai, 200443, China
| | - Lianjuan Yang
- Shanghai Skin Disease Hospital, Department of Medical Mycology, Tongji University School of Medicine, Shanghai, 200443, China
| | - Qing Cai
- Shanghai Skin Disease Hospital, Department of Medical Mycology, Tongji University School of Medicine, Shanghai, 200443, China
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14
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Smulevich AB, Lvov AN, Iuzbashian PG, Tereshenko AV, Michenko AV, Bobko SI, Voronova EI, Romanov DV. [Glossalgia as a psychodermatological syndrome]. Zh Nevrol Psikhiatr Im S S Korsakova 2021; 121:7-13. [PMID: 34460151 DOI: 10.17116/jnevro20211210717] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
OBJECTIVE To study clinical characteristics of burning mouth syndrome or glossalgia is a functional disorder with painful sensations in the oral cavity with verification of the psychopathological structure, typology and nosology of the syndrome within the continuum of neurotic/psychotic disorders and dermatological pathology, i.e. lichen planus (LP). MATERIAL AND METHODS The study sample (n=30, 27 female, mean age 59.3±15.6 years) was examined by dermatologist, neurologist and psychiatrist both clinically and psychometrically. The patients met the diagnostic criteria for glossalgia according to the IASP classification and ICD-10 for glossodynia (code K14.6). In 7 subjects, there was comorbidity with LP of the oral mucosa. RESULTS The psychopathological picture of glossalgia syndrome has a binary structure. Basic coenesthesiopathies, ranging in severity from homonomous sensations (isteralgias) to heteronomic sensopathies (senestopathies, senesthesia), are associated with secondary hypochondriacal phenomena: from health anxiety and monopatophobia to mastery of ideas and somatopsychic confusion, respectively. According to the psychopathological register (neurotic/psychotic) and the fact of objective verification of a dermatological disease (hypochondria sine materia/cum materia), there are three types of glossalgic syndrome: 1) organo-neurotic; 2) somatopsychotic; 3) dermatological (stress-induced somatic reactions). CONCLUSION BMS is a local syndrome limited to the oral cavity, however, in fact, it covers the entire clinical spectrum of psychosomatic pathology from mental diseases to psychodermatological ones.
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Affiliation(s)
- A B Smulevich
- I.M. Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia.,Mental Health Research Center, Moscow, Russia
| | - A N Lvov
- Moscow Scientific and Practical Center of Dermatology, Venereology and Cosmetology of Moscow City Health Department, Moscow, Russia
| | - P G Iuzbashian
- I.M. Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia
| | - A V Tereshenko
- Moscow Scientific and Practical Center of Dermatology, Venereology and Cosmetology of Moscow City Health Department, Moscow, Russia
| | - A V Michenko
- Moscow Scientific and Practical Center of Dermatology, Venereology and Cosmetology of Moscow City Health Department, Moscow, Russia
| | - S I Bobko
- Moscow Scientific and Practical Center of Dermatology, Venereology and Cosmetology of Moscow City Health Department, Moscow, Russia
| | - E I Voronova
- I.M. Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia.,Mental Health Research Center, Moscow, Russia
| | - D V Romanov
- I.M. Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia.,Mental Health Research Center, Moscow, Russia
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15
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Eita AAB, Zaki AM, Mahmoud SA. Serum 8-isoprostane levels in patients with resistant oral lichen planus before and after treatment with lycopene: a randomized clinical trial. BMC Oral Health 2021; 21:343. [PMID: 34266435 PMCID: PMC8281687 DOI: 10.1186/s12903-021-01711-z] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2021] [Accepted: 07/03/2021] [Indexed: 11/17/2022] Open
Abstract
Background Oral lichen planus is an autoimmune disease in which topical steroids are the first line of treatment. The adverse effects of systemic corticosteroids prescribed for resistant oral lichen planus cases advocate alternative modalities. Lycopene is an antioxidant with a wide range of beneficial properties. This trial aimed to evaluate the effect of pure lycopene as compared to systemic corticosteroids (Prednisolone) on the symptoms, signs and oxidative stress in patients with erosive oral lichen planus recalcitrant to topical steroids. Methods Twenty patients were randomly divided into the test (lycopene) and control (corticosteroids) groups. Numeric rating scale and Escudier et al. (Br J Dermatol 4:765–770, 2007. 10.1111/j.1365-2133.2007.08106.x) lesion scores were assessed at baseline and weeks 4 and 8 from baseline. Serum levels of 8-isoprostane were measured in all patients at baseline and at the end of treatment (week 8). Results There was a significant reduction in signs and symptoms after the end of treatment in each group. However, no significant difference was found between the lycopene and the corticosteroids group. Moreover, a significant reduction in 8-isoprostane levels was observed in the lycopene group from baseline and as compared to the control group. Conclusions Based on the study results, lycopene is a safe and effective therapeutic modality for resistant oral lichen planus. 8-isoprostane is a biomarker of lipid peroxidation that can be reduced by lycopene. Trial registration ID: PACTR202003484099670. 'Retrospectively registered on 11/3/2020'. Supplementary Information The online version contains supplementary material available at 10.1186/s12903-021-01711-z.
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Affiliation(s)
- Aliaa Abdelmoniem Bedeir Eita
- Oral Medicine, Periodontology, Diagnosis and Radiology Department, Faculty of Dentistry, Alexandria University, Alexandria, Egypt.
| | - Azza Mohamed Zaki
- Oral Medicine, Periodontology, Diagnosis and Radiology Department, Faculty of Dentistry, Alexandria University, Alexandria, Egypt
| | - Sabah Abdelhady Mahmoud
- Medical Biochemistry Department, Faculty of Medicine, Alexandria University, Alexandria, Egypt
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16
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New markers of oxidative stress in lichen planus and the influence of hepatitis C virus infection - a pilot study. ACTA ACUST UNITED AC 2021; 59:359-368. [PMID: 33951354 DOI: 10.2478/rjim-2021-0017] [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: 11/22/2020] [Indexed: 11/21/2022]
Abstract
INTRODUCTION Lichen planus (LP) is a mucocutaneous T-cell mediated disorder of unknown etiology. There is growing evidence that oxidative stress is an important player in the pathogenesis of LP. Therefore, we have investigated oxidative stress markers in LP and the influence of hepatitis C virus (HCV) infection, a frequently associated condition, on oxidative stress in LP patients. METHOD We have determined the serum levels of 4- hydroxynonenal (4-HNE) and symmetric dimethylarginine (SDMA), as markers of oxidative stress, and total antioxidant capacity (TAC), as a marker of the antioxidant defence, in 4 groups: group A - HCV positive patients with LP (n=12), group B - HCV positive patients without LP (n=12), group C - HCV negative patients with LP (n=31) and group D - control group (n=26). RESULTS In LP patients, we have identified an increased level of lipid peroxidation (4-HNE - group A - 8.41±1.11 µg/mL, group B - 7.97±2.17 µg/mL, group C - 7.81±1.96 µg/mL and group D - 6.15±1.17 µg/mL) and alterations in arginine methylation (SDMA - group A - 1.10±0.24 µmol/L, group B - 1.03±0.16 µmol/L, group C - 0.84±0.19 µmol/L and group D - 0.50±0.06 µmol/L) associated with a diminished antioxidant defence (TAC - group A - 234,50±49,96, µmol/L group B - 255,83±41,41 µmol/L, group C - 269,83±43,33 µmol/L and group D - 316,46 ±29,33 µmol/L), processes augmented by the association with HCV infection. CONCLUSION There is an imbalance between oxidants and antioxidants in patients with LP, an imbalance that is augmented by the presence of HCV infection. SDMA could be regarded as a novel biomarker of oxidative stress among these patients. To the best of our knowledge this is the first study to investigate the influence of HCV infection on oxidative stress in LP patients.
