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Manchanda Y, Rathi SK, Joshi A, Das S. Oral Lichen Planus: An Updated Review of Etiopathogenesis, Clinical Presentation, and Management. Indian Dermatol Online J 2024; 15:8-23. [PMID: 38283029 PMCID: PMC10810384 DOI: 10.4103/idoj.idoj_652_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2022] [Revised: 07/17/2023] [Accepted: 07/26/2023] [Indexed: 01/30/2024] Open
Abstract
Lichen planus (LP) is a chronic idiopathic immune-mediated inflammatory condition. LP is a heterogeneous disease with varied clinical presentations having different natural history, prognosis, sequelae, and outcomes. It can affect skin, hair, nails, and mucosae. Mucosal LP (including oral LP) tends to be persistent and resistant to treatment, compared to cutaneous LP. Oral LP (OLP) is broadly divided into two main categories: hyperkeratotic (usually asymptomatic) and erosive (commonly symptomatic). It can present with symptoms including odynophagia, dysphagia, dysgeusia, and sensitivity to hot spicy foods. Apart from the superficial epidermal changes, which vary with the type of clinical presentation, histopathologically oral LP shows a unifying similar and consistent feature of a lichenoid interface dermatitis. Recently, researchers have highlighted the critical role played by IL-17 in the pathogenesis of OLP. World Health Organization has categorized oral LP as one of the oral potentially malignant disorders (OPMD), albeit with a low risk of malignant transformation. Also, in the last couple of years there have been various reports on the usage of newer drugs like anti-IL17, anti-IL12/23, anti-IL 23, PDE4 inhibitors, and JAK inhibitors in the management of refractory OLP. The principal aim of treatment still remains to resolve the symptoms, prolong the symptoms free period, and reduce the risk of potential malignant transformation. We have described many new revelations made in recent times regarding the etiopathogenesis, associated conditions as well as management of OLP. Thus, the objective of this review is to present a comprehensive up-to-date knowledge including the recent advances made regarding OLP.
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Affiliation(s)
| | | | - Arun Joshi
- Consultant, Department of Dermatology, Farwaniya Hospital, Kuwait
| | - Sudip Das
- Head of the Department National Medical College, Kolkata, India
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2
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Mosaddad SA, Namanloo RA, Aghili SS, Maskani P, Alam M, Abbasi K, Nouri F, Tahmasebi E, Yazdanian M, Tebyaniyan H. Photodynamic therapy in oral cancer: a review of clinical studies. Med Oncol 2023; 40:91. [PMID: 36749489 DOI: 10.1007/s12032-023-01949-3] [Citation(s) in RCA: 24] [Impact Index Per Article: 24.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2022] [Accepted: 01/08/2023] [Indexed: 02/08/2023]
Abstract
A significant mortality rate is associated with oral cancer, particularly in cases of late-stage diagnosis. Since the last decades, oral cancer survival rates have only gradually improved despite advances in treatment. This poor success rate is mainly due to the development of secondary tumors, local recurrence, and regional failure. Invasive treatments frequently have a negative impact on the aesthetic and functional outcomes of survivors. Novel approaches are thus needed to manage this deadly disease in light of these statistics. In photodynamic therapy (PDT), a light-sensitive medication called a photosensitizer is given first, followed by exposure to light of the proper wavelength that matches the absorbance band of the photosensitizer. The tissue oxygen-induced cytotoxic free radicals kill tumor cells directly, harm the microvascular structure, and cause inflammatory reactions at the targeted sites. In the case of early lesions, PDT can be used as a stand-alone therapy, and in the case of advanced lesions, it can be used as adjuvant therapy. The current review article discussed the uses of PDT in oral cancer therapy based on recent advances in this field.
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Affiliation(s)
- Seyed Ali Mosaddad
- Student Research Committee, School of Dentistry, Shiraz University of Medical Sciences, Shiraz, Iran
| | | | - Seyedeh Sara Aghili
- Student Research Committee, School of Dentistry, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Poorya Maskani
- Dental Research Center, Research Institute of Dental Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mostafa Alam
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Kamyar Abbasi
- Department of Prosthodontics, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Farzad Nouri
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Zahedan University of Medical Sciences, Zahedan, Iran
| | - Elahe Tahmasebi
- Research Center for Prevention of Oral and Dental Diseases, Baqiyatallah University of Medical Sciences, Tehran, Iran
| | - Mohsen Yazdanian
- Research Center for Prevention of Oral and Dental Diseases, Baqiyatallah University of Medical Sciences, Tehran, Iran.
| | - Hamid Tebyaniyan
- Department of Science and Research, Islimic Azade University, Tehran, Iran.
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Sulewska ME, Tomaszuk J, Sajewicz E, Pietruski J, Starzyńska A, Pietruska M. Treatment of Reticular Oral Lichen Planus with Photodynamic Therapy: A Case Series. J Clin Med 2023; 12:jcm12030875. [PMID: 36769523 PMCID: PMC9917588 DOI: 10.3390/jcm12030875] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2022] [Revised: 01/10/2023] [Accepted: 01/16/2023] [Indexed: 01/25/2023] Open
Abstract
OBJECTIVES The aim of the study was to clinically evaluate the efficacy of photodynamic therapy in treatment of the reticular form of oral lichen planus (OLP). MATERIALS AND METHODS Twenty patients aged 40-76, with 40 confirmed OLP lesions in total, underwent photodynamic therapy (PDT) following the authors' own protocol, which used 5% 5-aminolevulinic acid as a photosensitizer applied two hours prior to illumination with a diode lamp emitting light at 630 nm and 300 mW. The therapy comprised of 10 weekly illumination sessions and was clinically evaluated between its completion and the end of a 12-month follow-up. RESULTS While the baseline mean size of all 40 lesions was 2.74 ± 3.03 cm2, it was 2.97 ± 3.4 cm2 for the 30 lesions on the buccal mucosa and 2.02 ± 1.32 cm2 for the remaining 10 on the gingiva and tongue. On completion of the therapy, 37 sites improved, including 14 showing complete remission. From that point, the mean size reduction of 56.2% (1.2 ± 1.4 cm2) rose to 67.88% (0.88 ± 1.3 cm2) 12 months later. CONCLUSIONS The results suggest that ALA-mediated photodynamic therapy was effective for the reticular form of OLP and may become an optional or complementary treatment.
