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Marques LC, de Medeiros Nunes da Silva LA, Santos PDPM, de Almeida Lima Borba Lopes A, Cunha KS, Milagres A, Rozza-de-Menezes RE, Junior AS, Conde DC. Oral lichenoid lesion in association with chemotherapy treatment for non-Hodgkin lymphoma or lichen planus? Review of the literature and report of two challenging cases. Head Face Med 2022; 18:32. [PMID: 36068636 PMCID: PMC9447333 DOI: 10.1186/s13005-022-00333-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2022] [Accepted: 08/23/2022] [Indexed: 12/03/2022] Open
Abstract
Background The diagnosis of oral lichenoid lesions (OLL) remains a challenge for clinicians and pathologists. Although, in many cases, OLL cannot be clinically and histopathologically distinguishable from oral lichen planus (OLP), one important difference between these lesions is that OLL has an identifiable etiological factor, e.g. medication, restorative material, and food allergy. The list of drugs that can cause OLL is extensive and includes anti-inflammatory drugs, anticonvulsants, antihypertensives, antivirals, antibiotics, chemotherapeutics, among others. This work aimed to perform a literature review of OLL related to chemotherapy drugs and to report two cases of possible OLL in patients with B-cell and T-cell non-Hodgkin lymphomas in use of chemotherapy and adjuvant medications. We also discuss the challenge to clinically and histopathologically differentiate OLL and OLP. Case presentation In both cases, oral lesions presented reticular, atrophic, erosive/ulcerated, and plaque patterns. The diagnosis of OLL was initially established in both cases by the association of histopathology and history of onset of lesions after the use of medications. Although the patients have presented a significant improvement in the oral clinical picture for more than 2 years of follow-up, they still have some lesions. Conclusion A well-detailed anamnesis associated with the drug history, temporal relationship of the appearance of the lesions, and follow-up of patients are fundamental for the diagnosis of OLL related to drugs. Nevertheless, its differentiation from OLP is still a challenge.
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Affiliation(s)
- Letícia Côgo Marques
- Postgraduate Program in Pathology, School of Medicine, Universidade Federal Fluminense (UFF), Niterói, RJ, Brazil
| | | | | | | | - Karin Soares Cunha
- Postgraduate Program in Pathology, School of Medicine, Universidade Federal Fluminense (UFF), Niterói, RJ, Brazil
| | - Adrianna Milagres
- Department of Pathology, School of Medicine, Universidade Federal Fluminense (UFF), Niterói, RJ, Brazil
| | | | - Arley Silva Junior
- Postgraduate Program in Pathology, School of Medicine, Universidade Federal Fluminense (UFF), Niterói, RJ, Brazil
| | - Danielle Castex Conde
- Postgraduate Program in Pathology, School of Medicine, Universidade Federal Fluminense (UFF), Niterói, RJ, Brazil.
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Zucoloto ML, Shibakura MEW, Pavanin JV, Garcia FT, da Silva Santos PS, Maciel AP, de Barros Gallo C, Souza NV, Innocentini LMAR, Humberto JSM, Motta ACF. Severity of oral lichen planus and oral lichenoid lesions is associated with anxiety. Clin Oral Investig 2019; 23:4441-4448. [PMID: 30989337 DOI: 10.1007/s00784-019-02892-2] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2018] [Accepted: 04/02/2019] [Indexed: 12/21/2022]
Abstract
OBJECTIVES Oral lichen planus (OLP) and oral lichenoid lesions (OLL) are chronic inflammatory diseases whose symptoms can impair patient's quality of life (QoL). Psychological factors seem to play an important role in these diseases. This study aimed to determine the impact of oral health and anxiety levels on the QoL of patients with OLP and OLL. PATIENTS AND METHODS This was a cross-sectional study composed of OLP and OLL patients and a control group matched by age and sex with no autoimmune/inflammatory or malignant oral lesions. Anxiety levels and oral health impact on QoL were assessed using the Hamilton Anxiety Scale (HAM-A) and the Oral Health Impact Profile-14 (OHIP-14), respectively. The instruments were filled through personal interview before starting the treatment for oral lesions. RESULTS A total of 87 patients diagnosed with OLP (n = 45) and OLL (n = 42), and 87 controls were included in the study. Statistical differences were observed for the psychic and somatic anxiety dimensions between severities of diseases. Patients with OLP or OLL had higher scores for the OHIP-14 dimensions physiological discomfort and social limitation compared with controls. In addition, higher scores for physical pain, physical disability, social disability, and handicap were detected among patients with greater severity. CONCLUSION Greater severity of OLP and OLL seems to be associated with increased levels of anxiety, higher scores of oral health impact profile, and decreased QoL. CLINICAL RELEVANCE Patients with severe OLP/OLL may benefit from additional therapeutic treatments, such as psychological and/or psychiatric management, concomitant to treatment specific to oral lesions.