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Zohdy M, Cazzaniga S, Nievergelt H, Blum R, Suter VGA, Feldmeyer L, Beltraminelli H. Inter-Observer and Intra-Observer Variations in the Assessment of Epithelial Dysplasia in Oral Lichenoid Diseases. Dermatopathology (Basel) 2021; 8:84-88. [PMID: 33915710 PMCID: PMC8167714 DOI: 10.3390/dermatopathology8020013] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2021] [Revised: 03/18/2021] [Accepted: 03/26/2021] [Indexed: 11/16/2022] Open
Abstract
Oral lichen planus (OLP) and oral lichenoid lesions (OLL) can both present with histological dysplasia. Despite the presence of WHO-defined criteria for the evaluation of epithelial dysplasia, its assessment is frequently subjective (inter-observer variability). The lack of reproducibility in the evaluation of dysplasia is even more complex in the presence of a lichenoid inflammation. We evaluated dysplasia in 112 oral biopsies with lichenoid inflammation in order to study the inter-observer and the intra-observer variability.
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Affiliation(s)
- Marwa Zohdy
- Department of Dermatology, Inselspital Bern University Hospital, University of Bern, CH-3010 Bern, Switzerland; (M.Z.); (S.C.); (H.N.); (R.B.); (H.B.)
- Department of Dermatology, Andrology and STDs, Mansoura University Hospitals, Mansoura University, Mansoura 35516, Egypt
| | - Simone Cazzaniga
- Department of Dermatology, Inselspital Bern University Hospital, University of Bern, CH-3010 Bern, Switzerland; (M.Z.); (S.C.); (H.N.); (R.B.); (H.B.)
- Centro Studi GISED, 24121 Bergamo, Italy
| | - Helga Nievergelt
- Department of Dermatology, Inselspital Bern University Hospital, University of Bern, CH-3010 Bern, Switzerland; (M.Z.); (S.C.); (H.N.); (R.B.); (H.B.)
| | - Roland Blum
- Department of Dermatology, Inselspital Bern University Hospital, University of Bern, CH-3010 Bern, Switzerland; (M.Z.); (S.C.); (H.N.); (R.B.); (H.B.)
| | - Valérie G. A. Suter
- Department of Oral Surgery and Stomatology, School of Dental Medicine, University of Bern, CH-3010 Bern, Switzerland;
| | - Laurence Feldmeyer
- Department of Dermatology, Inselspital Bern University Hospital, University of Bern, CH-3010 Bern, Switzerland; (M.Z.); (S.C.); (H.N.); (R.B.); (H.B.)
- Correspondence:
| | - Helmut Beltraminelli
- Department of Dermatology, Inselspital Bern University Hospital, University of Bern, CH-3010 Bern, Switzerland; (M.Z.); (S.C.); (H.N.); (R.B.); (H.B.)
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Dave A, Shariff J, Philipone E. Association between oral lichen planus and systemic conditions and medications: Case-control study. Oral Dis 2021; 27:515-524. [PMID: 32750751 DOI: 10.1111/odi.13572] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2020] [Revised: 07/10/2020] [Accepted: 07/15/2020] [Indexed: 12/29/2022]
Abstract
OBJECTIVE The aim of this study is to investigate the association between oral lichen planus (OLP) and a variety of systemic conditions, medication, and supplement usage. MATERIALS AND METHOD A total of 156 patients diagnosed with OLP and 156 controls at Columbia University Irving Medical Center from 2000 to 2013 were selected as part of the matched (1:1) case-control study. Demographics, systemic conditions, prescription medications and supplements were extracted from the patients' medical records. A univariable conditional logistic regression (CLR) analysis was performed to calculate unadjusted odds ratio, to identify significant variables associated with OLP (p < .10). Significant variables were further tested using multivariable CLR analysis with both forward and backward selection to calculate adjusted odds ratio (aOR) and further distinguish variables associated with OLP (p < .05). RESULTS This analysis identified six significant variables: thyroid disorder (aOR:5.1,95%CI:2.3-11.2), any form of cancer (aOR:3.4,95%CI:1.4-8.4), type 2 diabetes (aOR:2.8,95%CI:1.2-6.3), hyperlipidemia (aOR:2.3,95%CI:1.3-4.1), oral sedative usage (aOR:6.3,95%CI:1.8-22.5), and vitamin D supplementation (aOR:2.7,95%Cl:1.3-6.0). CONCLUSION Thyroid disorders, cancer, type 2 diabetes, hyperlipidemia, sedatives, and vitamin D supplementation were found to be associated with OLP. Additional investigation is required to explore these associations, which could shed light on the potential mechanism of OLP and reinforce the idea that oral lesions could be predicative of previously undetected systemic conditions.
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Affiliation(s)
- Anjali Dave
- College of Dental Medicine, Columbia University, New York, NY, USA
| | - Jaffer Shariff
- Division of Periodontics, Section of Oral, Diagnostic and Rehabilitation Sciences, College of Dental Medicine, Columbia University, New York, NY, USA
| | - Elizabeth Philipone
- Division of Oral and Maxillofacial Pathology, Columbia University Irving Medical Center and College of Dental Medicine, New York, NY, USA
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Aravind T, Janardhanan M, Suresh R, Savithri V, Mohan M. Histopathologic evaluation of oral lichen planus and oral lichenoid reaction: A comparative analysis based on basement membrane thickness and the distribution of mast cells. J Oral Maxillofac Pathol 2021; 25:549-550. [PMID: 35281137 PMCID: PMC8859588 DOI: 10.4103/jomfp.jomfp_220_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2020] [Revised: 08/13/2020] [Accepted: 05/18/2021] [Indexed: 11/23/2022] Open
Abstract
Background: Lichen planus is a chronic mucocutaneous disease of unknown etiology with well-established clinical and microscopic features. Oral lichenoid reactions are a family of lesions triggered by contact with specific agents such as metallic restorative materials, resins and drugs. Oral lichenoid reactions share clinical and histological features of oral lichen planus (OLP) but has varied management options. Hence, the discrimination between these two lesions is a major challenge for clinicians as well as pathologists. Aim: Histopathologic categorization of OLP and oral lichenoid reaction by comparing the thickness of basement membrane and the distribution of mast cells using special stains. Materials and Methods: The test group consists of formalin-fixed paraffin-embedded blocks of OLP (n = 15), and oral lichenoid reactions (n = 15) obtained from the archives of the Department of Oral Pathology, Amrita School of Dentistry. Three serial sections of 4 μm thickness were cut from each block. The sections were stained with H & E, periodic acid-Schiff (PAS) and toluidine blue, respectively. Results: A significant increase in the maximum basement membrane thickness (BMT) was noticed in OLP when compared to oral lichenoid reaction. A definite increase was also noticed in the number of mast cells in OLP and oral lichenoid reaction when compared to normal oral mucosa. There was a statistically significant increase in the number of degranulated mast cells in the deeper connective tissue in oral lichenoid reaction when compared to OLP. Conclusion: OLP and oral lichenoid reactions are two different entities showing similar clinical and microscopic presentation. The histochemical analysis of basement membrane and mast cells in these lesions might provide a more authentic method for differentiating these two lesions and might be of utmost value in deciding the treatment options.
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Rotaru D, Chisnoiu R, Picos AM, Picos A, Chisnoiu A. Treatment trends in oral lichen planus and oral lichenoid lesions (Review). Exp Ther Med 2020; 20:198. [PMID: 33123228 PMCID: PMC7588785 DOI: 10.3892/etm.2020.9328] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2020] [Accepted: 08/13/2020] [Indexed: 12/15/2022] Open
Abstract
Oral lichen planus (OLP) is a chronic inflammatory disease, associated with altered cell-mediated immunological function. It has long-term evolution, repeated exacerbations, sometimes painful and resistant to treatment, even all of these, OLP significantly affects patient's life quality. Not least, OLP is accompanied by an increased risk of malignant transformation. A wide spectrum of therapeutic options is available, but none are curative. In this review, 58 structured studies on the clinical symptomatology and treatment strategy of OLP were analyzed. The literature research was performed according to the criteria of the PRISMA system. This study summarizes current knowledge regarding management of OLP and oral lichenoid lesions, discusses the challenges of choosing an adequate treatment and, in attempt to improve the quality of patient life, trying to describe a therapeutic algorithm that takes into consideration the clinical features of the disease. Current OLP therapy aims at eliminating all mucosal-related lesions, reduce symptomatology and decrease the risk of oral cancer and include corticosteroids, immunomodulatory agents, retinoids, ultraviolet irradiation and/or laser therapy.