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Affiliation(s)
- Magdalena Ewa Sulewska
- Department of Periodontal and Oral Mucosa Diseases, Medical University of Białystok, ul. Waszyngtona 13, 15-269 Białystok, Poland
- Correspondence:
| | - Jagoda Tomaszuk
- Department of Periodontal and Oral Mucosa Diseases, Medical University of Białystok, ul. Waszyngtona 13, 15-269 Białystok, Poland
| | - Eugeniusz Sajewicz
- Department of Biocybernetics and Biomedical Engineering, Białystok University of Technology, ul. Wiejska 45c, 15-351 Białystok, Poland
| | - Jan Pietruski
- Dental Practice, ul. Waszyngtona 1/34, 15-269 Białystok, Poland
- Department of Oral Surgery, Medical University of Gdańsk, Dębinki 7, 80-211 Gdańsk, Poland
| | - Anna Starzyńska
- Department of Oral Surgery, Medical University of Gdańsk, Dębinki 7, 80-211 Gdańsk, 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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4
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Serafini G, De Biase A, Lamazza L, Mazzucchi G, Lollobrigida M. Efficacy of Topical Treatments for the Management of Symptomatic Oral Lichen Planus: A Systematic Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:1202. [PMID: 36673955 PMCID: PMC9859481 DOI: 10.3390/ijerph20021202] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/09/2022] [Revised: 12/30/2022] [Accepted: 01/05/2023] [Indexed: 06/17/2023]
Abstract
Oral lichen planus (OLP) is a chronic mucosal inflammatory disease associated with T-cell-mediated immunological dysfunction. Symptomatic OLP is a painful condition, and complete healing is often not achieved. The aim of this systematic review was to assess the effectiveness of topical drugs, medications, and other interventions compared to placebo or to other treatments in pain reduction and clinical resolution in adult patients with symptomatic OLP. A detailed electronic literature search was performed through the MEDLINE (PubMed) database between 1 January 2005 and 30 September 2022. Eligible studies were selected based on the inclusion criteria, and a quality assessment was conducted. From 649 titles, 121 articles were selected as abstracts, 75 papers were assessed as full text, along with 15 other papers obtained through a manual search. A total of 15 RCTs were finally included in the review process. Because of the significant heterogeneity in the study design of the included studies, no meta-analysis of the data could be performed. Topical corticosteroids represent the first-line treatment in the management of symptomatic OLP due to their efficacy and minimal adverse effects. Calcineurin inhibitors seem to be equally effective and are indicated in recalcitrant cases, extensive lesions, patients susceptible to oral candidiasis, or cases unresponsive to corticosteroids. Other treatments, such as aloe vera, chamomile, isotretinoin, ozone, and laser therapy, could be beneficial as adjunct therapies in association with first-line treatments.
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Affiliation(s)
- Giorgio Serafini
- Department of Oral and Maxillo Facial Sciences, “Sapienza” University of Rome, Via Caserta 6, 00161 Rome, Italy
| | | | - Luca Lamazza
- Department of Oral and Maxillo Facial Sciences, “Sapienza” University of Rome, Via Caserta 6, 00161 Rome, Italy
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Łukaszewska-Kuska M, Ślebioda Z, Dorocka-Bobkowska B. The effectiveness of topical forms of dexamethasone in the treatment of oral lichen planus- A systematic review. Oral Dis 2022; 28:2063-2071. [PMID: 34273228 DOI: 10.1111/odi.13966] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2021] [Revised: 06/25/2021] [Accepted: 07/14/2021] [Indexed: 01/20/2023]
Abstract
The goal of this systematic review was to assess the efficacy of dexamethasone compared to other treatments in oral lichen planus (OLP). The literature search used the following inclusion criteria: randomized controlled trials (RCT) comparing dexamethasone and other treatment strategies in patients with OLP. The outcome measures included relief of symptoms, decrement of erosive area size, and changes in quality of life. A computer and manual search was performed in Pubmed, Web of Science, and Cochrane Library up to January 31, 2021. The risk of bias was measured with the Revised Cochrane risk-of-bias tool for randomized trials. Eight trials with 131 study participants and 132 controls were identified. The following interventions were compared dexamethasone mouthwash, and 5% methylene blue-mediated photodynamic therapy, low-level laser therapy, amlexanox, clobetasol mouthwash, ketoconazole with amitriptyline, and thalidomide 1% paste. The therapeutic outcomes were more advantageous for dexamethasone in comparison with photodynamic therapy (PDT) (2 RCT) and low-level laser therapy (LLLT). Comparable effects were observed for dexamethasone, amlexanox, thalidomide, and PDT (1 RCT). Clobetasol showed more effective action than dexamethasone. Given the small sample sizes, heterogeneity and the few studies included, there is limited evidence to support the selection of treatment for OLP.
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Affiliation(s)
| | - Zuzanna Ślebioda
- Department of Gerodontology and Oral Pathology, Poznan University of Medical Sciences, Poznan, Poland
| | - Barbara Dorocka-Bobkowska
- Department of Gerodontology and Oral Pathology, Poznan University of Medical Sciences, Poznan, Poland
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Casu C, Murgia MS, Orrù G, Scano A. Photodynamic therapy for the successful management of cyclosporine-related gum hypertrophy: A novel therapeutic option. J Public Health Res 2022; 11:22799036221116177. [PMID: 36226306 PMCID: PMC9549190 DOI: 10.1177/22799036221116177] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2022] [Accepted: 07/09/2022] [Indexed: 11/28/2022] Open
Abstract
Background Drug-induced gingival overgrowth is associated with the intake of three classes of drugs: anticonvulsants, immunosuppressants, and calcium channel blockers. It is clinically characterized by hyperplasia of the gingival connective tissue which appears edematous, bloody, and purplish-red in color. In more severe cases, drug-induced gingival hyperplasia negatively affects the patient's quality of life, making it difficult to eat and practice good oral hygiene. Drug-induced gingival overgrowth therapy is controversial and, in fact, no studies in the literature highlight a well-defined therapeutic protocol. The therapies that are described provide primarily for non-surgical periodontal treatment and second-line surgical treatment. The aim of this work is to highlight a case of drug-induced gingival hyperplasia which was completely resolved thanks to photodynamic therapy which is completely free from side effects. Design and Methods Photodynamic therapy was performed on an 18 year-old female patient with LEDs at a power of 450-470 nm and 5500 mW/cm2 + 7500 mW/cm2, combined with a Curcuma longa-based photosensitizer. A single session was performed, with applications of approximately 30 s for each interdental papilla. Results The patient improved markedly after only one cycle of PDT. There was an absence of clinically detectable inflammation, edema, and rubor of the involved dental papillae. At the 4, 6, and 12 week follow-ups there were no recurrences. Conclusions This case report highlights the first case of drug-induced gingival hypertrophy entirely treated with photodynamic therapy to be described in the literature. Therefore, although it is only a case report, this therapy which is free from side effects should be investigated as an alternative to current therapies.
