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Lauritano D, Arrica M, Lucchese A, Valente M, Pannone G, Lajolo C, Ninivaggi R, Petruzzi M. Oral lichen planus clinical characteristics in Italian patients: a retrospective analysis. Head Face Med 2016; 12:18. [PMID: 27113338 PMCID: PMC4845340 DOI: 10.1186/s13005-016-0115-z] [Citation(s) in RCA: 41] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2015] [Accepted: 04/18/2016] [Indexed: 12/27/2022] Open
Abstract
Background Oral lichen Planus (OLP) is a chronic inflammatory disease involving skin and mucous membranes. Its etiology is still uncertain whilst an autoimmune mechanism is known to be implicated. OLP is commonly considered a geriatric disease and gender differences in prevalence are clear, whereby females are generally more frequently affected than males more often during the 5th and 6th decades of life. Lesions are symmetrical and bilateral and the buccal mucosa is frequently involved. The risk of malignant transformation is extremely low. This study aims to describe both the clinical characteristics and the prevalence of OLP among a group of patients from Southern Italy. The results of the present study were compared to analogous retrospective studies. Methods Eighty-seven (31 man and 56 woman) cases of OLP were retrospectively reviewed and demographic and clinical data were collected. Data about OLP as clinical forms, oral and extraoral sites involved and Visual Analogue Scale were also recorded. Results The average age of OLP onset was 59.2 years. The most common clinical presentation was the hyperkeratosic type. Symptomatic OLP was noted in 26.8 % of the patiens. The most frequently affected oral sites were buccal mucosa, tongue, gums. The most frequently associated systemic diseases were diabetes, hypertension, C hepatitis and thyroiditis. Only one patient developed a malignant transformation (1.2 %). Conclusions Previous retrospective studies report data partially comparable with our results. Different geographic area, number of enrolled patients and OLP classification criteria may justify the observed differences.
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Affiliation(s)
- Dorina Lauritano
- Department of Translational Medicine and Surgery Neuroscience Centre of Milan, University of Milano Bicocca, Monza, Italy
| | | | - Alberta Lucchese
- Dental Clinic of Second Universty of Naples (SUN), Naples, Italy
| | - Marina Valente
- Section of Pathology of University of Foggia, Foggia, Italy
| | | | - Carlo Lajolo
- School of Dentistry, Chatolic University, Rome, Italy
| | - Rossella Ninivaggi
- Interdisciplinary Department of Medicine (DIM) - Section of Dentistry, University "Aldo Moro" of Bari, Clinica odontoiatrica del Policlinico di Bari, Piazza Giulio Cesare 11, 70124, Bari, Italy
| | - Massimo Petruzzi
- Interdisciplinary Department of Medicine (DIM) - Section of Dentistry, University "Aldo Moro" of Bari, Clinica odontoiatrica del Policlinico di Bari, Piazza Giulio Cesare 11, 70124, Bari, Italy.
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Garcia-Pola MJ, Llorente-Pendás S, Seoane-Romero JM, Berasaluce MJ, García-Martín JM. Thyroid Disease and Oral Lichen Planus as Comorbidity: A Prospective Case-Control Study. Dermatology 2016; 232:214-9. [PMID: 26784745 DOI: 10.1159/000442438] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2014] [Accepted: 11/10/2015] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Thyroid disease has been mentioned to have a possible relation to the development of oral lichen planus (OLP). OBJECTIVE Because goiter is considered endemic in many countries, we proposed to determine whether thyroid disease constitutes a comorbidity of OLP. METHODS Two hundred and fifteen patients diagnosed as having OLP were evaluated concerning their serum thyroid-stimulating hormone and thyroxine (T4) levels. The results were contrasted with those obtained in control series of the same number of subjects matched for age and sex. RESULTS Diagnosis of thyroid disease was present in 15.3% of OLP patients (33/215) and in 5.2% (12/215) of the control group. In relation to OLP patients, the odds ratio of presence of thyroid disorders was 3.06 and that of using levothyroxine medication 3.21. CONCLUSIONS In the present study, OLP patients were associated with thyroid disease, specifically with hypothyroidism. Because most thyroid patients need T4 treatment, our findings confirmed that OLP and thyroid disease could be comorbidities.