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Affiliation(s)
- Doina Rotaru
- Department of Odontology, Endodontics and Oral Pathology, ‘Iuliu Hatieganu’ University of Medicine and Pharmacy, 400001 Cluj-Napoca, Romania
| | - Radu Chisnoiu
- Department of Odontology, Endodontics and Oral Pathology, ‘Iuliu Hatieganu’ University of Medicine and Pharmacy, 400001 Cluj-Napoca, Romania
| | - Alina Monica Picos
- Department of Prosthodontics, ‘Iuliu Hatieganu’ University of Medicine and Pharmacy, 400006 Cluj-Napoca, Romania
| | - Andrei Picos
- Department of Prevention in Dental Medicine, ‘Iuliu Hatieganu’ University of Medicine and Pharmacy, 400089 Cluj-Napoca, Romania
| | - Andrea Chisnoiu
- Department of Prosthodontics, ‘Iuliu Hatieganu’ University of Medicine and Pharmacy, 400006 Cluj-Napoca, Romania
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21
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A meta-analysis on association of IFN-γ rs2430561 polymorphism and the risk of oral lichen planus. GENE REPORTS 2020. [DOI: 10.1016/j.genrep.2020.100745] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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22
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Rotaru DI, Sofineti D, Bolboacă SD, Bulboacă AE. Diagnostic Criteria of Oral Lichen Planus: A Narrative Review. Acta Clin Croat 2020; 59:513-522. [PMID: 34177062 PMCID: PMC8212651 DOI: 10.20471/acc.2020.59.03.16] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2018] [Accepted: 11/27/2018] [Indexed: 01/29/2023] Open
Abstract
Oral lichen planus (OLP) is a disease with unclear etiology or pathogenesis, categorized by the World Health Organization as oral lichenoid lesions (OLL; interface mucositis or lichenoid mucositis) into a group of potentially malignant disorders. The diagnosis of OLP is challenging because the clinical and histopathologic features are frequently seen in OLP, OLL and/or other mucosal diseases with lichenoid characteristics. Furthermore, OLP has a dynamic nature. Finally, an early and precise diagnosis can play a decisive role, allowing timely treatment and thus improving the patient quality of life. This article summarizes the state-of-the-art regarding OLP and OLL and discusses the challenges faced on making an accurate diagnosis, aiming to provide a practical guideline for the postgraduates and oral physicians in reaching the diagnosis of these lesions.
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Abstract
Adverse reactions to medications are common and may have a variety of clinical presentations in the oral cavity. Targeted therapies and new biologic agents have revolutionized the treatment of cancers, autoimmune diseases, and inflammatory and rheumatologic diseases but have also been associated with adverse events in the oral cavity. This review describes the most common clinical presentations of oral mucosal reactions to medications, namely hyposalivation, lichenoid reactions, ulcers, bullous disorders, pigmentation, fibrovascular hyperplasia, reactive keratosis, dysesthesia, osteonecrosis, infection, angioedema, and malignancy.
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Affiliation(s)
- Anna Yuan
- Division of Oral Medicine, Tufts University School of Dental Medicine, 1 Kneeland Street, Boston, MA 02111, USA.
| | - Sook-Bin Woo
- Division of Oral Medicine and Dentistry, Brigham and Women's Hospital, 75 Francis Street, Boston, MA 02115, USA; Department of Oral Medicine, Infection and Immunity, Harvard School of Dental Medicine, 188 Longwood Avenue, Boston, MA 02115, USA
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24
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Agha-Hosseini F, Moosavi MS, Mirzaii-Dizgah I, Samami M. Muscarinic cholinergic receptors in minor salivary gland tissues of patients with oral lichen planus: A case-control study. J Oral Pathol Med 2020; 49:816-821. [PMID: 32744338 DOI: 10.1111/jop.13094] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2020] [Revised: 06/21/2020] [Accepted: 07/02/2020] [Indexed: 12/19/2022]
Abstract
BACKGROUND Oral lichen planus (OLP) is a common, chronic immunological and inflammatory condition. Many of the OLP patients complain of xerostomia. The M3 muscarinic cholinergic receptors (MR3) are the main receptors in the salivary glands responsible for water secretion into the saliva. This study aimed to assess the level of M3 muscarinic cholinergic receptors in minor salivary glands of OLP patients. METHODS This case-control cross-sectional study evaluated 40 OLP patients and 22 controls. All participants completed two questionnaires (xerostomia and xerostomia inventory). Stimulated and unstimulated saliva samples were collected. The saliva flow rate was calculated by dividing the saliva volume (in milliliters) by time (in minutes). Six minor salivary glands were also surgically removed from the lower lip of patients and controls, and weighed using a digital scale with 10-4 g accuracy. They were then frozen at -80°C, and the level of M3 receptors of the glands was determined using the ELISA kit. RESULTS The unstimulated and stimulated saliva flow rate was significantly lower in OLP patients. The xerostomia inventory score was significantly higher in the OLP group. The level of M3 muscarinic receptors in minor salivary glands of OLP patients was significantly higher than that in controls. CONCLUSIONS It may be concluded that the reduction in saliva flow significantly increases the number of M3 receptors in an attempt to compensate for this shortage and prevent xerostomia (compensatory upregulation).
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Affiliation(s)
- Farzaneh Agha-Hosseini
- Dental Research Center, Dentistry Research Institute, Tehran University of Medical Sciences and Department of Oral and Maxillofacial Medicine, Faculty of Dentistry, Tehran University of Medical Sciences, Tehran, Iran.,The Academy of Medical Sciences Tehran, Iran, Fellowship of Research Biology, Tehran, Iran
| | - Mahdieh-Sadat Moosavi
- Dental Research Center, Dentistry Research Institute, Tehran University of Medical Sciences and Department of Oral and Maxillofacial Medicine, Faculty of Dentistry, Tehran University of Medical Sciences, Tehran, Iran
| | - Iraj Mirzaii-Dizgah
- Department of Physiology, Faculty of Medicine, AJA University of Medical Sciences, Tehran, Iran
| | - Mohammad Samami
- Dental Sciences Research Center, Department of Oral and Maxillofacial Medicine, School of Dentistry, Guilan University of Medical Sciences, Rasht, Iran
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Guan G, Mei L, Polonowita A, Hussaini H, Seo B, Rich AM. Malignant transformation in oral lichen planus and lichenoid lesions: a 14-year longitudinal retrospective cohort study of 829 patients in New Zealand. Oral Surg Oral Med Oral Pathol Oral Radiol 2020; 130:411-418. [PMID: 32771414 DOI: 10.1016/j.oooo.2020.07.002] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2020] [Revised: 06/12/2020] [Accepted: 07/04/2020] [Indexed: 12/31/2022]
Abstract
OBJECTIVE The aim of this study was to identify the rate of malignant transformation in a longitudinal cohort of patients with oral lichen planus and oral lichenoid lesion (OLP/OLL) and to assess the associations between clinicopathologic aspects and malignant transformation. STUDY DESIGN Data were taken from the records of 829 patients histologically diagnosed with OLP/OLL in the years 2005 to 2018. RESULTS Of the study patients, 548 (66.1%) were females and 281 (33.9%) were males. The average age at diagnosis was 57.3 years. The hyperplastic type was the most frequent (58.5%). Most patients had multiple sites of involvement, with the buccal mucosa being the most frequent site of biopsy. Oral epithelial dysplasia developed in 5 (0.6%) patients with a previous histologic diagnosis of OLP/OLL and developed oral squamous cell carcinoma (OSCC) in 23 patients (2.8%) during the follow-up period. The atrophic/ulcerative forms are 25.8 times more likely to progress to OSCC compared with the hyperplastic types (hazard ratio [HR] 25.8; P < .05). The HR increases by 5% with every year of age (HR 1.05; 95% confidence interval; P < .05). CONCLUSIONS In our study, oral epithelial dysplasia developed in less than 1% of patients with OLP/OLL, and OSCC in 2.8%during the follow-up period. The atrophic/ulcerative forms are 25.8 times more likely to progress to OSCC compared with the hyperplastic types. The HR increases by 5% with every year of age.