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Affiliation(s)
- Cinzia Casu
- International Ph.D. in Innovation
Sciences and Technologies, University of Cagliari, Cagliari, Italy,Department of Surgical Science, Oral
Biotechnology Laboratory, University of Cagliari, Cagliari, Italy,Cinzia Casu, International Ph.D. in
Innovation Sciences and Technologies, University of Cagliari, Cagliari, Italy,
Cagliari 09124 Emails: ;
| | | | - Germano Orrù
- Department of Surgical Science, Oral
Biotechnology Laboratory, University of Cagliari, Cagliari, Italy
| | - Alessandra Scano
- Department of Surgical Science, Oral
Biotechnology Laboratory, University of Cagliari, Cagliari, Italy
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Didona D, Caposiena Caro RD, Sequeira Santos AM, Solimani F, Hertl M. Therapeutic strategies for oral lichen planus: State of the art and new insights. Front Med (Lausanne) 2022; 9:997190. [PMID: 36267615 PMCID: PMC9578567 DOI: 10.3389/fmed.2022.997190] [Citation(s) in RCA: 24] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2022] [Accepted: 08/16/2022] [Indexed: 11/24/2022] Open
Abstract
Oral lichen planus (OLP) is a chronic inflammatory disease of the oral mucosa. Several clinical subtypes of OLP have been reported, including the reticular and erosive one. On the one hand, reticular OLP is usually asymptomatic and is characterized by white streaks surrounded by well-defined erythematous borders. On the other hand, erosive OLP shows ulcerations and erosions surrounded by erythematous mucosa. While reticular OLP is relatively easy to control, erosive OLP is extremely painful and refractory to therapies, limiting the quality of life of the patients. In addition, treating erosive OLP is extremely tricky, and a gold standard treatment has not yet been established. However, several therapeutic approaches have been reported as effective, including systemic corticosteroids, systemic retinoids, and anti-interleukin (IL)-17/anti-IL-23 drugs. Indeed, our group and other several authors reported the effectiveness of anti-IL17, anti-IL12/23, and anti-IL23 agents in refractory OLP, highlighting the urgency of clinical studies on the use of anti-IL agents in OLP patients. In this paper, we reviewed the English- and German-language literature about therapeutic strategies for treating OLP, focusing on new systemic therapies for erosive OLP.
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Affiliation(s)
- Dario Didona
- Department of Dermatology and Allergology, Philipps-Universität Marburg, Marburg, Germany,*Correspondence: Dario Didona
| | | | | | - Farzan Solimani
- Department of Dermatology, Venereology and Allergology, Charité-Universitätsmedizin Berlin, Berlin, Germany,Berlin Institute of Health at Charité - Universitátsmedizin Berlin, BIH Biomedical Innovation Academy, BIH Charité Clinician Scientist Program, Berlin, Germany
| | - Michael Hertl
- Department of Dermatology and Allergology, Philipps-Universität Marburg, Marburg, Germany
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Saleh W, Khashaba O. Clinical responses of patients with systemic diseases to the photodynamic therapy of oral lichen planus. Photodiagnosis Photodyn Ther 2022; 39:102972. [PMID: 35732242 DOI: 10.1016/j.pdpdt.2022.102972] [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: 05/19/2022] [Revised: 06/14/2022] [Accepted: 06/15/2022] [Indexed: 11/16/2022]
Abstract
BACKGROUND Oral lichen planus (OLP) is a chronic disease commonly detected in older aged patients with female predominance. Treatment of OLP in diabetic and hypertensive patients usually shows some difficulties which require a more safe and effective treatment modality such as Photodynamic therapy (PDT). The current study aims to evaluate the role of PDT in treating OLP in diabetic and hypertensive patients. METHODS We evaluated the role of PDT in treating erosive OLP of type 2 diabetic and hypertensive patients. The following parameters were evaluated for each case at the time zero, after2 weeks, and 4 weeks of the study: subjective responses, objective responses, and the size of the lesion. RESULTS Our study included 9 diabetic and 7hypertensive patients with an age range of 30:60 years old. There were statistically significant differences between the diabetic and hypertensive patients in the objective response, area of ulceration, and the area of erythema at the end of the 4th week of the study (p<0.05). CONCLUSION PDT is an effective treatment modality for diabetic and hypertensive patients with no side effects or patient discomfort.
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Affiliation(s)
- Wafaa Saleh
- Oral Medicine, Periodontology, Diagnosis and Oral Radiology Department, Faculty of Dentistry, Mansoura University, Egypt, 33516..
| | - Omar Khashaba
- Oral Medicine, Periodontology, Diagnosis and Oral Radiology Department, Faculty of Dentistry, Mansoura University, Egypt, 33516
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Saberi S, Khoobi M, Alaeddini M, Etemad-Moghadam S, Jamshidloo R, Mohammadpour H, Shahabi S. The effect of photodynamic therapy on head and neck squamous cell carcinoma cell lines using spirulina platensis with different laser energy densities. Photodiagnosis Photodyn Ther 2021; 37:102688. [PMID: 34910993 DOI: 10.1016/j.pdpdt.2021.102688] [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] [Received: 07/31/2021] [Revised: 12/08/2021] [Accepted: 12/10/2021] [Indexed: 12/21/2022]
Abstract
BACKGROUND Considering the anti-cancer properties of spirulina platensis (S. platensis), we aimed to investigate the effectiveness of this algae as a novel natural photosensitizer for photodynamic therapy (PDT) against oral and hypopharyngeal cancer cells. The appropriate laser energy density to apply during PDT was also determined. METHODS AND MATERIALS CAL-27, FaDu and HGF cell lines were exposed to S. platensis with concentrations of 0.3 g/l and 0.6 g/l and were irradiated with 635 nm diode laser using 2, 4, 12, and 24 J/cm2 energy densities with constant power. MTT assay was performed to investigate cell viability and cytotoxicity after 24 h. The results were analyzed using two-way ANOVA and post hoc Tukey tests (P-value<0.05). RESULTS survival rate in CAL-27 (P-Value<0.001) and FaDu (P-Value<0.001) cell lines were significantly different following irradiation with various laser energy densities. Different concentrations of S. platensis had no significant effect on the viability of CAL-27 cells (P-Value=0.158) and FaDu cells (P-Value=0.072) and showed no significant cytotoxicity against HGF cells, with or without laser. CONCLUSION S. platensis could be considered as a novel safe and effective natural photosensitizer for cancer PDT with no cytotoxic effect on normal cells. When combined with laser using appropriate energy densities, it has the ability to induce death in oral and hypopharyngeal cancer cell lines.
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Affiliation(s)
- Sogol Saberi
- Laser Research Center of Dentistry, Dentistry Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Mehdi Khoobi
- Department of Radiopharmacy, Faculty of Pharmacy, Tehran University of Medical Sciences, Tehran, Iran; Biomaterials Group, Pharmaceutical Sciences Research Center, The Institute of Pharmaceutical Sciences (TIPS), Tehran University of Medical Sciences, Tehran, 1417614411, Iran
| | - Mojgan Alaeddini
- Dental Research Center, Dentistry Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Shahroo Etemad-Moghadam
- Dental Research Center, Dentistry Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Rahele Jamshidloo
- Department of Management, Hidaj Branch, Islamic Azad University, Hidaj, Iran
| | - Hadiseh Mohammadpour
- Dental Research Center, Dentistry Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Sima Shahabi
- Laser Research Center of Dentistry, Dentistry Research Institute, Tehran University of Medical Sciences, Tehran, Iran; Department of Dental Biomaterials, School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran.