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Al-Mohaya MA, Al-Harthi F, Arfin M, Al-Asmari A. TNF-α, TNF-β and IL-10 gene polymorphism and association with oral lichen planus risk in Saudi patients. J Appl Oral Sci 2015. [PMID: 26221924 PMCID: PMC4510664 DOI: 10.1590/1678-775720150075] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Abstract
Objectives Oral lichen planus (OLP) is a chronic inflammatory oral mucosal disease. Cytokines play an important role in the pathogenesis and disease progression of OLP. Various reports have implicated cytokine gene polymorphisms in susceptibility to develop some immune mediated conditions including OLP. The purpose of this study was to investigate the association of tumor necrosis factor (TNF)-α, TNF-β and interleukin (IL)-10 gene polymorphisms with the OLP risk. Material and Methods Forty two unrelated patients with OLP and 211 healthy volunteers were genotyped for TNF-α (-308 G/A), TNF-β (+252A/G), IL-10 (-1082G/A), IL-10 (-819C/T), and IL-10 (-592C/A) polymorphisms. Results The frequencies of allele A and genotype GA of TNF-α (-308G/A) were significantly higher while allele G and GG genotypes were lower in OLP patients as compared to the controls (P<0.001). The frequency of GA genotype of TNF-β (+252A/G) was significantly higher in patients than in controls while the AA genotype was completely absent in OLP patients. These results indicated that allele A and genotype GA of TNF-α (-308G/A) as well as the GA genotype of TNF-β (+252A/G) polymorphisms are associated with OLP risk. The frequencies of alleles and genotypes of -1082G/A, -819C/T and -592C/A polymorphisms in IL-10 gene did not differ significantly between OLP patients and controls (P>0.05). However, haplotype ATA extracted from 1082G/A, -819C/T, -592C/A polymorphisms of IL-10 were more prevalent in OLP patients when compared to controls indicating its possible association with OLP susceptibility. Conclusion It is concluded that TNF-α (-308G/A), TNF-β (+252A/G) and IL-10 (-1082G/A, -819C/T and -592C/A) polymorphisms are associated with the susceptibility of OLP, thus giving additional support for the genetic basis of this disease.
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Affiliation(s)
- Maha Ali Al-Mohaya
- Department of Dentistry, Prince Sultan Military Medical City, Riyadh, Saudi Arabia
| | - Fahad Al-Harthi
- Department of Dermatology, Prince Sultan Military Medical City, Riyadh, Saudi Arabia
| | - Misbahul Arfin
- Research Center, Prince Sultan Military Medical City, Riyadh, Saudi Arabia
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Chitturi RT, Sindhuja P, Parameswar RA, Nirmal RM, Reddy BVR, Dineshshankar J, Yoithapprabhunath TR. A clinical study on oral lichen planus with special emphasis on hyperpigmentation. J Pharm Bioallied Sci 2015; 7:S495-8. [PMID: 26538905 PMCID: PMC4606647 DOI: 10.4103/0975-7406.163513] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND Oral lichen planus (OLP) is a unique disorder affecting generally the older age group. Numerous studies have been done on various aspects of OLP such as pathogenesis, rate of malignant transformation, etc. However, very few studies are available with respect to clinical features especially association of hyperpigmentation and OLP. This study aims at studying the clinical aspects of OLP and study the association between hyperpigmentation and OLP in a south Indian population. MATERIALS AND METHODS A total of 58 patients with OLP who attended the outpatient department of our institution were included in the study and a complete history, followed by thorough intraoral examination was done. All the data were recorded and assessed for statistical analysis using SPSS software. RESULTS We found that the male to female ratio affected with OLP was 1:1 and the most common form of OLP that was seen was the reticular subtype. Also, buccal mucosa was the most common affected site and more than 60% patients had hyperpigmentation associated with the site affected by OLP. We found a statistically significant relation between the reticular type of OLP and the older age group (51-70 years) with hyperpigmentation. CONCLUSION Although further studies are required to say anything conclusively, post-inflammatory changes occurring the mucosa due to OLP could be a cause for hyperpigmentation in the sites affected.