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Affiliation(s)
- Miriane Lucindo Zucoloto
- Department of Social Medicine, Ribeirão Preto School of Medicine, University of São Paulo, Ribeirão Preto, SP, Brazil
| | - Matheus Eiji Warikoda Shibakura
- Department of Stomatology, Public Oral Health and Forensic Dentistry, Division of Oral Diagnosis, School of Dentistry of Ribeirão Preto, University of São Paulo, Av. do Café, s/n, Ribeirão Preto, SP, 14040-904, Brazil
| | - Jefferson Veronezi Pavanin
- Department of Stomatology, Public Oral Health and Forensic Dentistry, Division of Oral Diagnosis, School of Dentistry of Ribeirão Preto, University of São Paulo, Av. do Café, s/n, Ribeirão Preto, SP, 14040-904, Brazil
| | - Fernanda Teixeira Garcia
- Department of Stomatology, Public Oral Health and Forensic Dentistry, Division of Oral Diagnosis, School of Dentistry of Ribeirão Preto, University of São Paulo, Av. do Café, s/n, Ribeirão Preto, SP, 14040-904, Brazil
| | - Paulo Sérgio da Silva Santos
- Department of Surgery, Stomatology, Pathology and Radiology, Bauru School of Dentistry, University of São Paulo, Bauru, SP, Brazil
| | - Aloizio Premoli Maciel
- Department of Surgery, Stomatology, Pathology and Radiology, Bauru School of Dentistry, University of São Paulo, Bauru, SP, Brazil
| | - Camila de Barros Gallo
- Department of Stomatology, School of Dentistry, University of São Paulo, São Paulo, SP, Brazil
| | - Nathalia Vilela Souza
- Department of Stomatology, School of Dentistry, University of São Paulo, São Paulo, SP, Brazil
| | - Lara Maria Alencar Ramos Innocentini
- Department of Stomatology, Public Oral Health and Forensic Dentistry, Division of Oral Diagnosis, School of Dentistry of Ribeirão Preto, University of São Paulo, Av. do Café, s/n, Ribeirão Preto, SP, 14040-904, Brazil.,Division of Dentistry and Stomatology, Ribeirão Preto Clinical Hospital, Ribeirão Preto School of Medicine, University of São Paulo, Ribeirão Preto, SP, Brazil
| | - Janaina Silva Martins Humberto
- Department of Stomatology, Public Oral Health and Forensic Dentistry, Division of Oral Diagnosis, School of Dentistry of Ribeirão Preto, University of São Paulo, Av. do Café, s/n, Ribeirão Preto, SP, 14040-904, Brazil
| | - Ana Carolina Fragoso Motta
- Department of Stomatology, Public Oral Health and Forensic Dentistry, Division of Oral Diagnosis, School of Dentistry of Ribeirão Preto, University of São Paulo, Av. do Café, s/n, Ribeirão Preto, SP, 14040-904, Brazil.
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Srinivas K, Aravinda K, Ratnakar P, Nigam N, Gupta S. Oral lichen planus - Review on etiopathogenesis. Natl J Maxillofac Surg 2012; 2:15-6. [PMID: 22442603 PMCID: PMC3304232 DOI: 10.4103/0975-5950.85847] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023] Open
Abstract
Oral lichen planus (OLP) is a chronic mucocutaneous disease of uncertain etiopathogenesis. Several factors including stress, genetics, systemic diseases, viruses, dental restorative materials and drugs have been implicated as causative agents. The disease seems to be mediated by an antigen specific mechanism, activating cytotoxic T cells, and non specific mechanisms like mast cell degranulation and matrix metalloproteinase activation. Further clarity on the pathogenesis will aid in modifying therapeutic interventions, thus significantly reducing the morbidity of OLP patients.
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Affiliation(s)
- K Srinivas
- Department of Oral Medicine & Radiology, Career Postgraduate Institute of Dental Sciences & Hospital, Sitapur Road, Lucknow, India
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4
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Jayavelu P, Sambandan T. Prevalence of hepatitis C and hepatitis B virus infection(s) in patients with oral lichen planus. JOURNAL OF PHARMACY AND BIOALLIED SCIENCES 2012; 4:S397-405. [PMID: 23066298 PMCID: PMC3467868 DOI: 10.4103/0975-7406.100302] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2011] [Revised: 01/02/2012] [Accepted: 01/26/2012] [Indexed: 12/23/2022] Open
Abstract
AIM The aim of this study was to determine the prevalence of hepatitis B virus and hepatitis C virus (HCV) infections in patients with oral lichen planus (OLP) and to compare it with that of general population. MATERIALS AND METHODS A total of 60 patients were included in the study. Patients were selected from the outpatient department of Rama Dental College Research Centre, Kanpur, Uttar Pradesh. Thirty patients with OLP were included in Group 1. Thirty age- and sex-matched healthy patients with no history of oral or skin lesions were included in Group 2. Detailed case history, biopsy (the most representative site of the lesion is chosen for specimen), detection of hepatitis B surface antigen (HBsAg), and detection of anti-HCV antibody were carried out. RESULTS The serum of the entire study sample (Group 1 and Group 2) was tested for both hepatitis C antibodies and HBsAgs with the enzyme-linked immunosorbent assay (ELISA) test (using the third generation kit). It was found negative for both HBsAgs and hepatitis C antibodies. CONCLUSION In the present study, all the samples including OLP patients and healthy patients were seronegative for both hepatitis B (HBsAg) and hepatitis C (HCV antibody).
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Affiliation(s)
- Perumal Jayavelu
- Department of Oral and Maxillo Facial Surgery, Rama Dental College and Research Centre, Kanpur, UP, India
| | - Thirumal Sambandan
- Department of Oral Medicine and Radiology, Tamilnadu Government Dental College and Hospital, Chennai, India
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5
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Paulusová V, Rösch C, Dřízhal I, Perlík F, Mašín V, Sukumar S, Slezák R, Slanař O. Cytochrome P450 2D6 polymorphism and drug utilization in patients with oral lichen planus. Acta Odontol Scand 2010; 68:193-8. [PMID: 20201714 DOI: 10.3109/00016351003636382] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVE Oral lichen planus (OLP) is one of the commonest diseases of the oral mucosa. The etiology of the disease is unknown. Our goal was to determine frequencies of functionally important alleles which determine the metabolic rate (phenotype) of individuals with OLP and to compare drug utilization, with focus on CYP2D6, with that of a control group. MATERIAL AND METHODS The study population consisted of 46 patients with OLP, 60 sex- and age-matched control subjects for drug utilization evaluation and 223 healthy non-medicated controls for genotype comparison. DNA analysis was done using polymerase chain reaction and restriction fragment length polymorphism. The gene CYP2D6 was analyzed for the alleles CYP2D6*3,*4,*5,*6 and gene duplication. Drug utilization was evaluated according to Anatomical Therapeutic Chemical code, liver drug metabolism pathway and mono- or polytherapy. RESULTS Intake of drugs was significantly higher in the group of OLP patients in comparison with control subjects. The use of CYP2D6 substrates, inhibitors or inducers did not differ between OLP patients and controls. Predicted phenotype frequencies in OLP patients and healthy controls, respectively were as follows: ultrarapid metabolizers 2% and 5.8%, extensive metabolizers 52% and 49.8%, intermediate metabolizers 39% and 37.7% and poor metabolizers 7% and 6.7%. CONCLUSIONS We did not find a statistically significant difference in the frequency of CYP2D6 alleles between OLP patients and healthy controls. OLP patients used more medication than age- and sex-matched controls.