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Villa TG, Sánchez-Pérez Á, Sieiro C. Oral lichen planus: a microbiologist point of view. Int Microbiol 2021; 24:275-289. [PMID: 33751292 PMCID: PMC7943413 DOI: 10.1007/s10123-021-00168-y] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2020] [Revised: 02/15/2021] [Accepted: 02/16/2021] [Indexed: 02/06/2023]
Abstract
Oral lichen planus (OLP) is a chronic disease of uncertain etiology, although it is generally considered as an immune-mediated disease that affects the mucous membranes and even the skin and nails. Over the years, this disease was attributed to a variety of causes, including different types of microorganisms. This review analyzes the present state of the art of the disease, from a microbiological point of view, while considering whether or not the possibility of a microbial origin for the disease can be supported. From the evidence presented here, OLP should be considered an immunological disease, as it was initially proposed, as opposed to an illness of microbiological origin. The different microorganisms so far described as putative disease-causing agents do not fulfill Koch’s postulates; they are, actually, not the cause, but a result of the disease that provides the right circumstances for microbial colonization. This means that, at this stage, and unless new data becomes available, no microorganism can be envisaged as the causative agent of lichen planus.
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Affiliation(s)
- Tomás G. Villa
- Department of Microbiology, Faculty of Pharmacy, University of Santiago de Compostela, 15706 Santiago de Compostela, EU Spain
| | - Ángeles Sánchez-Pérez
- Sydney School of Veterinary Science, Faculty of Science, University of Sydney, Camperdown, NSW 2006 Australia
| | - Carmen Sieiro
- Department of Functional Biology and Health Sciences, Microbiology Area, Faculty of Biology, University of Vigo, 36310 Vigo, Pontevedra, EU Spain
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Wang B, Fan J, Wang L, Chai L. Photobiomodulation Therapy/Photodynamic Therapy Versus Steroid Therapy for Oral Lichen Planus: A Systematic Review and Meta-Analysis. PHOTOBIOMODULATION PHOTOMEDICINE AND LASER SURGERY 2021; 39:145-154. [PMID: 33601953 DOI: 10.1089/photob.2020.4930] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
Objective: To evaluate the efficiency of photobiomodulation therapy (PBMT) or photodynamic therapy (PDT) in treating oral lichen planus (OLP) as well as identifiy the side effects when compared with steroid therapy. Background: Nowadays, PBMT and PDT are increasingly applied for treating OLP with minimal adverse effects. Methods: The electronic databases of PubMed, Cochrane Central Register of Controlled Trial, Web of Science, and Embase were searched until March 13, 2020. Randomized controlled trials (RCTs) with 1 month of follow-up period were selected. Two reviewers extracted data from selected studies independently. Cochrane collaboration's tool for assessing risk of bias was used for assessing the quality of the RCTs. The random-effects model was employed for meta-analysis. Results: One thousand fifteen studies were initially identified. Finally, nine RCTs were included for quality assessment and seven studies for meta-analysis. Four RCTs were of unclear risk of bias and five were assessed as high risk of bias. The comparison showed no significant differences for pain scores [visual analog scale (VAS)] [mean differences (MD) = 0.38, confidence interval (CI) = 95% -0.64 to 1.40] and severity scores (reticular-atrophic-erosive scores) (MD = 1.67, CI = 95% -1.13 to 4.46) between topical corticosteroid therapy and PBMT after 1 month. For PDT, no significant differences were observed for sign scores (Thongprasm sign scoring) (MD = -0.31, CI = 95% -1.52 to 0.91) and pain scores (VAS) (MD = -2.30, CI = 95% -5.88 to 1.28) of the lesions when compared with topical corticosteroid therapy after 1 month of follow-up period. One study reported the discomfort of the affected area in patients of the PDT group when probe tip was moved. Conclusions: PBMT and PDT could be reliable alternatives to topical corticosteroids for OLP with no or less severe complications in a short-term period. However, further well-designed RCTs with long-term period are recommended to consolidate the conclusions in this regard.
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Affiliation(s)
- Bingjie Wang
- Department of Stomatology, The Affiliated People's Hospital of Ningbo University (Ningbo Yinzhou People's Hospital), Ningbo, China
| | - Jiayan Fan
- Department of Stomatology, Ningbo No.2 Hospital, Ningbo, China
| | - Liang Wang
- Department of Stomatology, Ningbo No.2 Hospital, Ningbo, China
| | - Luyi Chai
- Department of Stomatology, The Affiliated People's Hospital of Ningbo University (Ningbo Yinzhou People's Hospital), Ningbo, China
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12
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Wang X, Zhao Z, Tang N, Zhao Y, Xu J, Li L, Qian L, Zhang J, Fan Y. Microbial Community Analysis of Saliva and Biopsies in Patients With Oral Lichen Planus. Front Microbiol 2020; 11:629. [PMID: 32435231 PMCID: PMC7219021 DOI: 10.3389/fmicb.2020.00629] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2019] [Accepted: 03/20/2020] [Indexed: 12/25/2022] Open
Abstract
The specific etiology and pathogenesis of oral lichen planus (OLP) remain elusive, and microbial dysbiosis may play an important role in OLP. We evaluated the saliva and tissue bacterial community of patients with OLP and identified the colonization of bacteria in OLP tissues. The saliva (n = 60) and tissue (n = 24) samples from OLP patients and the healthy controls were characterized by 16S rDNA gene sequencing and the bacterial signals in OLP tissues were detected by fluorescence in situ hybridization (FISH) targeting the bacterial 16S rDNA gene. Results indicate that the OLP tissue microbiome was different from the microbiota of OLP saliva. Compared with the healthy controls, Capnocytophaga and Gemella were higher in OLP saliva, while Escherichia–Shigella and Megasphaera were higher in OLP tissues, whereas seven taxa, including Carnobacteriaceae, Flavobacteriaceae, and Megasphaera, were enriched in both saliva and tissues of OLP patients. Furthermore, FISH found that the average optical density (AOD) of bacteria in the lamina propria of OLP tissues was higher than that of the healthy controls, and the AOD of bacteria in OLP epithelium and lamina propria was positively correlated. These data provide a different perspective for future investigation on the OLP microbiome.