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Affiliation(s)
- Ravi Teja Chitturi
- Department of Oral Pathology, SIBAR Institute of Dental Sciences, Guntur, Andhra Pradesh, India
| | - Pandian Sindhuja
- Consultant Oral Pathologist, G.D Karthik Hospital, Karaikudi, Tamil Nadu, India
| | - R Arjun Parameswar
- Department of Oral Pathology, Pushpagiri Dental College, Thiruvalla, Kerala, India
| | - Ramdas Madhavan Nirmal
- Department of Oral Pathology, Rajah Muthiah Dental College and Hospital, Annamalai Nagar, Tamil Nadu, India
| | - B Venkat Ramana Reddy
- Department of Oral Pathology, SIBAR Institute of Dental Sciences, Guntur, Andhra Pradesh, India
| | - Janardhanam Dineshshankar
- Department of Oral Pathology, Vivekanandha Dental College for Women, Tiruchengode, Tamil Nadu, India
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Rabinovich OF, Guseva AV, Abramova ES. [Clinical and laboratory rationale for photodynamic therapy in patients with severe complicated oral lichen planus]. STOMATOLOGII︠A︡ 2015; 94:40-46. [PMID: 26171545 DOI: 10.17116/stomat201594240-46] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Affiliation(s)
| | - A V Guseva
- Central Research Institute of Dental and Maxillofacial
| | - E S Abramova
- Central Research Institute of Dental and Maxillofacial
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Detection of trace metallic elements in oral lichenoid contact lesions using SR-XRF, PIXE, and XAFS. Sci Rep 2015; 5:10672. [PMID: 26085368 PMCID: PMC4471725 DOI: 10.1038/srep10672] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2014] [Accepted: 04/23/2015] [Indexed: 12/17/2022] Open
Abstract
Oral lichen planus (OLP) and oral lichenoid contact lesions (OLCL) are chronic inflammatory mucocutaneous reactions with a risk of malignant transformation that alter the epithelium. OLP and OLCL have similar clinical and histopathological features and it is difficult to distinguish one from the other. Metallic restorations are suspected to generate OLCLs. Trace metal analysis of OLCL specimens may facilitate the discrimination of symptoms and identification of causative metallic restorations. The purpose of this study was to assess OLCL tissue samples for the prevalence of metallic elements derived from dental restorations, and to discriminate OLCL from OLP by using synchrotron radiation-excited X-ray fluorescence analysis (SR-XRF), particle-induced X-ray emission (PIXE), and X-ray absorption fine structure (XAFS). Typical elements of dental materials were detected in the OLCL, whereas no obvious element accumulation was detected in OLP and negative control specimens. The origin of the detected metallic elements was presumed to be dental alloys through erosion. Therefore, our findings support the feasibility of providing supporting information to distinguish OLCL from OLP by using elemental analysis.
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Affiliation(s)
- T Yap
- Melbourne Dental School; The University of Melbourne; Victoria Australia
| | - M McCullough
- Melbourne Dental School; The University of Melbourne; Victoria Australia
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Mostafa B, Ahmed E. Prevalence of oral lichen planus among a sample of the Egyptian population. J Clin Exp Dent 2015; 7:e7-e12. [PMID: 25810846 PMCID: PMC4368022 DOI: 10.4317/jced.51875] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2014] [Accepted: 11/04/2014] [Indexed: 01/26/2023] Open
Abstract
Objectives: To report on the prevalence of oral lichen planus among a sample of the Egyptian population.
Study Design: 4470 Egyptian patients, aged 15-75 years, were seen at the outpatient clinic at the Faculty of Oral and Dental Medicine, Cairo University, Egypt. 31.25 % of these patients were males and 68.75% were females. Oral mucosal lesions consistent with oral lichen planus (OLP) were identified both clinically and confirmed histologically (in atypical cases) so that the prevalence of oral lichen planus in this study is 1.43%.
