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Amaral-Sobrinho LFD, Lima FSD, Santos DBDN, Cavalcante IL, de Arruda JAA, Netto JDNS, Andrade NS, de Andrade BAB, Tenório JR. Oral Lesions of Immune-Mediated and Autoimmune Diseases: A 12-year Experience at a Single Brazilian Referral Center. Head Neck Pathol 2024; 18:49. [PMID: 38884863 PMCID: PMC11183038 DOI: 10.1007/s12105-024-01654-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/15/2024] [Accepted: 05/14/2024] [Indexed: 06/18/2024]
Abstract
BACKGROUND Oral lesions of immune-mediated and autoimmune diseases have been well-documented, but studies from Brazil are limited. The varied spectrum of oral lesions within this demographic group poses challenges to clinicians, particularly when they occur in isolation. This study aimed to evaluate the occurrence, clinical characteristics, and management of patients with oral lesions of immune-mediated and autoimmune diseases at a single center in Brazil. METHODS A retrospective cross-sectional study was conducted from 2010 to 2022. Clinicodemographic data, histopathological features, and treatment modalities were analyzed descriptively and analytically. RESULTS Of the 3,790 oral and maxillofacial lesions diagnosed, 160 (4.2%) were confirmed as immune-mediated or autoimmune diseases. The population surveyed predominantly consisted of women (73.7%), with a mean age of 60.2 years. Oral lichen planus (51.3%), mucous membrane pemphigoid (MMP) (23.7%), and pemphigus vulgaris (PV) (19.4%) were the most prevalent lesions. The buccal mucosa (59.4%) was predominantly affected, with pain reported in 46.2% of cases, notably in individuals with PV and MMP. The average time to disease stabilization post-local and/or systemic corticosteroid therapy was 15.8 months for systemic lupus erythematosus, 8.7 months for MMP, and 6.5 months for PV. CONCLUSION Although oral lesions related to immune-mediated and autoimmune diseases are uncommon, their diverse clinicopathological aspects require multidisciplinary management.
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Affiliation(s)
- Lucas Fellipe do Amaral-Sobrinho
- Department of Oral Diagnosis and Pathology, School of Dentistry, Universidade Federal do Rio de Janeiro, Cidade Universitária, R. Rodolpho Paulo Rocco, n. 325, 1st floor, Rio de Janeiro, RJ, Brazil
| | - Fernanda Silva de Lima
- Department of Oral Diagnosis and Pathology, School of Dentistry, Universidade Federal do Rio de Janeiro, Cidade Universitária, R. Rodolpho Paulo Rocco, n. 325, 1st floor, Rio de Janeiro, RJ, Brazil
| | - Diego Belmiro do Nascimento Santos
- Department of Oral Diagnosis and Pathology, School of Dentistry, Universidade Federal do Rio de Janeiro, Cidade Universitária, R. Rodolpho Paulo Rocco, n. 325, 1st floor, Rio de Janeiro, RJ, Brazil
| | - Israel Leal Cavalcante
- Department of Oral Diagnosis and Pathology, School of Dentistry, Universidade Federal do Rio de Janeiro, Cidade Universitária, R. Rodolpho Paulo Rocco, n. 325, 1st floor, Rio de Janeiro, RJ, Brazil
- Department of Dentistry, Universidade de Fortaleza, Fortaleza, Brazil
| | - José Alcides Almeida de Arruda
- Department of Oral Diagnosis and Pathology, School of Dentistry, Universidade Federal do Rio de Janeiro, Cidade Universitária, R. Rodolpho Paulo Rocco, n. 325, 1st floor, Rio de Janeiro, RJ, Brazil.
| | - Juliana de Noronha Santos Netto
- Department of Oral Diagnosis and Pathology, School of Dentistry, Universidade Federal do Rio de Janeiro, Cidade Universitária, R. Rodolpho Paulo Rocco, n. 325, 1st floor, Rio de Janeiro, RJ, Brazil
| | | | - Bruno Augusto Benevenuto de Andrade
- Department of Oral Diagnosis and Pathology, School of Dentistry, Universidade Federal do Rio de Janeiro, Cidade Universitária, R. Rodolpho Paulo Rocco, n. 325, 1st floor, Rio de Janeiro, RJ, Brazil
| | - Jefferson R Tenório
- Department of Oral Diagnosis and Pathology, School of Dentistry, Universidade Federal do Rio de Janeiro, Cidade Universitária, R. Rodolpho Paulo Rocco, n. 325, 1st floor, Rio de Janeiro, RJ, Brazil
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Abdelsamie M, Zahran F, Hussine AA, Shaker O, Al-Mahallawi AM. Clinical and biochemical assessment of the effect of topical use of coenzyme Q10 versus topical corticosteroid in management of symptomatic oral lichen planus: randomized controlled clinical trial. BMC Oral Health 2023; 23:506. [PMID: 37480004 PMCID: PMC10360223 DOI: 10.1186/s12903-023-03206-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2023] [Accepted: 07/06/2023] [Indexed: 07/23/2023] Open
Abstract
BACKGROUND Oral lichen planus (OLP) is a chronic mucocutaneous immunologically mediated condition that has a great adverse effect on oral functions. Corticosteroids are still the first drugs of choice used in the treatment of OLP; however, they have extensive medical side effects. The present study was carried out to assess the clinical therapeutic effect of the topical use of coenzyme Q10 (coQ10 or ubiquinol) versus topical corticosteroids in the management of symptomatic OLP and to determine whether the effect, if any, was due to the powerful antioxidant activity of coQ10. SUBJECTS AND METHODS We performed a randomized, double blinded controlled trial at the Faculty of Dentistry, Cairo University, Egypt. The study was conducted on 34 patients suffering from symptomatic OLP. Patients were randomly divided into two groups: intervention group (I),who received topical CoQ10 in the form of mucoadhesive tablets (40% CoQ10) 3 times daily for one month and control group (II),who received topical corticosteroid (kenacort in Orabase: triamcinolone acetonide 0.1% 5-g adhesive paste - dermapharm), 4 times daily for one month. Patients were evaluated at one-week intervals using the clinical parameters (score) of pain (VAS) and lesion size. Additionally, salivary levels of malondialdehyde (MDA) were detected in both groups before and after treatment using ELISA. All recorded data were analysed using independent t test, ANOVA followed by Bonferroni post hoc test for lesion size and salivary level of MDA data and Mann-Whitney U test and Friedman test for VAS data. RESULTS Both groups showed a significant reduction in pain and the size of the lesions (p ≤ 0.05) with no statistically significant difference between them (p > 0.05), and this clinical improvement was associated with a reduction in the salivary levels of MDA in both groups. CONCLUSIONS The topical use of CoQ10 mucoadhesive tablets was as effective as the topical use of triamcinolone acetonide, and its clinical effect was associated with a reduction in the salivary level of MDA. TRIAL REGISTRATION The study protocol was registered at www. CLINICALTRIAL gov (NCT04091698) and registration date: 17/9/2019.