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Affiliation(s)
- Xuewei Wang
- Jiangsu Key Laboratory of Oral Diseases, Nanjing Medical University, Nanjing, China.,Department of Oral Medicine, Affiliated Hospital of Stomatology, Nanjing Medical University, Nanjing, China
| | - Zhibai Zhao
- Jiangsu Key Laboratory of Oral Diseases, Nanjing Medical University, Nanjing, China.,Department of Oral Medicine, Affiliated Hospital of Stomatology, Nanjing Medical University, Nanjing, China
| | - Nan Tang
- Jiangsu Key Laboratory of Oral Diseases, Nanjing Medical University, Nanjing, China.,Department of Oral Medicine, Affiliated Hospital of Stomatology, Nanjing Medical University, Nanjing, China
| | - Yuping Zhao
- Jiangsu Key Laboratory of Oral Diseases, Nanjing Medical University, Nanjing, China.,Department of Oral Medicine, Affiliated Hospital of Stomatology, Nanjing Medical University, Nanjing, China
| | - Juanyong Xu
- Jiangsu Key Laboratory of Oral Diseases, Nanjing Medical University, Nanjing, China.,Department of Oral Medicine, Affiliated Hospital of Stomatology, Nanjing Medical University, Nanjing, China
| | - Liuyang Li
- Jiangsu Key Laboratory of Oral Diseases, Nanjing Medical University, Nanjing, China.,Department of Oral Medicine, Affiliated Hospital of Stomatology, Nanjing Medical University, Nanjing, China
| | - Ling Qian
- Jiangsu Key Laboratory of Oral Diseases, Nanjing Medical University, Nanjing, China.,Department of Oral Medicine, Affiliated Hospital of Stomatology, Nanjing Medical University, Nanjing, China
| | - Junfeng Zhang
- Medical School, Nanjing University of Chinese Medicine, Nanjing, China
| | - Yuan Fan
- Jiangsu Key Laboratory of Oral Diseases, Nanjing Medical University, Nanjing, China.,Department of Oral Medicine, Affiliated Hospital of Stomatology, Nanjing Medical University, Nanjing, China
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13
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Andreadis D, Pavlou AM, Vakirlis E, Anagnostou E, Vrani F, Poulopoulos A, Kolokotronis A, Ioannidis D, Sotiriou E. Daylight photodynamic therapy for the management of actinic cheilitis. Arch Dermatol Res 2020; 312:731-737. [PMID: 32266532 DOI: 10.1007/s00403-020-02069-y] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2019] [Accepted: 03/30/2020] [Indexed: 12/20/2022]
Abstract
Early identification and adequate treatment of actinic cheilitis (AC), which affects the lower lip vermillion and is considered a precursor of squamous cell carcinoma, is mandatory. Photodynamic therapy (PDT) has been successfully used in AC. PDT with the use of daylight (DLPDT) is equally effective and more convenient than the conventional PDT. Data on short and long-term efficacy of DLPDT in AC are limited. Our primary purpose was to assess efficacy of DLPDT in AC as well as safety and tolerance. Twenty-two individuals with histologically confirmed AC received 2 MAL (5-aminolevulinic acid)-DLPDT sessions 1 week apart. Patients were evaluated clinically 3, 6, and 12 months after treatment. Non-complete responders were biopsied and excluded from the study if histological alterations were indicative of AC. Adverse events were recorded from baseline to the end of the 12-month follow-up period. Twenty patients completed the study. Overall, complete clinical response 12 months after treatment was 80% (16/20), while an association between treatment response and grade of dysplasia was observed (p = 0.016). With respect to response by grade, complete clinical response achieved in grade I AC was 100% (12/12) and 50% (4/8) in grade II AC. Main adverse events included mild erythema, oedema, and scaling, with no pain associated with DLPDT. According to our results, DLPDT seems to be of significant benefit for the treatment of grade I AC. Combination with the other treatment modalities could improve the efficacy in grade II AC. Further studies are needed for the assessment of late recurrences.
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Affiliation(s)
- Dimitrios Andreadis
- Department of Oral Medicine/Pathology, School of Dentistry, Aristotle University of Thessaloniki, Thessaloniki, Greece.
| | - Achilleia -Maria Pavlou
- Department of Oral Medicine/Pathology, School of Dentistry, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Efstratios Vakirlis
- First Dermatology Department, Medical School, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Eleftherios Anagnostou
- Department of Oral Medicine/Pathology, School of Dentistry, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Fotini Vrani
- First Dermatology Department, Medical School, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Athanasios Poulopoulos
- Department of Oral Medicine/Pathology, School of Dentistry, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Alexandros Kolokotronis
- Department of Oral Medicine/Pathology, School of Dentistry, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Dimitrios Ioannidis
- First Dermatology Department, Medical School, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Elena Sotiriou
- First Dermatology Department, Medical School, Aristotle University of Thessaloniki, Thessaloniki, Greece
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14
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Lavaee F, Shadmanpour M. Comparison of the effect of photodynamic therapy and topical corticosteroid on oral lichen planus lesions. Oral Dis 2019; 25:1954-1963. [PMID: 31478283 DOI: 10.1111/odi.13188] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2019] [Revised: 07/31/2019] [Accepted: 08/06/2019] [Indexed: 11/30/2022]
Abstract
OBJECTIVE In this study, the effect of photodynamic therapy with topical corticosteroid in oral lichen planus patients was compared. MATERIAL AND METHODS In this randomized, double-blind clinical trial, eight patients with bilateral oral OLP lesions were recruited. Toluidine blue was applied on the lesions of both sides; a 660-nm diode laser InGaAlP was irradiated for 10 min (power: 25 mW, fluence: 19.23 J/cm2 , probe cross section: 0.78 cm2 ) for three sessions. In the control side of the oral mucosa, only sham laser was used. Follow-up sessions were held on weeks 3 and 7. In week 3, oral paste triamcinolone acetonide 0.1% was prescribed. Response rates were assessed clinically by VAS, Thongprasom sign scoring, clinical severity index, efficacy indices, and the amount of reduction in the size of the lesions. The Mann-Whitney test was used to evaluate the treatment outcomes. RESULTS In spite of the control side, all scores improved significantly between sessions 0 and 4 for the intervention side. The differences between the changes in almost all scores between sessions 0 and 4 in both the intervention and control sides were significantly considerable (p value < .05). CONCLUSION Photodynamic therapy can be used as an alternative therapy alongside standard methods or as a new modality for refractory OLP.
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Affiliation(s)
- Fatemeh Lavaee
- Oral and Dental Disease Research Center, Oral and Maxillofacial Medicine Department, School of Dentistry, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Maryam Shadmanpour
- Orthodontics Department, School of Dentistry, Shiraz University of Medical Sciences, Shiraz, Iran
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15
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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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16
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Cassol-Spanemberg J, Blanco-Carrión A, Rodríguez-de Rivera-Campillo ME, Estrugo-Devesa A, Jané-Salas E, López-López J. Cutaneous, genital and oral lichen planus: A descriptive study of 274 patients. Med Oral Patol Oral Cir Bucal 2019; 24:e1-e7. [PMID: 30573709 PMCID: PMC6344000 DOI: 10.4317/medoral.22656] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2018] [Accepted: 11/13/2018] [Indexed: 12/20/2022] Open
Abstract
Background Lichen planus (LP) is a chronic autoimmune disease that affects the oral mucosa as well as the skin, genital mucosa and other sites. Objective: to evaluate the correlation between oral, genital and cutaneous lichen planus, in a sample of LP patients. Material and Methods This descriptive study reviewed 274 clinical histories of patients, who all presented histological confirmation of lichen planus verified by a pathologist, attending research centers in Barcelona. Results A total of 40 LP patients (14.59%) presented genital lesions. Of 131 patients with cutaneous LP (47.8%), the most commonly affected zones were the body’s flexor surfaces, representing 60.1% of cases. 24% of patients (n=55) related the start of the lesions with previous stress events. Of the 131 subjects with cutaneous lesions, 19% (n=25) also presented oral lichen planus (OLP). Of the total sample, 53.6% (n=147) of patients presented oral lesions. The systemic diseases most commonly associated with this patient sample were psychological problems such as stress, anxiety and depression (48%), hypertension (27%), gastric problems (12%), and diabetes (9.7%). A family history of lichen planus was found in only 2 cases (0,72%) out of the total of 274. Conclusions Any patient with OLP should undergo a thorough history and examination to investigate potential extraoral manifestations. The fact that 37 patients with OLP in this patient series were identified with simultaneous involvement at more than one site highlights the need for thorough evaluation and multidisciplinary approaches to this disease. Key words:Oral lichen planus, extra-oral manifestations, cutaneous lichen planus, genital lichen planus.