Results: 64 patients were diagnosed with OLP (20 males and 44 females). The average age of the affected group was 48.07 years. Associated skin lesions were detected in 15/64 patients (23.44%) and tobacco habits was observed in 20/64 patients (31.25%). The average period of follow-up of the affected cases was 1-2 years, during which two cases developed squamous cell carcinoma of the oral lesion.
Conclusions: Within the limitations of this study it revealed the prevalence of OLP among middle-aged women. Atrophic lesions were most frequent, followed by the erosive forms. Anti-HCV circulating antibodies were more common in patients with OLP and, notably, OLP was associated with Diabetes mellitus in 15.63% of patients.
Key words:Prevalence, oral lichen planus, Egypt.
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Affiliation(s)
- Basma Mostafa
- Assistant Professor. Oral and Dental Research Division, National Research Centre, Cairo, Egypt
| | - Enji Ahmed
- Lecturer. Oral Medicine and Periodontology Dep., Faculty of Oral and Dental Medicine, Cairo University, Egypt
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Barbosa NG, Silveira ÉJD, Lima ENDA, Oliveira PT, Soares MSM, de Medeiros AMC. Factors associated with clinical characteristics and symptoms in a case series of oral lichen planus. Int J Dermatol 2014; 54:e1-6. [DOI: 10.1111/ijd.12485] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
- Natália G. Barbosa
- Oral Pathology Postgraduate Program; Federal University of Rio Grande do Norte; Natal RN Brazil
| | - Éricka J. D. Silveira
- Oral Pathology Postgraduate Program; Federal University of Rio Grande do Norte; Natal RN Brazil
| | - Emeline N. de A. Lima
- Oral Pathology Postgraduate Program; Federal University of Rio Grande do Norte; Natal RN Brazil
| | - Patrícia T. Oliveira
- Oral Pathology Postgraduate Program; Federal University of Rio Grande do Norte; Natal RN Brazil
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Radochová V, Dřízhal I, Slezák R. A retrospective study of 171 patients with oral lichen planus in the East Bohemia - Czech Republic - single center experience. J Clin Exp Dent 2014; 6:e556-61. [PMID: 25674326 PMCID: PMC4312686 DOI: 10.4317/jced.51784] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2014] [Accepted: 08/21/2014] [Indexed: 11/29/2022] Open
Abstract
Objectives: Oral lichen planus is chronic inflammatory disease with a high prevalence in the population. This study describes the epidemiological and clinical characteristics of group of patients with oral lichen planus in the Czech Republic.
Material and Methods: Data was taken from the medical records of 171 patients referred to the Oral Medicine Unit at the University Hospital in Hradec Králové with histologically confirmed clinical diagnosis of oral lichen planus in the period 2003 – 2013. The data were retrospectively reviewed.
Results: Of the 171 patients, 116 (67.8%) were women and 55 (32.2%) were men. The mean age was 55.2 ± 12.4 years (range of 85.0 – 20.9). The reticular form was the most frequent 93.6% (160 pts.), desquamative gingivitis was 12.9% (22). The buccal mucosa was the site most affected 89.5% (153 pts.). The lesions were asymptomatic in 52 patients (30.4%). Extraoral lesions were observed in 20.5% (35 pts.) of the patients, skin involvement was in 16.4% (28 pts.). Smokers were 29 patients. Local treatment used 116 (67.8%), only 6 patients used systemic short tome corticoid therapy. No evidence between OLP and malignant transformation was observed.
Conclusions: This retrospective study show very similar profile and clinical features of the patients with OLP as in other studies.
Key words:Oral lichen planus, clinical features, extraoral manifestation.