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Abstract
Amalgam has been used for the restoration of teeth for well over 100 years, and is the most successful of the direct restorative materials with respect to longevity. Despite the increasing use of tooth-coloured materials, with advantages of aesthetics and adhesion, amalgam is one of the most widely used dental restorative materials. One of the principal disadvantages of amalgam, apart from aesthetics, is that it may have adverse biological effects, both locally and systemically. Locally, it can cause an erythematous lesion on the adjacent oral soft tissues (tongue and buccal mucosa), and systemically free mercury in the amalgam may give rise to a hypersensitivity reaction. The purpose of this paper is to review the literature concerning the local adverse reactions to dental amalgam. The focus will be on the reactions of the oral mucosa, and brief consideration will be given to laboratory cytotoxicity of dental amalgam and its components, and to the 'amalgam tattoo'.
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Affiliation(s)
- M J McCullough
- School of Dental Science, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Australia
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7
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Carrozzo M. Oral diseases associated with hepatitis C virus infection. Part 1. sialadenitis and salivary glands lymphoma. Oral Dis 2008; 14:123-30. [PMID: 18208477 DOI: 10.1111/j.1601-0825.2007.01436.x] [Citation(s) in RCA: 50] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Morbidity associated with hepatitis C virus (HCV) infection is due not only to the sequelae of chronic liver disease, but also to a variety of extraheaptic manifestations (EHM). Some of the most frequently reported EHM of HCV infection involves the oral region predominantly or exclusively and they are the topics of this 2-part review. The current part 1 discusses the evidences on the association of salivary glands disorders with HCV. HCV- infected patients may frequently have histological signs of Sjögren-like sialadenitis with mild or even absent clinical symptoms. However, the pathogenetic role of HCV in Sjogren Syndrome (SS) development and the characteristics distinguishing classic SS from HCV-related sialadenitis are still an issue. It is unclear if the virus may cause a disease mimicking primary SS or if HCV is directly responsible for the development of SS in a specific subset of patients. Notably, some patients may present a triple association between HCV, SS-like sialadenitis and salivary gland lymphoma and the virus may be involved in the lymphomagenesis. The risk of having a salivary gland lymphoma is particularly high in patients with mixed cryoglobulinemia. Little attention has been paid to the effects of anti-HCV treatment on sialadenitis or lymphoma development.
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Affiliation(s)
- M Carrozzo
- Department of Oral Medicine, School of Dental Sciences, University of Newcastle upon Tyne, Newcastle upon Tyne, UK.
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8
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Abstract
Hepatitis C affects approximately 170 million people worldwide. Extrahepatic manifestations of chronic hepatitis C infection are clinically evident in nearly 40% of patients. Much research has been done over the last decade to better understand their incidence, clinical presentation, mechanism of disease, and the role of antiviral therapy in their treatment. Of the commonly reported manifestations, cryoglobulinemia, membranoproliferative glomerulonephritis, and porphyria cutanea tarda remain the best understood manifestations. More recently, the association of insulin resistance and diabetes mellitus with chronic hepatitis C has been demonstrated. This paper serves to review the growing body of literature detailing the extrahepatic manifestations of chronic hepatitis C.
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Affiliation(s)
- Nicole A Palekar
- Department of Medicine, Gastroenterology and Hepatology Service, Brooke Army Medical Center, Fort Sam Houston, TX, USA.
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9
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Kunte C, Erlenkeuser-Uebelhoer I, Michelsen S, Scheerer-Dhungel K, Plewig G. [Treatment of therapy-resistant erosive oral lichen planus with extracorporeal photopheresis (ECP)]. J Dtsch Dermatol Ges 2005; 3:889-94. [PMID: 16232276 DOI: 10.1111/j.1610-0387.2005.05759.x] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
BACKGROUND Erosive, oral lichen planus is typically therapy-resistant. Histologically and immunopathologically there are many similarities between lichen planus and lichenoid graft versus host disease (GvHD). Extracorporeal photopheresis (ECP) therapy has been shown effective in GvHD in several publications; only one study addresses its use in chronic erosive lichen planus. PATIENTS AND METHODS Four patients with erosive oral lichen planus were treated. Therapy was performed on two consecutive days (therapy cycle) every two weeks. Following clinical improvement, the therapy intervals were prolonged. RESULTS In all four patients clinical symptoms and mucosal lesions improved after seven to nine therapy cycles. A temporary worsening occurred in two patients following dental procedures. One of those patients still requires regular ECP therapy. Two patients discontinued therapy following nearly complete remission for other reasons. One patient stopped therapy after 19 cycles of ECP therapy and has remained in complete remission for 9 months. No side effects were seen during treatment. CONCLUSIONS Extracorporeal photopheresis is an effective therapeutic option for the treatment of erosive oral lichen planus, especially due to the lack of side effects in contrast to other established therapies. Adjunctive topical treatment is also required.