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Affiliation(s)
- J Cassol-Spanemberg
- Bellvitge University Campus, Department of Dental Medicine - School of Dentistry, Pabellón de Gobierno, C/. Feixa LLarga s/n, 08907 L'Hospitalet de Llobregat, Barcelona - Spain,
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17
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Vieira DL, Leite AF, Figueiredo PTDS, Vianna LM, Moreira-Mesquita CR, de Melo NS. A Conservative Approach for Localized Spongiotic Gingivitis Hyperplasia Using Photodynamic Therapy: A Case Report and Review of the Literature. PHOTOBIOMODULATION PHOTOMEDICINE AND LASER SURGERY 2019; 37:57-61. [DOI: 10.1089/photob.2018.4454] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Affiliation(s)
- Danielle Leal Vieira
- Department of Dentistry, Faculty of Health Sciences, University of Brasília, Brasília, Brazil
| | - André Ferreira Leite
- Department of Dentistry, Faculty of Health Sciences, University of Brasília, Brasília, Brazil
| | | | - Leonora Maciel Vianna
- Department of Pathology, Pathological Anatomy Center, University Hospital of Brasilia, University of Brasília, Brasília, Brazil
| | | | - Nilce Santos de Melo
- Department of Dentistry, Faculty of Health Sciences, University of Brasília, Brasília, Brazil
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18
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Vieira DL, Leite AF, de Souza Figueiredo PT, Vianna LM, Moreira-Mesquita CR, de Melo NS. A Conservative Approach for Localized Spongiotic Gingivitis Hyperplasia Using Photodynamic Therapy: A Case Report and Review of the Literature. Photomed Laser Surg 2018:pho.2018.4454. [PMID: 30335567 DOI: 10.1089/pho.2018.4454] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
OBJECTIVE To describe a clinical case of successful conservative management of Localized Juvenile Spongiotic Gingivitis Hyperplasia (LJSGH) using photodynamic therapy (PDT) and reviews the current literature on this pathology. BACKGROUND DATA LJSGH is a recently described rare disease with controversial treatment results. As of today, 13 publications report surgical treatment approaches. The use of CO2 laser and cryotherapy was reported only in one study. The use of PDT was not previously reported. PATIENTS AND METHODS A 9-year-old male patient was referred to our institution with the chief complaint of asymptomatic "inflamed gingiva" starting 1 year before. Clinical examination revealed an erythematous line accompanying the gingival contour, with a certain degree of hyperplasia. The diagnosis of LJSGH was performed based on clinical features and later confirmed histopathologically. A novel approach using PDT was then proposed. The photosensitizer was methylene blue, and a semiconductor laser diode was used. RESULTS One week after starting PDT, gingival hyperplasia was partially reduced. Immediately after the end of treatment, a significant reduction of gingival hyperplasia was observed. PDT proved to be safe, quick and painless, with no esthetic harm. CONCLUSIONS This case illustrates the benefit of a more conservative approach as opposed to surgical procedure, with good clinical response and decreased morbidity over a 2-year follow-up period.
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Affiliation(s)
- Danielle Leal Vieira
- 1 Department of Dentistry, Faculty of Health Sciences, University of Brasília , Brasília, Brazil
| | - André Ferreira Leite
- 1 Department of Dentistry, Faculty of Health Sciences, University of Brasília , Brasília, Brazil
| | | | - Leonora Maciel Vianna
- 2 Department of Pathology, Pathological Anatomy Center, University Hospital of Brasilia, University of Brasília , Brasília, Brazil
| | | | - Nilce Santos de Melo
- 1 Department of Dentistry, Faculty of Health Sciences, University of Brasília , Brasília, Brazil
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19
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Progress in the development of nanosensitizers for X-ray-induced photodynamic therapy. Drug Discov Today 2018; 23:1791-1800. [DOI: 10.1016/j.drudis.2018.05.029] [Citation(s) in RCA: 41] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2018] [Revised: 05/09/2018] [Accepted: 05/21/2018] [Indexed: 12/29/2022]
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20
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Rakesh N, Clint JB, Reddy SS, Nagi R, Chauhan P, Sharma S, Sharma P, Kaur A, Shetty B, Ashwini S, Pavan Kumar T, Vidya GS. Clinical evaluation of photodynamic therapy for the treatment of refractory oral Lichen planus - A case series. Photodiagnosis Photodyn Ther 2018; 24:280-285. [PMID: 30261326 DOI: 10.1016/j.pdpdt.2018.09.011] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2018] [Revised: 08/08/2018] [Accepted: 09/21/2018] [Indexed: 12/28/2022]
Abstract
Oral lichen planus (OLP) is a chronic inflammatory, immune mediated mucocutaneous disorder of uncertain etiology. Psychologic stress has been found to be a main contributing factor in onset and progression of lesions. Most erosive OLP patients are refractory to available therapies, even corticosteroids, and report remarkable side effects. As photodynamic therapy (PDT) has proved it to be an effective and safe alternative treatment of abnormal or neoplastic cells we employed PDT for this diagnosis. Due to limited literature on application of this method for treatment of refractory erosive OLP, we present a series of 10 cases of bilateral erosive LP treated by 5 -Aminolevulinic acid mediated PDT. Outcome of our clinical cases showed remarkable improvement in lesions with reduction in Reticulation, Erythema, Ulceration (REU) score (from 5 to 3) and burning sensation as recorded by Visual Analogue Scale (Pretreatment VAS ranged from 5 to 8, posttreatment VAS was 0-1). PDT could be used as a complementary treatment method for symptomatic resistant OLP lesions, although our findings necessitate further research to validate the efficacy of this method for control of resistant oral lichen planus.