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Affiliation(s)
- Vladimíra Radochová
- M.D, Charles University in Prague, Faculty of Medicine and University Hospital in Hradec Králové, Czech Republic: Department of Dentistry
| | - Ivo Dřízhal
- M.D, PhD, Assoc. Prof, Charles University in Prague, Faculty of Medicine and University Hospital in Hradec Králové, Czech Republic: Department of Dentistry
| | - Radovan Slezák
- M.D, PhD, Assoc. Prof, Charles University in Prague, Faculty of Medicine and University Hospital in Hradec Králové, Czech Republic: Department of Dentistry
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Otero-Rey EM, Suarez-Alen F, Peñamaria-Mallon M, Lopez-Lopez J, Blanco-Carrion A. Malignant transformation of oral lichen planus by a chronic inflammatory process. Use of topical corticosteroids to prevent this progression? Acta Odontol Scand 2014; 72:570-7. [PMID: 24850508 DOI: 10.3109/00016357.2014.914570] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
BACKGROUND Oral lichen planus is a potentially malignant disorder with a capacity, although low, for malignant transformation. Of all the factors related to the process of malignant transformation, it is believed that the chronic inflammatory process plays a key role in the development of oral cancer. This inflammatory process is capable of providing a microenvironment based on different inflammatory cells and molecules that affect cellular growth, proliferation and differentiation. OBJECTIVES The objectives of our study are: to review the available evidence about the possible relationship between the chronic inflammatory process present in oral lichen planus and its malignant transformation, to discuss the potential therapeutic implications derived from this relationship and to study the role that topical corticosteroids play in the control of oral lichen planus inflammation and its possible progression to malignant transformation. CONCLUSION The maintenance of a minimum dose of topical corticosteroids could prevent the inflammatory progression of oral lichen planus to oral cancer.
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Affiliation(s)
- Eva Maria Otero-Rey
- Department of Stomatology, School of Dental Medicine, University of Santiago de Compostela , Spain
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Budimir V, Richter I, Andabak-Rogulj A, Vučićević-Boras V, Budimir J, Brailo V. Oral lichen planus - retrospective study of 563 Croatian patients. Med Oral Patol Oral Cir Bucal 2014; 19:e255-60. [PMID: 24608217 PMCID: PMC4048114 DOI: 10.4317/medoral.18940] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2013] [Accepted: 02/14/2013] [Indexed: 12/20/2022] Open
Abstract
Objectives: To investigate the epidemiological and clinical characteristics of oral lichen planus (OLP) in a group of Croatian patients seen between 2006 and 2012.
Study Design: A group of 563 patients with a diagnosis of OLP was retrospectively reviewed in our clinic. Data regarding age, gender, medical history, drugs, smoking, alcohol, chief complaint, clinical type, localization, histology, treatment and malignant transformation were registered.
Results: Of the 563 patients, 414 were females and 149 were males. The average age at the diagnosis was 58 (range 11-94). The most common site was buccal mucosa (82.4%). Most of our patients did not smoke (72.5%) or consume alcohol (69.6%). Patients reported oral soreness (43.3%), mucosal roughness (7%), xerostomia (3%), gingival bleeding (2%) and altered taste (0.5%) as the chief complaint, while almost half of them were asymptomatic (44.2%). The most common types of OLP were reticular (64.8%) and erosive (22.9%). Plaque-like (5.7%) atrophic/erythemtous (4.3%) and bullous (2.3%) type were also observed. Malignant transformation rate of 0.7% was recorded.
Conclusions: OLP mostly affects non-smoking middle-aged women. Buccal mucosa is the most commonly affected site. In almost half of the cases patients are asymptomatic. In spite of the small risk for malignant transformation all patients should be regularly monitored.
Key words:Oral lichen planus, malignant transformation, epidemiology, retrospective study.