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Affiliation(s)
- Guangzhao Guan
- Department of Oral Diagnostic and Surgical Sciences, Faculty of Dentistry, University of Otago, Dunedin, New Zealand.
| | - Li Mei
- Department of Oral Sciences, Faculty of Dentistry, University of Otago, Dunedin, New Zealand
| | - Ajith Polonowita
- Department of Oral Diagnostic and Surgical Sciences, Faculty of Dentistry, University of Otago, Dunedin, New Zealand
| | - Haizal Hussaini
- Department of Oral Diagnostic and Surgical Sciences, Faculty of Dentistry, University of Otago, Dunedin, New Zealand
| | - Benedict Seo
- Department of Oral Diagnostic and Surgical Sciences, Faculty of Dentistry, University of Otago, Dunedin, New Zealand
| | - Alison Mary Rich
- Department of Oral Diagnostic and Surgical Sciences, Faculty of Dentistry, University of Otago, Dunedin, New Zealand
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Hatipoglu O, Temur KT, Pertek Hatipoglu F. Effectivity of patch test in determining the relationship between oral lichenoid lesions and dental amalgam: A meta-analysis. JOURNAL OF ORAL AND MAXILLOFACIAL SURGERY, MEDICINE, AND PATHOLOGY 2020; 32:226-232. [DOI: 10.1016/j.ajoms.2019.11.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/04/2023]
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Tolentino Júnior DS, de Oliveira CM, de Assis EM. Population-based Study of 24 Autoimmune Diseases Carried Out in a Brazilian Microregion. J Epidemiol Glob Health 2019; 9:243-251. [PMID: 31854165 PMCID: PMC7310795 DOI: 10.2991/jegh.k.190920.001] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2019] [Accepted: 09/18/2019] [Indexed: 01/22/2023] Open
Abstract
In Brazil, epidemiological data on autoimmune diseases are scarce due to the lack of a specific policy of attention to this group of diseases. This study aimed to estimate the general and relative prevalence of the diseases presented, as well as to know the sociodemographic profile of the identified cases. This cross-sectional study was conducted with an epidemiological survey of patients with confirmed diagnosis of autoimmune diseases from primary health care in the Aguas Formosas microregion, Minas Gerais, Brazil. We have included all new and old cases found of individuals of both sexes and all ages, including those who died and emigrated during this period. A total of 407 carriers and 24 different autoimmune diseases were identified. The prevalence of autoimmune diseases in this region was 673.6 cases per 100,000 inhabitants [95% confidence interval (CI): 609.8-742.4]. Highest prevalence was identified for Hashimoto's thyroiditis 140.6 cases per 100,000 (95% CI: 112.4-173.9), followed by vitiligo 132.4 cases per 100,000 (95% CI: 105.0-164.8), and rheumatoid arthritis 105.9 cases per 100,000 (95% CI: 81.6-135.3). The sex ratio was higher in females (69%), the most affected age group was over 60 years (30.5%), with greater predominance in the urban area (81.3%). Our data showed the general and relative prevalence of the identified diseases, allowing to know the sociodemographic profile of the identified cases and the epidemiological trend of these morbidities in a low-income Brazilian region.
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Affiliation(s)
| | - Carla Meireles de Oliveira
- Department of Epidemiological Surveillance, Municipal Health Secretariat, Crisólita, Minas Gerais, Brazil
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Dawoud BES, Mohamed SH, Wareing J. Lichen Planus − the role of the general dental practitioner. ACTA ACUST UNITED AC 2019. [DOI: 10.12968/denu.2019.46.6.573] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Oral lichen planus is frequently encountered in primary and secondary dental care. The soft tissues of the mouth should always be examined carefully at check-ups and any abnormality be palpated to detect change in consistency (induration) along with any changes in colour or general appearance. Such changes should prompt a referral for specialist review.CPD/Clinical Relevance: The general dental practitioner (GDP) can play a simple yet effective role in the management of lichen planus by removing obvious traumatic stimuli, improving oral hygiene and advising on simple topical treatment.
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Affiliation(s)
- Basim ES Dawoud
- Academic Foundation Doctor, Leeds General Infirmary/University of Leeds Medical School
| | - Samira H Mohamed
- General Dental Practitioner, MyDentist 2, Manston Lane, Crossgates, Leeds, LS15 8HZ
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Ozbagcivan O, Akarsu S, Semiz F, Fetil E. Comparison of serum lipid parameters between patients with classic cutaneous lichen planus and oral lichen planus. Clin Oral Investig 2019; 24:719-725. [PMID: 31129877 DOI: 10.1007/s00784-019-02961-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2018] [Accepted: 05/09/2019] [Indexed: 10/26/2022]
Abstract
OBJECTIVES Previous studies have shown that patients with lichen planus (LP) have an increased occurrence of inflammation-related dyslipidemia. Although classic cutaneous LP (CCLP) and oral LP (OLP) are basically known as the different subtypes of the same disease sharing the common histopathological features, they actually have significant differences both in the clinical behavior and in the molecular inflammatory pathogenesis. We aimed to compare the lipid profile of patients with CCLP and OLP. MATERIALS AND METHODS This study included 120 patients, 30 with isolated CCLP, 30 with isolated OLP, 30 with CCLP + OLP, and 30 controls consecutively admitted to the outpatient clinics of Dermatology Department of Dokuz Eylul University Hospital, Izmir, Turkey. RESULTS Triglycerides (TG), total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C) values, TC/high-density lipoprotein cholesterol (HDL-C), and LDL-C/HDL-C atherogenic indexes were significantly higher, and HDL-C values were significantly lower in all LP subtypes compared with the controls. Among LP subtypes, although the differences were not statistically significant, TG, TC, and LDL-C values were markedly higher in OLP and OLP + CCLP patients compared with CCLP patients. OLP and CCLP + OLP patients also showed significantly higher TC/HDL-C and LDL-C/HDL-C atherogenic indexes compared with CCLP patients. CONCLUSIONS Patients with OLP have a more impaired lipid metabolism and significantly higher atherogenic indexes compared with patients with CCLP. The differences in the molecular inflammatory pathways between OLP and CCLP and the longer disease duration of OLP leading to long-lasting inflammation may elucidate this distinction. CLINICAL RELEVANCE We recommend to pay close attention to the early recognition of coexisting atherogenic dyslipidemia and to apply the early protective measures against the development of cardiovascular disease in OLP patients.
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Affiliation(s)
- Ozlem Ozbagcivan
- Department of Dermatology Faculty of Medicine, Dokuz Eylul University, Inciraltı, 35340, Izmir, Turkey.