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Affiliation(s)
- N Rakesh
- Dental and Maxillofacial Modeling and Simulation Center, Department of Oral Medicine and Radiology, Faculty of Dental Sciences, M.S. Ramaiah University of Applied Sciences, Bangalore, Karnataka
| | - Joseph Ben Clint
- Department of Oral Medicine and Radiology, Faculty of Dental Sciences, M.S. Ramaiah University of Applied Sciences, Bangalore, Karnataka
| | - Sujatha S Reddy
- Department of Oral Medicine and Radiology, Faculty of Dental Sciences, M.S. Ramaiah University of Applied Sciences, Bangalore, Karnataka
| | - Ravleen Nagi
- Department of Oral Medicine and Radiology, New Horizon Dental College and Research Institute, Sakri, Bilaspur.
| | - Pallavi Chauhan
- Department of Oral Medicine and Radiology, Faculty of Dental Sciences, M.S. Ramaiah University of Applied Sciences, Bangalore, Karnataka
| | | | - Pushphanjali Sharma
- Department of Oral Medicine and Radiology, Faculty of Dental Sciences, M.S. Ramaiah University of Applied Sciences, Bangalore, Karnataka
| | | | - Bhavya Shetty
- Department of Periodontology, Faculty of Dental Sciences, M.S. Ramaiah University of Applied Sciences, Bangalore, Karnataka
| | - S Ashwini
- Department of Periodontology, Faculty of Dental Sciences, M.S. Ramaiah University of Applied Sciences, Bangalore, Karnataka
| | - T Pavan Kumar
- Department of Oral Medicine and Radiology, Faculty of Dental Sciences, M.S. Ramaiah University of Applied Sciences, Bangalore, Karnataka
| | - G S Vidya
- Chief Consulting Surgeon, Sree NRJV Specialists Dental Clinic, Bangalore, Karnataka
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21
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Liu WB, Sun LW, Yang H, Wang YF. Treatment of oral lichen planus using 308-nm excimer laser. Dermatol Ther 2017; 30. [PMID: 28833900 DOI: 10.1111/dth.12510] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2016] [Revised: 04/23/2017] [Accepted: 05/02/2017] [Indexed: 01/22/2023]
Affiliation(s)
- Wei-Bing Liu
- Department of Dermatology; 404 Hospital of People's Liberation Army; Weihai Shandong Provence 262200 China
| | - Li-Wei Sun
- Department of Dermatology; 404 Hospital of People's Liberation Army; Weihai Shandong Provence 262200 China
| | - Hua Yang
- Department of Dermatology; 404 Hospital of People's Liberation Army; Weihai Shandong Provence 262200 China
| | - Yan-Fei Wang
- Department of Dermatology; 404 Hospital of People's Liberation Army; Weihai Shandong Provence 262200 China
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22
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Bakhtiari S, Azari-Marhabi S, Mojahedi SM, Namdari M, Rankohi ZE, Jafari S. Comparing clinical effects of photodynamic therapy as a novel method with topical corticosteroid for treatment of Oral Lichen Planus. Photodiagnosis Photodyn Ther 2017; 20:159-164. [PMID: 28669793 DOI: 10.1016/j.pdpdt.2017.06.002] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2016] [Revised: 05/07/2017] [Accepted: 06/08/2017] [Indexed: 01/27/2023]
Abstract
BACKGROUND Oral lichen planus is an autoimmune disorder with several challenges in treatment. Photodynamic therapy has been proposed as a new treatment option for the disease. AIM The present study compared the clinical effects of photodynamic therapy to dexamethasone mouthwash in the treatment of oral lichen planus lesions. MATERIALS AND METHODS In this randomized clinical trial, 30 patients with oral lichen planus were included.15 patients were treated with 5% methylene blue mediated photodynamic therapy using Fotosan device for 30s (630nm wavelength and 7.2-14.4J/cm2 dose) for 4 sessions in the days 1, 4, 7, 14. In another group, the treatment was done on 15 patients by 0.5mg tab dexamethasone solution in 5cc water, rinsed 4 times in a day within two weeks. The sign score, symptoms scores (pain), clinical severity and treatment efficacy were measured at the days 15, 30, 60, 90 after beginning of the treatment. The results were subjected to Mann-whitney U test in both groups. RESULTS No significant difference existed between the two modalities regarding the treatment efficacy index, sign score, symptom score and clinical severity on the 15, 30, 60 and 90 post-treatment days. Decreases in patient's symptoms were statistically significant in both groups. CONCLUSION Photodynamic therapy was as effective as the dexamethasone mouth wash in the treatment of oral lichen planus. It could be used as a safe modality in the treatment of oral lichen planus lesions without identified side effects.
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Affiliation(s)
- Sedigheh Bakhtiari
- Department of Oral and Maxillofacial Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Saranaz Azari-Marhabi
- Department of Oral and Maxillofacial Medicine, School of Dentistry, Qom University of Medical Sciences, Qom, Iran
| | - Seyyed Masoud Mojahedi
- Department of Laser, Dental School, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mahshid Namdari
- Department of Biostatistics, Faculty of Paramedical Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Zahra Elmi Rankohi
- Department of Oral and Maxillofacial Medicine, Guilan University of Medical Sciences, Rasht, Iran.
| | - Soudeh Jafari
- Department of Oral and Maxillofacial Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Assessment of in vivo experiments: The newly synthesized porphyrin with proper light source enhanced effectiveness of PDT comparing to 5-ALA-mediated PDT. Photodiagnosis Photodyn Ther 2017; 18:179-184. [DOI: 10.1016/j.pdpdt.2017.02.014] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2016] [Revised: 02/07/2017] [Accepted: 02/26/2017] [Indexed: 01/02/2023]
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24
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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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25
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Mostafa D, Moussa E, Alnouaem M. Evaluation of photodynamic therapy in treatment of oral erosive lichen planus in comparison with topically applied corticosteroids. Photodiagnosis Photodyn Ther 2017; 19:56-66. [PMID: 28450262 DOI: 10.1016/j.pdpdt.2017.04.014] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2017] [Accepted: 04/24/2017] [Indexed: 01/04/2023]
Abstract
BACKGROUND The treatment of erosive oral lichen planus represents a therapeutic challenge. Despite numerous existing remedies, some of these treatments display disappointing results. Since it is a chronic disease with no current cure, the best treatment should target mainly the reduction of the duration and severity of symptomatic outbreaks with minimal side effects. To date, corticosteroids remain the first choice of treatment for oral lichen planus (OLP) patients. Although, topical corticosteroids have been found to be the safest and the most successful agents in the treatment of OLP, their prolonged use may cause mucosal problems and may lead to systemic complications. Recently, the use of photodynamic therapy has been well introduced in the treatment of oral diseases. Our clinical study was done to evaluate clinically the effect of photodynamic therapy mediated by methylene blue (MB-PDT) on signs and symptoms of erosive oral lichen planus (EOLP) lesions in comparison with the conventional topical corticosteroids (TC) treatment. The present work tried this recent modality of treatment to overcome the disadvantages of TC. MATERIAL AND METHODS Twenty patients with clinical and histological diagnosis of EOLP were selected from Oral Medicine and periodontology department in Faculty of Dentistry, Alexandria University in a randomized parallel study design. They were divided into two groups; group A (control group) involved ten patients who were instructed to use the conventional TC (kenakort A-orabase). While, group B (study group) contained ten patients who received PDT using diode laser 660nm mediated by methylene blue (MB). RESULTS Both groups presented statistically significant difference from baseline to follow up periods. But, the MB-PDT in treatment of EOLP showed more remarkable reduction in pain and lesion scores in comparison with corticosteroids treatment. CONCLUSION The results of this study allow the conclusion that the MB-PDT is considered to be a better treatment for OELP in comparison with TC because it is much more effective in pain reduction and lesion regression.