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Affiliation(s)
- Christian Kunte
- Klinikum der Ludwig-Maximilians-Universität München, Klinik und Poliklinik für Dermatologie und Allergologie, Frauenlobstrasse 9-11, D-80337 Munich, Germany.
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10
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Lodi G, Giuliani M, Majorana A, Sardella A, Bez C, Demarosi F, Carrassi A. Lichen planus and hepatitis C virus: a multicentre study of patients with oral lesions and a systematic review. Br J Dermatol 2005; 151:1172-81. [PMID: 15606512 DOI: 10.1111/j.1365-2133.2004.06257.x] [Citation(s) in RCA: 71] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
BACKGROUND An association between hepatitis C virus (HCV) infection and lichen planus (LP) has been investigated, but results have been inconsistent. OBJECTIVES To investigate the relationship between LP and HCV seropositivity. Methods In a cross-sectional study we tested the sera of 303 consecutive newly diagnosed patients with histologically proven LP referred to three Italian centres for the presence of anti-HCV IgG. A comparable control group was also tested. Next, in a systematic review, studies were identified by searching different databases in April 2004. Inclusion criteria were: (i) analytical study design; (ii) clinical and histological diagnosis of LP; and (iii) serological test for anti-HCV antibodies as main outcome. The risk of bias was assessed on the basis of characteristics of the study group, appropriateness of the control group and study design. Pooled data were analysed by calculating odds ratios (ORs), using a random effects model. RESULTS In the cross-sectional study, nearly one in five (19.1%) of the LP group was HCV positive, while a much lower prevalence of infection was found in the control group (3.2%) [OR 7.08; 95% confidence interval (CI) 3.43-14.58]. The systematic review yielded 25 relevant studies, six of which had a low risk of bias. There was a statistically significant difference in the proportion of HCV-seropositive subjects among patients with LP, compared with controls (OR 4.80; 95% CI 3.25-7.09). Following subgroup analyses, the variability of HCV prevalence in patients with LP seemed to depend on geographical area, but not on age. CONCLUSIONS Anti-HCV circulating antibodies are more common in patients with LP than in controls, although such an association may not be significant in some geographical areas.
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Affiliation(s)
- G Lodi
- Unit of Oral Medicine and Pathology, Department of Medicine, University of Milan, via Beldiletto 1/3, Milan 20142, Italy.
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11
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Affiliation(s)
- Adrian Reuben
- Division of GI/Hepatology, Department of Medicine, Medical University of South Carolina, USA
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12
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Petruzzi M, De Benedittis M, Loria MP, Dambra P, D'Oronzio L, Capuzzimati C, Tursi A, Lo Muzio L, Serpico R. Immune response in patients with oral lichen planus and HCV infection. Int J Immunopathol Pharmacol 2004; 17:93-8. [PMID: 15000872 DOI: 10.1177/039463200401700113] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
In recent years an association between oral lichen planus (OLP) and HCV infection has been reported, but the frequency of this association seems to differ in the various geographic areas. It is clear, instead, that some abnormalities occur in the immune-regulation mechanisms of patients with OLP and it is thought to be due to the chronic antigenic stimulus of HCV that causes functional disorders of the immune system in infected patients. Possible immunologic difference between 17 patients with OLP and HCV+ and 17 patients with OLP and HCV- were investigated using standard immunofluorescence and flow cytometry techniques. The distribution of T and B cells was normal in all patients examined, while NK CD56+ cells were increased, above all in HCV- patients. About 65% of T CD4+ lymphocytes coexpressed the CD45RO isoform (p=0.002), while approximately 32% expressed CD45RA, without significant differences in comparison to HCV+ subjects (p>0.05). Moreover, almost all the CD4+CD45RO+ subpopulation coexpressed CD29 in all patients examined. No significant differences between the two groups of patients were detected as to the increase of cytotoxic T CD8+CD57+ lymphocytes. The B cells CD19+CD5+ responsible for the production of "natural" antibodies were detectable in both the examined groups, even if not in all HCV+ subjects (30% +/- 10.1 in HCV- and 27% +/- 19.4 in HCV+ patients; p=0.47). These findings suggest the existence of differences in lymphocyte subpopulations between OLP-HCV+ subjects and OLP-HCV- patients.
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Affiliation(s)
- M Petruzzi
- Department of Dentistry and Surgery, University of Bari, Bari, Italy
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13
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Campisi G, Di Fede O, Craxi A, Di Stefano R, Margiotta V. Oral lichen planus, hepatitis C virus, and HIV: No association in a cohort study from an area of high hepatitis C virus endemicity. J Am Acad Dermatol 2004; 51:364-70. [PMID: 15337978 DOI: 10.1016/j.jaad.2004.01.002] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
OBJECTIVES We sought to assess the age-specific prevalence of oral lichen planus (OLP) in Mediterranean patients with chronic hepatitis C virus (HCV) and to evaluate the features of OLP in relation to sex, smoking, HCV genotype, HIV-1 coinfection, and antiviral treatments. METHODS In all, 178 anti-HCV-positive adults (60 women and 118 men; age range 20-66 years) recruited from two cohorts (104 HIV-negative patients and 74 patients with HIV coinfection) underwent oral examination. RESULTS Overall prevalence of OLP was 2.8% (5 of 178) (male/female ratio 0.2; odds ratio=0.119; 95% confidence interval=0.013-1.106), only among HIV-negative participants, always in the reticular pattern, and in the adult age. HCV genotype, tobacco smoking, and treatment (interferon alfa/ribavirin) were not significantly associated to OLP. CONCLUSIONS Among HCV-infected patients, we found a low prevalence of OLP. The absence of OLP in HIV-coinfected patients suggests immunosuppression secondary to defective CD4 functions.