| | - Sevgi Akarsu
- Department of Dermatology Faculty of Medicine, Dokuz Eylul University, Inciraltı, 35340, Izmir, Turkey
| | - Fatma Semiz
- Department of Dermatology Faculty of Medicine, Dokuz Eylul University, Inciraltı, 35340, Izmir, Turkey
| | - Emel Fetil
- Department of Dermatology Faculty of Medicine, Dokuz Eylul University, Inciraltı, 35340, Izmir, Turkey
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Sulewska M, Duraj E, Sobaniec S, Graczyk A, Milewski R, Wróblewska M, Pietruski J, Pietruska M. A clinical evaluation of efficacy of photodynamic therapy in treatment of reticular oral lichen planus: A case series. Photodiagnosis Photodyn Ther 2019; 25:50-57. [PMID: 30447415 DOI: 10.1016/j.pdpdt.2018.11.009] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2018] [Revised: 09/24/2018] [Accepted: 11/13/2018] [Indexed: 12/24/2022]
Abstract
Background The aim of the study was to clinically evaluate the efficacy of photodynamic therapy in treatment of reticular oral lichen planus (OLP). Methods Fifty patients aged 26-84, with 124 OLP lesions in total, underwent photodynamic therapy (PDT) mediated with topically applied 5% 5-aminolevulinic acid. ALA was activated by a custom-made diode lamp with a high-power LED emitting light at 630 nm and 300 mW delivered through an optical fiber probe. A light exposure dose was 150 J/cm2. The therapy comprised of 10 weekly illumination sessions. The lesions' response was macroscopically measured in millimeters with a periodontal probe and clinically evaluated at each session, then on completion of the series and throughout the 12-month follow-up. Results The baseline mean size of lesions was 3.99 cm2±3.73. The lesions on the buccal mucosa and lips (lining mucosa) were larger than those on the gingiva and tongue (masticatory mucosa) - 4.58 cm2±4.01 and 2.93 cm2±2.91 respectively. On completion of the therapy 109 sites improved, including 46 in complete remission. The mean reduction in size was 62.91% (p = 0.000000). 12-month after therapy mean reduction of the lesions was 78.7% (p = 0.000000), specifically 79.48% (p = 0.000000) within the lining mucosa and 76.11% on the masticatory mucosa. Conclusions The results proved that ALA-mediated photodynamic therapy with a 630 nm light was effective and as such it can be used as an optional treatment for symptomatic OLP.
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Affiliation(s)
- Magdalena Sulewska
- Department of Periodontal and Oral Mucosa Diseases, Medical University of Białystok, ul. Waszyngtona 13, 15-269, Białystok, Poland.
| | - Ewa Duraj
- Department of Periodontal and Oral Mucosa Diseases, Medical University of Białystok, ul. Waszyngtona 13, 15-269, Białystok, Poland
| | - Stefan Sobaniec
- Department of Periodontal and Oral Mucosa Diseases, Medical University of Białystok, ul. Waszyngtona 13, 15-269, Białystok, Poland
| | - Alfreda Graczyk
- Laboratory of Biochemistry and Spectroscopy, Institute of Optoelectronics, Military Academy of Technology, ul. gen. Sylwestra Kaliskiego 2, 00-908, Warszawa, Poland
| | - Robert Milewski
- Department of Statistics and Medical Informatics, Medical University of Białystok, ul. Szpitalna 37, 15-295, Białystok, Poland
| | - Marta Wróblewska
- Dental Practice, ul. Kardynała Wyszyńskiego 16, 18-400, Łomża, Poland
| | - Jan Pietruski
- Dental Practice, ul. Waszyngtona 1/34, 15-269, Białystok, Poland
| | - Małgorzata Pietruska
- Department of Periodontal and Oral Mucosa Diseases, Medical University of Białystok, ul. Waszyngtona 13, 15-269, Białystok, Poland; Dental Practice, ul. Waszyngtona 1/34, 15-269, Białystok, Poland
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Healing of Oral Lichenoid Lesions following Replacement of Dental Amalgam Restorations with Feldspathic Ceramic Inlay-Onlay Restorations: Clinical Results of a Follow-Up Period Varied from Three Months up to Five Years. BIOMED RESEARCH INTERNATIONAL 2018; 2018:7918781. [PMID: 30627572 PMCID: PMC6304520 DOI: 10.1155/2018/7918781] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/18/2018] [Accepted: 11/19/2018] [Indexed: 11/17/2022]
Abstract
Objective Previous studies have shown the effect of amalgam removal on the healing of oral lichenoid lesions (OLLs); however, no specific replacement materials have been suggested. The present series evaluated long-term results following the complete replacement of amalgam restorations with feldspathic ceramic inlay-onlay restorations for a group of patients with OLLs whose lesions were suspected to be related to amalgam restorations. Materials and Methods Twenty-four patients who had OLLs suspected to be related to their amalgam restorations were initially recruited. The patients underwent patch tests for a series of dental materials, in addition to clinical and histopathological examination. Sixteen (67%) of the 24 patients had their amalgam replaced with feldspathic ceramic inlay-onlay restorations and were examined within a follow-up period of 3 months to 5 years. Results After 3 months of clinical follow-up, complete healing (63%) was noted in all patients with OLLs whose lesions were in only close contact with their amalgam restorations. Healing was significantly related to the combination of lesions with close contact with the amalgam restoration and a diagnosis of OLL (x2 test, P=0.02). Conclusion Feldspathic ceramic can be safely used as a replacement material for patients with OLLs to diminish adverse reactions to amalgam restorations.
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Gopal P, Gibson JA, Lisovsky M, Nalbantoglu ILK. Unique causes of esophageal inflammation: a histopathologic perspective. Ann N Y Acad Sci 2018; 1434:219-226. [PMID: 29766506 DOI: 10.1111/nyas.13732] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2018] [Revised: 03/16/2018] [Accepted: 03/20/2018] [Indexed: 12/18/2022]
Abstract
Gastroenterologists frequently perform endoscopic esophageal mucosal biopsies for pathologic diagnosis in patients experiencing symptoms of esophagitis. The more common causes of esophagitis diagnosed on esophageal mucosal biopsy include reflux esophagitis, eosinophilic esophagitis, and infectious esophagitis caused by Candida albicans, herpes simplex virus, and/or cytomegalovirus. However, there are several causes of esophagitis seen less frequently by pathologists that are very important to recognize. We discuss unique types of esophageal inflammation, including acute bacterial esophagitis, esophageal manifestations of dermatologic diseases, medication-induced esophageal injury, and sloughing esophagitis; and we review their clinical and histopathologic features.
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Affiliation(s)
- Purva Gopal
- Department of Pathology, University of Texas Southwestern Medical Center, Dallas, Texas
| | - Joanna A Gibson
- Department of Pathology, Yale School of Medicine, New Haven, Connecticut
| | - Mikhail Lisovsky
- Department of Pathology and Laboratory Medicine, Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire
| | - ILKe Nalbantoglu
- Department of Pathology, Yale School of Medicine, New Haven, Connecticut
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Katsoulas N, Tosios K, Sklavounou-Andrikopoulou A. Lichenoid lesions of the upper lip: A retrospective study of 24 cases. Med Oral Patol Oral Cir Bucal 2018; 23:e302-e307. [PMID: 29680851 PMCID: PMC5945236 DOI: 10.4317/medoral.22303] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2017] [Accepted: 03/28/2018] [Indexed: 11/26/2022] Open
Abstract
Background Lichenoid lesions of the upper labial mucosa, without other oral or extraoral manifestations seem to be rare. The clinicopathologic features of 24 such cases are presented and the pertinent literature is reviewed. Material and Methods 24 Caucasian patients that clinically presented lichenoid features on the upper labial mucosa, with or without lichenoid lesions on the adjacent gingiva, were included in the study. Clinical features were extracted from the patients’ records, while dental plaque/calculus accumulation and composite resin restorations of the adjacent teeth were recorded. Four cases where an incisional biopsy was performed were further evaluated. Results There were 8 males and 16 females, with a mean age of 62.7 years. 64.2% were under hypertensive therapy. In 13 cases gingival involvement was noticed, 16 cases exhibited calculus deposition, while 6 cases presented with composite resin fillings of the adjacent teeth. In 4 cases an incisional biopsy was performed showing features of lichenoid reaction. In 37.5% significant improvement was observed after topical treatment with corticosteroids and antimicrobial agents. Conclusions Lichenoid lesions of the upper lip may represent a distinct variety of oral lichenoid lesions, but as the number of cases reported so far is too small for definite conclusions on pathogenesis and management to be made, a long-term follow-up is mandatory. Key words:Lichenoid lesions, upper lip, oral lichen planus, lichenoid reactions.