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Affiliation(s)
| | - Fat'heya Zahran
- Oral Medicine, Faculty of Dentistry, Cairo University, Cairo, Egypt
| | - Amal A Hussine
- Oral Medicine, Faculty of Dentistry, Cairo University, Cairo, Egypt
| | - Olfat Shaker
- Medical Biochemistry and Molecular Biology, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Abdulaziz Mohsen Al-Mahallawi
- Department of Pharmaceutics and Industrial Pharmacy, Faculty of Pharmacy, Cairo University, Cairo, Egypt
- School of Life and Medical Sciences, University of Hertfordshire Hosted By Global Academic Foundation, New Administrative Capital, Cairo, Egypt
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Sanches ACB, Pires ALPV, Medrado ARAP, de Almeida Reis SR, Freitas VS, Martins GB. Oral Lichen Planus: Associations Between Histomorphometric Characteristics and White and Red Lesions. Head Neck Pathol 2022; 16:969-979. [PMID: 35579856 PMCID: PMC9729480 DOI: 10.1007/s12105-022-01442-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/21/2021] [Accepted: 02/24/2022] [Indexed: 12/24/2022]
Abstract
Histomorphometry seems to provide more rigid quantitative elements for histological analysis and to bring less subjectivity to the diagnosis of oral lichen planus lesions (OLP). This study aimed to verify the association between white and red lesions and histomorphometric characteristics of OLP lesions. This retrospective cross-sectional study assessed 48 hematoxylin- and eosin-stained histological sections from incisional biopsies obtained from OLP cases. A single previously calibrated evaluator performed the light microscopy analyses to evaluate morphological and morphometric parameters. Analyses of associations among variables were performed using the Fisher's exact test. Morphometric variables were assessed using the Mann-Whitney non-parametric test. Comparisons among the three groups (age range) were performed using the Kruskal-Wallis test. In this study, 81.2% of the participants were women aged < 50 years. Keratosis, acanthosis, and inflammatory infiltrates were noted in 10.4, 10.4, and 37.5% of moderate/severe cases, respectively. Inflammatory infiltrate (52.1%), papillary projections (54.2%), saw teeth (12.5%), basal layer degeneration (39.6%), and Civatte bodies (68.8%) were also observed. There was no significant association between lesion type and clinicopathological variables (p > 0.05) or between lesion type and histological (p > 0.05) and morphometric variables (p > 0.05). Furthermore, the morphometric variables analyzed did not differ between white and red lesions (p > 0.05) or in their associations with clinicopathological variables (p > 0.05). The results of this investigation showed no associations between white and red OLP lesions and the histomorphometric characteristics evaluated.
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Affiliation(s)
- Ana Carla Barletta Sanches
- Postgraduate Program in Interactive Processes of Organs and Systems of the Institute of Health Sciences, Federal University of Bahia, Salvador, Brazil ,Laboratório de Bioquímica Oral, Instituto de Ciências da Saúde (UFBA), Av. Reitor Miguel Calmon, s/n. Sala 410. Vale do Canela, Salvador, Brazil
| | | | | | - Silvia Regina de Almeida Reis
- Bahiana School of Medicine and Public Health, Salvador, Bahia Brazil ,Pathology, Berlin’s Free University, Berlin, Germany
| | - Valéria Souza Freitas
- Oral Pathology, Federal University of Rio Grande do Norte, Natal, Brazil ,Dentistry Course, State University of Feira de Santana, Feira de Santana, Brazil ,Postgraduate Program in Public Health, State University of Feira de Santana, Bahia, Brazil
| | - Gabriela Botelho Martins
- Postgraduate Program in Interactive Processes of Organs and Systems of the Institute of Health Sciences, Federal University of Bahia, Salvador, Brazil ,Clinical Stomatology, PUCRS, Porto Alegre, Brazil ,Institute of Health Sciences, Federal University of Bahia, Salvador, Brazil
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