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Affiliation(s)
- G Campisi
- Unit of Oral Medicine, Department of Oral Sciences, University of Palermo, Italy
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14
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Klanrit P, Thongprasom K, Rojanawatsirivej S, Theamboonlers A, Poovorawan Y. Hepatitis C virus infection in Thai patients with oral lichen planus. Oral Dis 2004; 9:292-7. [PMID: 14629329 DOI: 10.1034/j.1601-0825.2003.00955.x] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
OBJECTIVE Many studies focusing on the association between hepatitis C virus (HCV) infection and oral lichen planus (OLP) have been conducted. Diversities of geographical locations could be a major factor influencing the prevalence of HCV. This study was aimed to define whether there was a relationship between the OLP and HCV infection in Thailand. MATERIALS AND METHODS Serum samples of 60 patients (with OLP) and 60 controls (without OLP), whose age and gender were matched, were respectively screened for anti-HCV by ELISA (third generation), and reverse transcription polymerase chain reaction (RT-PCR) for HCV-RNA. RESULTS We found five patients (8.33%) with OLP infected with HCV: three patients were positive for both anti-HCV and HCV-RNA; one patient was only positive for anti-HCV; and one patient was only positive for HCV-RNA; whereas all the controls were negative for both anti-HCV and HCV-RNA (P=0.029). Three of five cases of OLP with HCV infection had histories of blood transfusions over 10 years ago. CONCLUSION The present study reports a small, but statistically significant high prevalence of HCV infection among patients with OLP, although the underlying mechanism still remains unknown.
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Affiliation(s)
- P Klanrit
- Department of Oral Diagnosis, Faculty of Dentistry, Khon Kaen University, Khon Kaen, Thailand
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15
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Ramer MA, Altchek A, Deligdisch L, Phelps R, Montazem A, Buonocore PM. Lichen planus and the vulvovaginal-gingival syndrome. J Periodontol 2003; 74:1385-93. [PMID: 14584875 DOI: 10.1902/jop.2003.74.9.1385] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Lichen planus is a dermatologic disease that affects both skin and mucosa. Here we report five cases of lichen planus that presented as the oral component of the vulvovaginal-gingival syndrome. Four of the cases were associated with biopsy-proven oral lichen planus, and all five patients had oral lesions that clinically resembled lichen planus. Three patients were taking medications that are associated with lichenoid drug reactions; four patients were postmenopausal; and all five patients had desquamative vulvovaginitis. Clinicians may see these patients when they show persistent signs and symptoms of oral lichen planus. We report five case histories and review the 127 cases found in the literature to make the practicing clinician aware of this unusual clinical entity. The hepatitis C virus association and drug-induced lichenoid mucositis are topics that are addressed. In addition, clarification of the issues surrounding the premalignant potential of oral lichen planus is provided with evidence, rationale, and data from the literature to support the position that true oral lichen planus has no inherent predisposition to become malignant.
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Affiliation(s)
- M A Ramer
- Department of Pathology, The Mount Sinai School of Medicine, New York, NY 10029, USA.
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16
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Thongprasom K, Luengvisut P, Wongwatanakij A, Boonjatturus C. Clinical evaluation in treatment of oral lichen planus with topical fluocinolone acetonide: a 2-year follow-up. J Oral Pathol Med 2003; 32:315-22. [PMID: 12787037 DOI: 10.1034/j.1600-0714.2003.00130.x] [Citation(s) in RCA: 61] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
BACKGROUND Oral lichen planus (OLP) is a chronic inflammatory disease which is recalcitrant to medical treatment. The purpose of this study was to compare the effectiveness of various forms of the topical steroid fluocinolone acetonide applications in patients with OLP. METHODS Data of OLP patients were collected retrospectively from the chart record and the 97 OLP patients were divided into three groups. The first group (n = 28) was treated with a 0.1% solution of fluocinolone acetonide (FAS), the second group (n = 22) with 0.1% fluocinolone acetonide in orabase (FAO), and the third group (n = 47) with both FAS and FAO (FAS/FAO) throughout the study. Each group was clinically evaluated as complete remission (CR), partial remission (PR), or no response (NR), following the treatment. Also, the side-effect of oral candidiasis was recorded in each group. RESULTS Two years of treatment resulted in complete remission of 77.3, 21.4, and 17.0% of patients in the FAO, FAS, and FAS/FAO groups, respectively. There was a statistically significant difference in disease remission (P < 0.05), but not in oral candidiasis appearance (P > 0.05) among various forms of topical steroid application. CONCLUSION The study concluded that FAO or FAS can produce improved results in the management of OLP by long-term follow-up.
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Affiliation(s)
- K Thongprasom
- Faculty of Dentistry, Oral Medicine Department, Chulalongkorn University, Bangkok 10330, Thailand.
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17
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Maticic M, Poljak M, Seme K, Skaleric U. The IgG antibody profile to various antigen regions of hepatitis C virus differs in oral fluid and serum of patients with chronic hepatitis C. ORAL MICROBIOLOGY AND IMMUNOLOGY 2003; 18:176-82. [PMID: 12753470 DOI: 10.1034/j.1399-302x.2003.00063.x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Antibodies to hepatitis C virus (HCV) can be detected not only in serum but also in oral fluid. The aim of the study was to determine IgG antibody reactivity directed to six antigen regions of HCV in oral fluid and to evaluate the significance of the antibody pattern in oral fluid compared to serum. Oral fluid and serum samples of 32 HCV viremic patients were collected to detect antibodies to six antigen regions incorporated as antigen bands into modified commercial updated third generation line immuno-assay. Compared to serum, a significantly lower cumulative antibody response and reactivity to five HCV antigens was found in oral fluid. The significantly highest prevalence of oral fluid reactivity was recorded with antigen C1 (78%), whereas in serum the most significantly frequent reactivity was detected with antigen NS3 (100%). The absence of antibody reactivity with antigen E2 was similar in both body fluids. The discrepancy in antibody pattern to HCV antigens between oral fluid and serum indicates the possible existence of local viral replication, viral mutants, viral inhibitors in oral cavity and, most probably, leakage of the muco-vascular barrier.