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Affiliation(s)
- N Katsoulas
- Department of Oral Medicine and Pathology, School of Dentistry, National and Kapodistrian University of Athens, Athens, Greece 2, Thivon Str,
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34
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Yorulmaz A, Yalcin B, Boyvat A, Ataoglu O, Bozdogan O. Malignant Transformation of Dental Material-induced Oral Lichenoid Contact Reaction: A Case Report Describing Outcomes After Amalgam Removal. ARCHIVES OF CLINICAL AND EXPERIMENTAL MEDICINE 2018. [DOI: 10.25000/acem.369509] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
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Abstract
The International Contact Dermatitis Research Group proposes a classification for the clinical presentation of contact allergy. The classification is based primarily on the mode of clinical presentation. The categories are direct exposure/contact dermatitis, mimicking or exacerbation of preexisting eczema, multifactorial dermatitis including allergic contact dermatitis, by proxy, mimicking angioedema, airborne contact dermatitis, photo-induced contact dermatitis, systemic contact dermatitis, noneczematous contact dermatitis, contact urticaria, protein contact dermatitis, respiratory/mucosal symptoms, oral contact dermatitis, erythroderma/exfoliative dermatitis, minor forms of presentation, and extracutaneous manifestations.
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36
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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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Rusanen P, Marttila E, Uittamo J, Hagström J, Salo T, Rautemaa-Richardson R. TLR1-10, NF-κB and p53 expression is increased in oral lichenoid disease. PLoS One 2017; 12:e0181361. [PMID: 28715461 PMCID: PMC5513542 DOI: 10.1371/journal.pone.0181361] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2017] [Accepted: 06/29/2017] [Indexed: 11/18/2022] Open
Abstract
Toll-like receptors (TLRs) and nuclear factor-κB (NF-κB) in keratinocytes play an important role in dermatological autoimmune diseases. Tumour suppressor protein p53 regulates TLR expression. The aim of this study was to compare the expression of TLR1-TLR10, p53 and NF-κB in patients with oral lichenoid disease (OLD) with healthy mucosa. Oral mucosal biopsies from 24 patients with OLD and 26 healthy controls (HC) were analysed for the expression of TLR1-TLR10, NF-κB and p53 by immunohistochemistry. The expression of all TLRs was increased in OLD epithelia compared to HC samples and the difference was significant in TLR1, TLR3, TLR4, TLR5, TLR6 and TLR7. In the basement membrane zone, the immunoreactivity of TLR5 was significantly more intense in OLD compared to HC. In the intermediate layer, the immunoreactivity of NF-κB was significantly stronger in OLD, whereas the staining for p53 was more intense in all layers of OLD compared to HC samples. In OLD, a positive correlation between TLR2 and NF-κB in the basal layer and between TLR5, p53 and NF-κB in the intermediate layers was discovered. The expression of TLRs, p53 and NF-κB is increased in OLD, which may play a role in the pathogenesis of this chronic immune-mediated mucosal disease.
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Affiliation(s)
- Peter Rusanen
- Department of Bacteriology and Immunology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
- * E-mail:
| | - Emilia Marttila
- Department of Oral and Maxillofacial Diseases, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Johanna Uittamo
- Department of Oral and Maxillofacial Diseases, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
- Research Unit on Acetaldehyde and Cancer, University of Helsinki, Helsinki, Finland
| | - Jaana Hagström
- Department of Pathology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Tuula Salo
- Department of Oral and Maxillofacial Diseases, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
- Cancer and Translational Medicine Research Unit, University of Oulu, and Medical Research Centre Oulu University Hospital, Oulu, Finland
| | - Riina Rautemaa-Richardson
- Division of Infection, Immunity and Respiratory Medicine, Faculty of Biology, Medicine and Health, University of Manchester; and University Hospital of South Manchester, Manchester, United Kingdom
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Al-Janaby H, El-Sakka H, Masood M, Ashani W Mendis W, M Slack-Smith L, Parsons R, M Frydrych A. Xerostomia and Salivary Gland Hypofunction in Patients with Oral Lichen Planus Before and After Treatment with Topical Corticosteroids. Open Dent J 2017; 11:155-163. [PMID: 28567139 PMCID: PMC5418946 DOI: 10.2174/1874210601711010155] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2016] [Revised: 02/16/2017] [Accepted: 02/28/2017] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND Oral lichen planus and mouth dryness are common pathoses, yet not entirely understood. These two conditions may be associated, with a few studies investigating the relationship between mouth dryness and oral lichen planus providing conflicting results. None of the studies have explored the specific impact of disease treatment on mouth dryness. OBJECTIVE The purpose of this observational before and after comparison study was to examine the effect of treatment of oral lichen planus with topical corticosteroids on mouth dryness. METHODS Nineteen subjects with oral lichen planus were evaluated for the severity of xerostomia using a xerostomia inventory and a visual analogue scale. Stimulated and unstimulated whole salivary flow rates, unstimulated salivary pH and buffering capacity were also measured. All subjects were evaluated before and after treatment with topical corticosteroids. RESULTS All subjects reported xerostomia before treatment with topical corticosteroids, with 79% reporting a significant improvement (P = 0.03) after treatment. Topical corticosteroid treatment was not associated with statistically significant differences in stimulated or unstimulated salivary flow rates, unstimulated salivary pH or buffering capacity. CONCLUSION The results of this study suggest that treatment of oral lichen planus with topical corticosteroids may decrease the severity of dry mouth symptoms.
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Affiliation(s)
- Hala Al-Janaby
- School of Dentistry, The University of Western Australia, Perth, Western Australia
| | - Haytham El-Sakka
- School of Dentistry, The University of Western Australia, Perth, Western Australia
| | - Manal Masood
- School of Dentistry, The University of Western Australia, Perth, Western Australia
| | | | - Linda M Slack-Smith
- School of Dentistry, The University of Western Australia, Perth, Western Australia
| | - Richard Parsons
- School of Dentistry, The University of Western Australia, Perth, Western Australia
| | - Agnieszka M Frydrych
- School of Dentistry, The University of Western Australia, Perth, Western Australia
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A clinical evaluation of the efficacy of photodynamic therapy in the treatment of erosive oral lichen planus: A case series. Photodiagnosis Photodyn Ther 2017; 18:12-19. [DOI: 10.1016/j.pdpdt.2017.01.178] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2016] [Revised: 12/28/2016] [Accepted: 01/18/2017] [Indexed: 01/15/2023]
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He Y, Gong D, Shi C, Shao F, Shi J, Fei J. Dysbiosis of oral buccal mucosa microbiota in patients with oral lichen planus. Oral Dis 2017; 23:674-682. [PMID: 28199766 DOI: 10.1111/odi.12657] [Citation(s) in RCA: 43] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2016] [Revised: 11/15/2016] [Accepted: 01/25/2017] [Indexed: 12/20/2022]
Affiliation(s)
- Y He
- Department of Oral Medicine, School & Hospital of Stomatology, Tongji University; Shanghai Engineering Research Center of Tooth Restoration and Regeneration; Shanghai China
| | - D Gong
- Department of Oral Medicine, School & Hospital of Stomatology, Tongji University; Shanghai Engineering Research Center of Tooth Restoration and Regeneration; Shanghai China
| | - C Shi
- Department of Oral Medicine, School & Hospital of Stomatology, Tongji University; Shanghai Engineering Research Center of Tooth Restoration and Regeneration; Shanghai China
| | - F Shao
- Department of Oral Medicine, School & Hospital of Stomatology, Tongji University; Shanghai Engineering Research Center of Tooth Restoration and Regeneration; Shanghai China
| | - J Shi
- School of Life Science and Technology; Tongji University; Shanghai China
| | - J Fei
- School of Life Science and Technology; Tongji University; Shanghai China
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Shan D, Long H, Lai W. TRPA1 may contribute to the exacerbation of oral lichen planus through Koebner phenomenon. Oral Dis 2017; 23:809-810. [PMID: 28067971 DOI: 10.1111/odi.12636] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Affiliation(s)
- D Shan
- Department of Orthodontics, State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - H Long
- Department of Orthodontics, State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - W Lai
- Department of Orthodontics, 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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Ferreira SJ, Machado MÂN, de Lima AAS, Johann ACBR, Grégio AMT, Azevedo-Alanis LR. Identification of AgNORs and cytopathological changes in oral lichen planus lesions. Acta Histochem 2017; 119:32-38. [PMID: 27916273 DOI: 10.1016/j.acthis.2016.11.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2016] [Revised: 09/17/2016] [Accepted: 11/10/2016] [Indexed: 11/17/2022]
Abstract
OBJECTIVE To evaluate cytopathological changes in epithelial cells of the oral mucosa of patients with oral lichen planus (OLP) compared with patients without OLP. SUBJECTS AND METHODS Swabs were collected from the oral mucosa of 20 patients with OLP (case group) and 20 patients without OLP (control group) using liquid-based cytology. After Papanicolaou staining, the smears were characterized based on Papanicolaou classification and degree of maturation. Nuclear area (NA) measurements, cytoplasmic area (CA) measurements, and the NA/CA ratio were determined from 50 epithelial cells per slide. For quantification of argyrophilic nucleolar organizer regions (AgNORs), the smears were stained with silver nitrate, and the number of AgNORs was counted in 100 cells. RESULTS In both groups, there was a predominance of Papanicolaou Class I nucleated cells in the superficial layer. The average values of NA (p>0.05) and CA (p=0.000) were greater in the case group (NA=521.6, CA=22,750.3) compared with the control group (NA=518.9, CA=18,348.0). The NA/CA ratio was 0.025 for the case group and 0.031 for the control group (p=0.004). There was no significant difference between the mean AgNORs values of both groups (p>0.05). CONCLUSION The oral mucosa of patients with OLP exhibited significant cytomorphometric changes. However, there was no evidence of malignancy.