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Affiliation(s)
- Diana Mostafa
- Department of Preventive Dental Sciences, Al-Farabi Colleges, Riyadh, Saudi Arabia.
| | - Eglal Moussa
- Professor of Oral Medicine Department, Faculty of Dentistry, Alexandria University, Egypt
| | - Manal Alnouaem
- Professor of Oral Pathology Department, Faculty of Dentistry, Alexandria University, Egypt
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Andreadis D, Pavlou AM, Sotiriou E, Vrani F, Ioannides D, Kolokotronis A. Utility of photodynamic therapy for the management of oral potentially malignant disorders and oral cancer. TRANSLATIONAL RESEARCH IN ORAL ONCOLOGY 2016. [DOI: 10.1177/2057178x16669161] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
Photodynamic therapy (PDT), defined as “the light-induced inactivation of cells, microorganisms, or molecules,” combines the use of a photosensitive agent or photosensitizer (PS) activated by irradiation with a light source to produce reactive oxygen species and highly reactive singlet oxygen. PDT has been used for the treatment of different oral diseases with promising results. This review describes the basic principles of PDT, including the nature of PS and the light sources, and focuses on evaluating the efficacy of this method, according to the existing data, for the treatment of different oral diseases. PubMed was used as the source of the relevant literature, about the clinical application of PDT in actinic cheilitis (AC), leukoplakia, oral lichen planus, oral lichenoid lesions, and oral cancer. Complete response to PDT as high as 100% has been reported not only in cases of AC but also in dysplasias/carcinomas in situ, T1N0, and T2N0. According to the available data, PDT appears to be a safe, well-tolerated therapy with limited adverse effects and excellent cosmetic outcome. Although PDT is a very promising therapy, further research is needed in order to investigate the cases that fail to respond, to examine the long-term prognosis for cases of reported complete response and thus avoid the future recurrence of diseases.
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Affiliation(s)
- Dimitrios Andreadis
- Department of Oral Medicine/Pathology, School of Dentistry, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Achilleia-Maria Pavlou
- Department of Oral Medicine/Pathology, School of Dentistry, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Eleni Sotiriou
- First Department of Dermatology, School of Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Fani Vrani
- First Department of Dermatology, School of Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Dimitrios Ioannides
- First Department of Dermatology, School of Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Alexandros Kolokotronis
- Department of Oral Medicine/Pathology, School of Dentistry, Aristotle University of Thessaloniki, Thessaloniki, Greece
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Moura NMM, Ramos CIV, Linhares I, Santos SM, Faustino MAF, Almeida A, Cavaleiro JAS, Amado FML, Lodeiro C, Neves MGPMS. Synthesis, characterization and biological evaluation of cationic porphyrin–terpyridine derivatives. RSC Adv 2016. [DOI: 10.1039/c6ra25373c] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
A new series of cationic porphyrin–terpyridine derivatives was prepared. These new compounds are able to generate 1O2 and show high efficiency in the photoinactivation of bioluminescent Gram-negative E. coli.
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Affiliation(s)
- Nuno M. M. Moura
- Organic Chemistry Laboratory
- QOPNA
- Department of Chemistry
- University of Aveiro
- 3810-193 Aveiro
| | - Catarina I. V. Ramos
- Mass Spectrometry Laboratory
- QOPNA
- Department of Chemistry
- University of Aveiro
- 3810-193 Aveiro
| | - Inês Linhares
- Department of Biology
- CESAM
- University of Aveiro
- 3810-193 Aveiro
- Portugal
| | - Sérgio M. Santos
- CICECO
- Department of Chemistry
- University of Aveiro
- 3810-193 Aveiro
- Portugal
| | - M. Amparo F. Faustino
- Organic Chemistry Laboratory
- QOPNA
- Department of Chemistry
- University of Aveiro
- 3810-193 Aveiro
| | - Adelaide Almeida
- Department of Biology
- CESAM
- University of Aveiro
- 3810-193 Aveiro
- Portugal
| | - José A. S. Cavaleiro
- Organic Chemistry Laboratory
- QOPNA
- Department of Chemistry
- University of Aveiro
- 3810-193 Aveiro
| | - Francisco M. L. Amado
- Mass Spectrometry Laboratory
- QOPNA
- Department of Chemistry
- University of Aveiro
- 3810-193 Aveiro
| | - Carlos Lodeiro
- BIOSCOPE Research Team
- UCIBIO
- REQUIMTE
- Departamento de Química
- Faculdade de Ciências e Tecnologia
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28
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Adtani P, Malathi N. Epstein-Barr virus and its association with rheumatoid arthritis and oral lichen planus. J Oral Maxillofac Pathol 2015; 19:282-5. [PMID: 26980953 PMCID: PMC4774278 DOI: 10.4103/0973-029x.174643] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2014] [Accepted: 11/22/2015] [Indexed: 12/21/2022] Open
Abstract
CONTEXT Pathogenesis of autoimmune diseases (AD) is one of a multifactorial milieu. A genetic predisposition, an immune system failure, hormonal imbalance and environmental factors play important roles. Among the many environmental factors, the role of infection is gaining importance in the pathogenesis of various autoimmune disorders; among them, Epstein-Barr virus (EBV) plays a pivotal role. Literature states an association of various AD with EBV namely multiple sclerosis, autoimmune thyroiditis, systemic lupus erythematous, oral lichen planus (OLP), rheumatoid arthritis (RA), autoimmune hepatitis, Sjögren's syndrome and Kawasaki disease; among these, the most commonly occurring are OLP and RA. AIM Considering the frequency of occurrences, our aim was to perform a qualitative analysis of EBV viral capsid antigen (EBV VCA) IgG in the sera of patients with RA, OLP and establish a comparison with normal. SETTINGS AND DESIGN In-vitro experiment in a research laboratory. SUBJECTS AND METHODS Five-milliliter blood sample was collected from 25 patients diagnosed with RA and OLP. Serum was separated and EBV VCA IgG antibody titer was detected using NovaTec EBV VCA IgG ELISA kit. STATISTICAL ANALYSIS USED Chi-square test. RESULTS Six out of 25 subjects with RA and 4 out of 25 subjects with OLP tested positive for EBV VCA IgG. CONCLUSIONS Both environmental and genetic factors are important contributory components for autoimmune conditions. Screening for viral etiology would improve the efficacy of conventional treatment and reduce the risk of relapses.
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Affiliation(s)
- Pooja Adtani
- Department of Oral Pathology and Microbiology, Faculty of Dental Sciences, Sri Ramachandra University, Chennai, Tamil Nadu, India
| | - Narasimhan Malathi
- Department of Oral Pathology and Microbiology, Faculty of Dental Sciences, Sri Ramachandra University, Chennai, Tamil Nadu, India
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