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Affiliation(s)
- M Maticic
- Department of Infectious Diseases, University Medical Centre Ljubljana, Ljubljana, Slovenia.
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18
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Jaber MA, Porter SR, Bain L, Scully C. Lack of association between hepatitis C virus and oral epithelial dysplasia in British patients. Int J Oral Maxillofac Surg 2003; 32:181-3. [PMID: 12729779 DOI: 10.1054/ijom.2002.0258] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Oral lichen planus may be a premalignant condition. An association between hepatitis C virus (HCV) infection and oral lichen planus has been described in Southern European and Japanese patients, and recently an association between HCV and oral squamous cell carcinoma was suggested from a study of Japanese patients. The present study investigated the frequency of chronic liver disease and HCV infection in UK patients with oral epithelial dysplasia (OED), a known premalignant disorder. Subjects included 75 patients with histologically proven OED and 110 healthy controls. Liver function and IgG antibodies to HCV were examined serologically. No patient with OED or control subject had serological evidence of hepatic disease, and anti-HCV antibodies were detected in only two (2.6%) of the 75 patients with OED, none of the controls being HCV seropositive. It is concluded that in the UK there is no association between HCV infection and OED.
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Affiliation(s)
- M A Jaber
- Eastman Dental Institute and Hospital for Oral Health Care Sciences, Department of Oral Medicine, University of London, 256 Gray's Inn Road, London, WC1X 8LD, UK
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19
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Bez C, Hallett R, Carrozzo M, Lodi G, Gandolfo S, Carrassi A, Scully C, Porter SR. Lack of association between hepatotropic transfusion transmitted virus infection and oral lichen planus in British and Italian populations. Br J Dermatol 2001; 145:990-3. [PMID: 11899155 DOI: 10.1046/j.1365-2133.2001.04518.x] [Citation(s) in RCA: 18] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
BACKGROUND A possible association between oral lichen planus (OLP) and chronic hepatic disease has been found in some populations, although this is probably geographically influenced. In 1997 a new hepatotropic virus, transfusion transmitted virus (TTV), was identified but has not been studied in relation to OLP. OBJECTIVE The present investigation evaluated the genoprevalence of TTV DNA in the sera of British and Italian patients suffering from OLP using two different sets of primers to identify TTV subgenomic DNA. METHODS Study groups comprised 40 adult subjects (21 British, 19 Italian) with OLP. For each country, two control groups, a disease-control group and a healthy-control group, were included. The presence of TTV DNA in the sera of patients and control subjects was assessed using two different polymerase chain reactions (PCR) and DNA sequence analysis. RESULTS Statistical analysis did not reveal evidence of any association between TTV infection and OLP or country of residence. CONCLUSION An association between TTV and OLP is unlikely.
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Affiliation(s)
- C Bez
- Department of Oral Medicine, Eastman Dental Institute for Oral Health Care Sciences, UCL, University of London, UK
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20
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Mega H, Jiang WW, Takagi M. Immunohistochemical study of oral lichen planus associated with hepatitis C virus infection, oral lichenoid contact sensitivity reaction and idiopathic oral lichen planus. Oral Dis 2001; 7:296-305. [PMID: 12117205 DOI: 10.1034/j.1601-0825.2001.00718.x] [Citation(s) in RCA: 20] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
OBJECTIVES Oral lichen planus (OLP) is a common mucocutaneous disorder and might be associated to a possible pathogenic relationship with hepatitis C virus (HCV) infection or hypersensitivity to dental alloy. We examined the clinical and immunohistochemical features of OLP associated with HCV infection (OLP-HCV), oral lichenoid contact sensitivity reaction (OLCSR), and idiopathic oral lichen planus (iOLP). The immunohistochemical expressions of CD4, CD8, B cells, Class II major histocompatibility complex antigen (HLA-DR), S-100, HSP60, Proliferating cell nuclear antigen (PCNA) and Ki-67 were compared to study the pathogenic differences of the three OLP groups. MATERIALS AND METHODS Three groups of OLP patients, (I) OLP-HCV patients (n = 17), (2) OLCSR patients (n = 10) and (3) iOLP patients (n = 14) were retrieved from clinical records and tissues examined immunohistochemically by the avidin-biotin-complex technique. RESULTS The patients with OLP-HCV showed widespread lesions. The proportion of CD8+ cells was found to be significantly higher in the lamina propria of the OLP-HCV patients and a significantly lower proportion of CD8+ cells of the OLCSR patients was noticed in the epithelium or the connective tissue papillae than in the iOLP patients. There were no significant differences in either the number of CD4+ cells or B cells between the three OLP groups. No significant differences in the number of HLA-DR+ cells were found between the three OLP groups and some OLP-HCV patients showed a significant increase of S-100+ cells in the epithelium compared with iOLP patients. There were no significant differences in either the number of PCNA+ or Ki-67+ cells between the groups. The patients showed similar weak expressions of HSP60 in the three OLP groups. CONCLUSION The different distributions of the CD8+ cells that could have functionally different roles might be related to the distinct pathogenic mechanisms in the three OLP groups.