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Affiliation(s)
- Stefânia Jeronimo Ferreira
- Graduate Program in Dentistry, School of Health and Biosciences, Pontifícia Universidade Católica do Paraná, Rua Imaculada Conceição, 1155, Curitiba, Pr 80215-901, Brazil.
| | | | | | - Aline Cristina Batista Rodrigues Johann
- Graduate Program in Dentistry, School of Health and Biosciences, Pontifícia Universidade Católica do Paraná, Rua Imaculada Conceição, 1155, Curitiba, Pr 80215-901, Brazil.
| | - Ana Maria Trindade Grégio
- Graduate Program in Dentistry, School of Health and Biosciences, Pontifícia Universidade Católica do Paraná, Rua Imaculada Conceição, 1155, Curitiba, Pr 80215-901, Brazil.
| | - Luciana Reis Azevedo-Alanis
- Graduate Program in Dentistry, School of Health and Biosciences, Pontifícia Universidade Católica do Paraná, Rua Imaculada Conceição, 1155, Curitiba, Pr 80215-901, Brazil.
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Basheer S, Shameena PM, Sudha S, Varma S, Vidyanath S, Varekar A. Expression of survivin and p53 in oral lichen planus, lichenoid reaction and lichenoid dysplasia: An immunohistochemical study. J Oral Maxillofac Pathol 2017; 21:456-457. [PMID: 29391729 PMCID: PMC5763877 DOI: 10.4103/jomfp.jomfp_39_15] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
Context: The malignant transformation potential of oral lichen planus (OLP) and related lesions is a subject of great controversy. Aim: The aim of this study was to compare the expression of proteins related to apoptosis and tumour suppressor gene processes in OLP, oral lichenoid reaction (OLR) and oral lichenoid dysplasia (OLD). Materials and Methods The immunohistochemical study was carried out to investigate the expressions of survivin and p53 in a total of 30 lesional biopsy specimens - 10 cases each of OLP, OLR and OLD. The expression rates were further compared with 10 control specimens of normal oral mucosa (NORM). Results: Immunoreactivity for p53 was seen in 7 cases (70%) of OLD, 4 cases (40%) of OLP and 2 cases (20%) of OLR and none of NORM. We obtained a significant difference (P = 0.01) in mean p53 expression between the different entities. The positive staining rate of survivin was found to be significantly different between OLD (50%), OLP (10%), OLR (0%), and normal mucosa (0%) (P = 0.004). There was a positive correlation between p53 and survivin expression in OLP and OLD using Pearson's correlation coefficient. Conclusion: Lichenoid dysplasia has shown p53 and survivin expression in the range of not OLP, but leukoplakia. On the other hand, OLR seems to be an innocuous lesion. The study results with OLP are inconclusive but points toward a small but important malignant potential in OLP. This kind of comparative study highlights the importance of biopsying OLP and related lesions for proper diagnosis and appropriate management.
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Affiliation(s)
| | - P M Shameena
- Department of Oral and Maxillofacial Pathology, Government Dental College, Thrissur, Kerala, India
| | - S Sudha
- Department of Oral and Maxillofacial Pathology, Government Dental College, Kozhikode, Kerala, India
| | - Sujatha Varma
- Department of Oral and Maxillofacial Pathology, Government Dental College, Kozhikode, Kerala, India
| | - S Vidyanath
- Century International Institute of Dental Science And Research Centre, Kasargod, Kerala, India
| | - Aniruddha Varekar
- Bharati Vidyapeeth Deemed University Dental College and Hospital, Sangli, Maharashtra, India
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45
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Oral lichenoid lesions: distinguishing the benign from the deadly. Mod Pathol 2017; 30:S54-S67. [PMID: 28060366 DOI: 10.1038/modpathol.2016.121] [Citation(s) in RCA: 56] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2016] [Revised: 05/31/2016] [Accepted: 06/02/2016] [Indexed: 12/25/2022]
Abstract
Oral lichen planus is a chronic inflammatory disease of unknown etiology or pathogenesis with varied disease severity that waxes and wanes over a long period of time. Although a common oral mucosal disease, accurate diagnosis is often challenging due to the overlapping clinical and histopathological features of oral lichen planus and other mucosal diseases. Other immune-mediated mucocutaneous diseases can exhibit lichenoid features including mucous membrane pemphigoid, chronic graft-versus-host disease, and discoid lupus erythematosus. Reactive changes to dental materials or to systemic medications can mimic oral lichen planus both clinically and histologically. In these situations the clinical presentation can be useful, as oral lichen planus presents as a multifocal process and is usually symmetrical and bilateral. Dysplasia of the oral cavity can exhibit a lichenoid histology, which may mask the potentially premalignant features. Proliferative verrucous leukoplakia, an unusual clinical disease, can often mimic oral lichen planus clinically, requiring careful correlation of the clinical and pathologic features.
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Kun J, Perkecz A, Knie L, Sétáló G, Tornóczki T, Pintér E, Bán Á. TRPA1 receptor is upregulated in human oral lichen planus. Oral Dis 2016; 23:189-198. [PMID: 27718297 DOI: 10.1111/odi.12593] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2016] [Revised: 09/14/2016] [Accepted: 10/04/2016] [Indexed: 12/28/2022]
Abstract
OBJECTIVE Oral lichen planus (OLP) is a chronic inflammatory disease of unknown etiology with antigen-specific and non-specific mechanisms. Transient receptor potential ankyrin 1 (TRPA1) is a non-selective cation channel activated by noxious stimuli such as oxidative stress products evoking pain and release of proinflammatory mediators from sensory nerve endings culminating in neurogenic inflammation. Extraneuronal TRPA1s, for example, on immune cells possess yet unknown functions. SUBJECTS AND METHODS We studied the buccal mRNA expression (qPCR) and protein localization (immunohistochemistry) of TRPA1 receptors and key OLP mediator transcripts in oral mucosa samples of healthy volunteers (n = 9), OLP patients (n = 43), and OLP-like hyperkeratotic patients (n = 12). RESULTS We measured 27.7- and 25.5-fold TRPA1 mRNA increase in OLP and OLP-like hyperkeratotic patients compared to healthy controls. TRPA1 transcripts elevated 2.4-fold in hypertensive OLP but not in hyperkeratotic patients compared to counterparts, reduced by 1.6-fold by angiotensin-convertase inhibitor intake. TRPA1 messenger RNA was more coexpressed with transcripts of tumor necrosis factor α than with interferon γ. Keratinocytes, macrophages but not T cells expressed TRPA1. CONCLUSIONS We provided evidence for the extraneuronal presence and upregulation of the proinflammatory TRPA1 receptor in buccal samples of patients with OLP. This may implicate the ion channel in the pathomechanism of OLP.
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Affiliation(s)
- J Kun
- Department of Pharmacology and Pharmacotherapy, University of Pécs Medical School, Pécs, Hungary.,Molecular Pharmacology Group, Szentágothai Research Center, University of Pecs, Pécs, Hungary.,MTA-PTE NAP B Chronic Pain Research Group, University of Pécs, Pécs, Hungary
| | - A Perkecz
- Department of Pharmacology and Pharmacotherapy, University of Pécs Medical School, Pécs, Hungary
| | - L Knie
- Department of Dentistry, Oral and Maxillofacial Surgery, University of Pécs Medical School, Pécs, Hungary
| | - G Sétáló
- Department of Medical Biology, University of Pécs Medical School, Pécs, Hungary
| | - T Tornóczki
- Oral Pathology Unit, Department of Pathology, University of Pécs Medical School, Hungary
| | - E Pintér
- Department of Pharmacology and Pharmacotherapy, University of Pécs Medical School, Pécs, Hungary.,Molecular Pharmacology Group, Szentágothai Research Center, University of Pecs, Pécs, Hungary
| | - Á Bán
- Department of Dentistry, Oral and Maxillofacial Surgery, University of Pécs Medical School, Pécs, Hungary
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47
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Bastos DB, Santos IS, Valente VB, Biel ACO, Felipini RC, Biasoli ER, Miyahara GI, Bernabé DG. Lollipop-induced oral lichenoid reaction in a child. Int J Paediatr Dent 2016; 26:486-489. [PMID: 27258615 DOI: 10.1111/ipd.12240] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
BACKGROUND Oral lichenoid reactions (OLRs) have been rarely reported in pediatric patients. CASE REPORT This article reports an unusual case of a 15-year-old girl who had white plaques in tongue and buccal mucosa oral which initially were diagnosed as oral lichen planus (OLP). At first, the patient and her family denied systemic or local medication use. Biopsy was performed, and histopathological aspects were suggestive of OLP. Despite the attempt of treatment with topical corticoid, the lesions did not recede. Patient's behavior and medical history were again investigated and revealed that she had been using almost daily in her school an artificially colored and flavored lollipop. One week after removing lollipop use behavior, the oral lesions showed complete resolution and OLR diagnosis was defined. CONCLUSION The present case denotes that OLR should be considered in the differential diagnosis of oral white plates in children and artificially colored sweets can be its causal agent.
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Affiliation(s)
- Daniela B Bastos
- Oral Oncology Center, Araçatuba Dental School, UNESP - Univ Estadual Paulista, São Paulo, Brazil.,Department of Pathology and Clinical Propedeutics, Araçatuba Dental School, UNESP - Univ Estadual Paulista, São Paulo, Brazil
| | - Ingrid S Santos
- Oral Oncology Center, Araçatuba Dental School, UNESP - Univ Estadual Paulista, São Paulo, Brazil.,Department of Pathology and Clinical Propedeutics, Araçatuba Dental School, UNESP - Univ Estadual Paulista, São Paulo, Brazil
| | - Vitor B Valente
- Oral Oncology Center, Araçatuba Dental School, UNESP - Univ Estadual Paulista, São Paulo, Brazil.,Department of Pathology and Clinical Propedeutics, Araçatuba Dental School, UNESP - Univ Estadual Paulista, São Paulo, Brazil
| | | | - Renata C Felipini
- Department of Pathology and Clinical Propedeutics, Araçatuba Dental School, UNESP - Univ Estadual Paulista, São Paulo, Brazil
| | - Eder R Biasoli
- Oral Oncology Center, Araçatuba Dental School, UNESP - Univ Estadual Paulista, São Paulo, Brazil.,Department of Pathology and Clinical Propedeutics, Araçatuba Dental School, UNESP - Univ Estadual Paulista, São Paulo, Brazil
| | - Glauco I Miyahara
- Oral Oncology Center, Araçatuba Dental School, UNESP - Univ Estadual Paulista, São Paulo, Brazil.,Department of Pathology and Clinical Propedeutics, Araçatuba Dental School, UNESP - Univ Estadual Paulista, São Paulo, Brazil
| | - Daniel G Bernabé
- Oral Oncology Center, Araçatuba Dental School, UNESP - Univ Estadual Paulista, São Paulo, Brazil. .,Department of Pathology and Clinical Propedeutics, Araçatuba Dental School, UNESP - Univ Estadual Paulista, São Paulo, Brazil.
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48
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Thompson JM, Cohen LM, Yang CS, Kroumpouzos G. Severe, ulcerative, lichenoid mucositis associated with secukinumab. JAAD Case Rep 2016; 2:384-386. [PMID: 27752531 PMCID: PMC5061307 DOI: 10.1016/j.jdcr.2016.07.009] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023] Open
Affiliation(s)
| | | | - Catherine S Yang
- Department of Dermatology, Alpert Medical School of Brown University, Providence, Rhode Island
| | - George Kroumpouzos
- Department of Dermatology, Alpert Medical School of Brown University, Providence, Rhode Island; GK Dermatology, PC, South Weymouth, Massachusetts
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49
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Abstract
The oral allergy syndrome is one of the most common form of food allergy and manifests as contact urticaria of the oral mucosa after consumption of cross reacting foods. Whereas allergic contact stomatitis often occurs due to dental materials, allergic contact cheilitis is usually a reaction due to topical therapeutics like herpes ointments or lip care products. As late type reactions are more frequent than immediate type reactions in the anogenital mucosa, contact dermatitis in this area should be identified via epicutaneous testing. In case of contact urticaria at the genital mucosa, a semen allergy or a latex allergy should be given due consideration as a possible cause. Angioedemas, which are mostly common histamine mediated, usually prefer skin areas with loose connective tissue such as the oral or genital mucosa. Fixed drug eruption also occurs preferentially in these areas. Bullous drug-induced skin reactions (e.g., SJS and TEN) are characterized by severe hemorrhagic, erosive affections of mucous membranes.
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50
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Cheng YSL, Gould A, Kurago Z, Fantasia J, Muller S. Diagnosis of oral lichen planus: a position paper of the American Academy of Oral and Maxillofacial Pathology. Oral Surg Oral Med Oral Pathol Oral Radiol 2016; 122:332-54. [PMID: 27401683 DOI: 10.1016/j.oooo.2016.05.004] [Citation(s) in RCA: 274] [Impact Index Per Article: 34.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2016] [Revised: 05/03/2016] [Accepted: 05/11/2016] [Indexed: 12/26/2022]
Abstract
Despite being one of the most common oral mucosal diseases and recognized as early as 1866, oral lichen planus (OLP) is still a disease without a clear etiology or pathogenesis, and with uncertain premalignant potential. More research is urgently needed; however, the research material must be based on an accurate diagnosis. Accurate identification of OLP is often challenging, mandating inclusion of clinico-pathological correlation in the diagnostic process. This article summarizes current knowledge regarding OLP, discusses the challenges of making an accurate diagnosis, and proposes a new set of diagnostic criteria upon which to base future research studies. A checklist is also recommended for clinicians to provide specific information to pathologists when submitting biopsy material. The diagnostic process of OLP requires continued clinical follow-up after initial biopsy, because OLP mimics can manifest, necessitating an additional biopsy for direct immunofluorescence study and/or histopathological evaluation in order to reach a final diagnosis.
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Affiliation(s)
- Yi-Shing Lisa Cheng
- Department of Diagnostic Sciences, Texas A&M University College of Dentistry, Dallas, TX, USA.
| | - Alan Gould
- Louisville Oral Pathology Laboratory, Louisville, KY, USA
| | - Zoya Kurago
- Department of Oral Health and Diagnostic Sciences, College of Dental Medicine, Augusta University, Augusta, GA, USA
| | - John Fantasia
- Department of Dental Medicine, Hofstra North Shore-Long Island Jewish Health System, New Hyde Park, NY, USA
| | - Susan Muller
- Professor Emeritus, Emory University School of Medicine, Atlanta, GA; Atlanta Oral Pathology, Decatur, GA, USA
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