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Affiliation(s)
- H Mega
- Department of Oral Pathology, Faculty of Dentistry, Tokyo Medical and Dental University, Japan
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21
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Kirtak N, Inalöz HS, Erbağci Z. The prevalence of hepatitis C virus infection in patients with lichen planus in Gaziantep region of Turkey. Eur J Epidemiol 2001; 16:1159-61. [PMID: 11484806 DOI: 10.1023/a:1010968309956] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
The purpose of this case-control study was to investigate the association between lichen planus (LP) and hepatitis C virus (HCV) infection in Gaziantep region of Turkey. Seventy-three patients with LP and a control group of patients (n: 73) with a dermatological disorder other than LP were detected for HCV infection using a third generation enzyme-linked immunosorbent assay (ELISA). A serological positivity for HCV was found in five of LP patients (6.84%), whereas it was positive for only one patient of the control group (1.36%). A statistically significant difference was found between LP and control groups (p < 0.05). We conclude that the coexistence of the two diseases is probably more than coincidental.
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Affiliation(s)
- N Kirtak
- Department of Dermatology, University of Gaziantep, Faculty of Medicine, Turkey
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22
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Kirtak N, Inalöz HS, Ozgöztasi, Erbağci Z. The prevalence of hepatitis C virus infection in patients with lichen planus in Gaziantep region of Turkey. Eur J Epidemiol 2001. [PMID: 11484806 DOI: 10.1023/a: 1010968309956] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
The purpose of this case-control study was to investigate the association between lichen planus (LP) and hepatitis C virus (HCV) infection in Gaziantep region of Turkey. Seventy-three patients with LP and a control group of patients (n: 73) with a dermatological disorder other than LP were detected for HCV infection using a third generation enzyme-linked immunosorbent assay (ELISA). A serological positivity for HCV was found in five of LP patients (6.84%), whereas it was positive for only one patient of the control group (1.36%). A statistically significant difference was found between LP and control groups (p < 0.05). We conclude that the coexistence of the two diseases is probably more than coincidental.
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Affiliation(s)
- N Kirtak
- Department of Dermatology, University of Gaziantep, Faculty of Medicine, Turkey
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Abstract
Although lichen planus is a relatively common mucocutaneous disorder in adults, it has only rarely been described in children. Moreover, even less data has been published regarding mucosal lesions in children. Six case reports of childhood oral lichen planus are presented and the available literature reviewed. It is believed that this paper documents the largest series of cases of childhood oral mucosal lichen planus to be reported in the literature to date. Lichen planus should be considered in the differential diagnosis of oral mucosal white patches in children, particularly those of Asian origin.
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Affiliation(s)
- F Alam
- Unit of Oral Medicine, University of Birmingham School of Dentistry, St. Chad's Queensway, Birmingham B4 6NN, UK
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24
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Pemberton MN, Sloan P, Thakker NS. Oral lichenoid lesions after hepatitis B vaccination. ORAL SURGERY, ORAL MEDICINE, ORAL PATHOLOGY, ORAL RADIOLOGY, AND ENDODONTICS 2000; 89:717-9. [PMID: 10846126 DOI: 10.1067/moe.2000.104541] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
The association of mucocutaneous lichen planus and chronic liver disease is widely recognized. The hepatitis B and C viruses have been implicated as being important in this association, although their exact role remains unclear. Recently, lichenoid lesions of the skin after a hepatitis B vaccination have also been reported. In this case, a woman of Southeast Asian origin had lichenoid lesions affecting the oral mucous membranes develop after she was vaccinated against hepatitis B. The lesions appeared 3 weeks after the administration of the third dose of the vaccine and persisted for about 1 year. As the use of the hepatitis B vaccine becomes more widespread, more such cases can be expected to be encountered.
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Affiliation(s)
- M N Pemberton
- Department of Dental Medicine and Surgery, University Dental Hospital of Manchester, Manchester, England
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25
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Abstract
Significant changes were made in 1997 by The Expert Committee on the Diagnosis and Classification of Diabetes Mellitus of the American Association of Diabetes regarding the diagnosis and classification of diabetes mellitus. The terms "insulin-dependent diabetes mellitus" (IDDM) and "non-insulin-dependent diabetes mellitus" (NIDDM) were dropped. The new classification is, in general, based on etiology rather than on treatment and includes four groups: Type I (autoimmune), Type 2 (non-autoimmune), Other specific types, and Gestational diabetes. The fasting blood glucose level for diagnosis was lowered from 140 mg/dL to 126 mg/dL. A random blood glucose of 200 mg/dL or greater in a patient with symptoms of diabetes is diagnostic. Each of these diagnostic tests needs to be repeated on a separate day. The glucose tolerance test is no longer recommended for routine diagnostic use. Recommendations for the screening of diabetes mellitus in presumably healthy individuals are presented. New advances in insulin and its delivery to the diabetic patient are discussed. The impact of diabetes mellitus on the oral cavity is updated.
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26
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Carrozzo M, Gandolfo S, Lodi G, Carbone M, Garzino-Demo P, Carbonero C, Porter SR, Scully C. Oral lichen planus in patients infected or noninfected with hepatitis C virus: the role of autoimmunity. J Oral Pathol Med 1999; 28:16-9. [PMID: 9890452 DOI: 10.1111/j.1600-0714.1999.tb01988.x] [Citation(s) in RCA: 45] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Serum proteins, serum immunoglobulins, anti-nuclear antibodies (ANA), anti-smooth muscle antibodies (ASMA), anti-mitochondrial antibodies (AMA), anti-liver-kidney antibodies (LKM), anti-parietal-cell gastric antibodies (APCA), anti-epithelial antibodies and concomitant autoimmune disease were studied in 27 OLP-HCV+ve subjects and in a comparable group of 23 who were OLP-HCV-ve. In addition, all the patients with chronic liver disease who were sero-positive for ANA, AMA or LKM were scored using the new aggregate scoring system to detect those with the accepted criteria for the diagnosis of autoimmune hepatitis (AIH). Hypergammaglobulinemia was more frequent in OLP-HCV+ve than in OLP-HCV-ve (P = 0.008) subjects. Serum IgG and IgM levels were higher in HCV+ve than in HCV-ve (respectively, P = 0.017 and P = 0.018) individuals. However, there was no difference in the frequency of any autoantibody between OLP-HCV+ve and OLP-HCV-ve patients. Overall, immunologically-related abnormalities were found in 17(63%) OLP-HCV+ve and 11(48%) OLP-HCV-ve (P = 0.43) patients. Three OLP-HCV-ve and no OLP-HCV+ve patients had score criteria of probable AIH. The present and our previous data suggest that OLP patients with HCV infection neither had evidence of autoimmune liver damage nor had abnormal humoral immune-responses, with the exception of higher than control levels of serum immunoglobulins. Cryoglobulins may be responsible.
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Affiliation(s)
- M Carrozzo
- Department of Oral Medicine and Periodontology, School of Medicine and Dentistry, University of Turin, Italy
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27
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28
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Lo Muzio L, Mignogna MD, Favia G, Procaccini M, Testa NF, Bucci E. The possible association between oral lichen planus and oral squamous cell carcinoma: a clinical evaluation on 14 cases and a review of the literature. Oral Oncol 1998. [PMID: 9813716 DOI: 10.1016/s1368-8375(98)80001-8] [Citation(s) in RCA: 87] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Between 1986 and 1996, 263 patients, 156 females and 107 males, affected by oral lichen planus (OLP), were followed at the Division of Oral Medicine and Pathology, University of Naples 'Federico II', Italy, and at the Institute of Dentistry and Maxillofacial Surgery, University of Bari, Italy. During this follow-up, the possible association of OLP with oral squamous cell carcinoma (SCC), together with the possible association of OLP, oral SCC and chronic HCV-hepatitis, were investigated. 14 cases (5.32%) were known to have developed oral SCC: 10 (3.8%) in an area of pre-existing OLP, 3 (1.14%) in other sites, in 1 case the diagnosis of OLP and SCC was synchronous (0.38%). 3 patients were positive for anti-HCV antibody. Many carcinomas were in areas of reticular/plaque OLP. 3 patients had multiple simultaneous sites of oral involvement (21.42%); 5 patients developed oral SCC in different sites during the follow-up period (35.71%). These data, together with a clear histological evidence of progression to carcinoma within OLP lesions, suggest the probability of some cases of at least OLP having an intrinsic property predisposing to neoplastic transformation, confirming previous studies. For these reasons, the authors think that it is necessary to follow-up the patients regularly at least annually and possibly for life for the early diagnosis of a possible neoplastic degeneration. These consideration are particularly important in the case of atrophic or erosive OLP, and plaque OLP, especially when involving the dorsum of tongue.
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Affiliation(s)
- L Lo Muzio
- Institute of Dentistry and Maxillofacial Surgery, University of Bari, Faculty of Medicine, Italy
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29
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Lodi G, Porter SR, Scully C. Hepatitis C virus infection: Review and implications for the dentist. ORAL SURGERY, ORAL MEDICINE, ORAL PATHOLOGY, ORAL RADIOLOGY, AND ENDODONTICS 1998; 86:8-22. [PMID: 9690239 DOI: 10.1016/s1079-2104(98)90143-3] [Citation(s) in RCA: 20] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
OBJECTIVE The purpose of this report was to review the current literature on hepatitis C virus infection, with particular attention to the aspects of interest for dental health care staff. MATERIAL AND METHODS The authors searched original research and review articles on specific aspects of hepatitis C virus infection, including articles on virology, epidemiology, transmission, diagnosis, natural history, extrahepatic manifestations, therapy and oral aspects of hepatitis C virus infection. The relevant material was evaluated and reviewed. RESULTS Hepatitis C virus is an RNA virus that is present throughout the world and has major geographic variations. The virus, transmitted mainly by means of blood contact, causes chronic hepatitis in up to 80% of cases and may give rise to hepatic cirrhosis and hepatocellular carcinoma in a significant proportion of patients. Although it is of limited efficacy, interferon alpha is currently the drug of choice in the treatment of the infection. Hepatitis C virus infection is associated with a number of extrahepatic manifestations that may include oral diseases such as lichen planus or sialadenitis. Although there are documented cases of nosocomial transmission to health care workers after percutaneous exposure, the prevalence of hepatitis C virus among dental staff members is probably similar to that in the general population. CONCLUSION Hepatitis C virus infection is a relatively common infection worldwide (1.4% in the US general population) that causes significant chronic hepatic disease. The dentist is thus likely to face a growing number of patients with a diagnosis of hepatitis C virus infection. For this reason it is essential for dental health care workers to be aware of the principal features of the disease and of its oral and dental implications.
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Affiliation(s)
- G Lodi
- Department of Oral Medicine, Eastman Dental Institute for Oral Health Care Sciences, University of London, United Kingdom
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30
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Ingafou M, Porter SR, Scully C, Teo CG. No evidence of HCV infection or liver disease in British patients with oral lichen planus. Int J Oral Maxillofac Surg 1998; 27:65-6. [PMID: 9506305 DOI: 10.1016/s0901-5027(98)80101-x] [Citation(s) in RCA: 79] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
An association between chronic hepatic disease and/or hepatitis C (HCV) infection and lichen planus (LP) has been described in patients from Italy, Japan and Spain. There are no data on the frequency of the association with HCV in British patients. In the present investigation, the HCV seropositivity and liver function status of 55 British patients with oral LP were assessed and compared with these parameters in 110 healthy control subjects. None of the patients with LP or control subjects had serum IgG antibodies to HCV or had abnormal liver function. It was concluded that while LP may be associated with HCV infection and liver disease in some southern European and other patients, such a co-occurrence was not detected in British patients.
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Affiliation(s)
- M Ingafou
- Department of Oral Medicine, Eastman Dental Institute for Oral Health Care Sciences, University of London, UK
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