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Affiliation(s)
- Vice Budimir
- Dept. of Oral Medicine, School of Dental Medicine, Gunduliceva 5, 10 000 Zagreb, Croatia,
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63
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The malignant transformation of oral lichen planus and oral lichenoid lesions. J Am Dent Assoc 2014; 145:45-56. [DOI: 10.14219/jada.2013.10] [Citation(s) in RCA: 209] [Impact Index Per Article: 19.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
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Lopez-Jornet P, Martinez-Canovas A, Pons-Fuster A. Salivary biomarkers of oxidative stress and quality of life in patients with oral lichen planus. Geriatr Gerontol Int 2013; 14:654-9. [PMID: 24205825 DOI: 10.1111/ggi.12153] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/04/2013] [Indexed: 12/12/2022]
Abstract
AIM Lichen planus is a T cell-mediated chronic inflammatory disease of unknown etiology. The objective of the present study was to evaluate the status of oxidative stress in saliva and the anti-oxidant defense system in relation to quality of life parameters in patients with oral lichen planus (OLP). METHODS The sample consisted of 70 patients (40 with OLP and 30 control patients). The average age of OLP patients was 60 years (9 males and 31 females), and of the control group 57 years (6 males and 24 females). All participants completed the Oral Health Impact Profile-49 quality of life questionnaire. Total anti-oxidant activity and lipid peroxidation products in saliva were evaluated, using ferric reducing anti-oxidant power and thiobarbituric acid reactive substance. RESULTS Mean levels of salivary malondialdehyde were higher in the OLP group than the control group (P = 0.001), and total anti-oxidant capacity was lower among OLP patients than control patients (P = 0.02). There was no correlation between Oral Health Impact Profile-49 findings and the oxidative stress parameters studied. CONCLUSIONS The results of the present study point to the possible function of oxidative stress in the etiopathogenesis of OLP.
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Affiliation(s)
- Pia Lopez-Jornet
- Oral Medicine, Ageing Research Institute, Faculty of Medicine and Dentistry, University of Murcia, Murcia, Spain
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Liu C, Xie B, Yang Y, Lin D, Wang C, Lin M, Ge L, Zhou H. Efficacy of intralesional betamethasone for erosive oral lichen planus and evaluation of recurrence: a randomized, controlled trial. Oral Surg Oral Med Oral Pathol Oral Radiol 2013; 116:584-90. [DOI: 10.1016/j.oooo.2013.07.023] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2013] [Revised: 07/21/2013] [Accepted: 07/23/2013] [Indexed: 02/06/2023]
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67
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Thiessen N, Alter M, Kapp A, Gutzmer R. [Squamous cell carcinoma developing in oral lichen planus]. DER HAUTARZT 2013; 64:843-5. [PMID: 24127014 DOI: 10.1007/s00105-013-2631-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Oral lichen planus is a mucosal inflammatory disease whose pathogenesis is unclear. The chronic inflammation leads to development of a squamous cell carcinoma in 1-2% of the patients; we present an exemplary case.
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Affiliation(s)
- N Thiessen
- Hautklinik, Klinikum Stadt Ludwigshafen am Rhein gGmbH, Bremserstr. 79, 67063, Ludwigshafen, Deutschland,
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Munde AD, Karle RR, Wankhede PK, Shaikh SS, Kulkurni M. Demographic and clinical profile of oral lichen planus: A retrospective study. Contemp Clin Dent 2013; 4:181-5. [PMID: 24015006 PMCID: PMC3757879 DOI: 10.4103/0976-237x.114873] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
Introduction: Oral lichen planus (OLP) is a relatively common inflammatory mucocutaneous disorder that frequently involves the oral mucosa. The clinical presentation of OLP ranges from mild painless white keratotic lesions to painful erosions and ulcerations. An important complication of OLP is the development of oral squamous cell carcinoma, which led the World Health Organization (WHO) to classify OLP as a potentially malignant disorder. The demographic and clinical characteristics of OLP have been well-described in several relatively large series from developed countries, whereas such series from developing countries are rare. Objective: The objective of this retrospective study was to investigate the epidemiological and clinical characteristics of 128 OLP patients in rural population of India. Materials and Methods: In this study, the diagnostic criteria proposed by van der Meij et al. in 2003 based on the WHO definition of OLP were used to identify cases. Results: In 128 patients, M:F ratio was 1.61:1. The buccal mucosa was the most common site (88.20%). White lichen was seen in 83.59% and red lichen in 16.40% cases. Reticular type of OLP was the most common form (83.5%) followed by erosive (15.6%) and atrophic OLP (0.78%). The incidence of systemic diseases included hypertension (11%), diabetes mellitus (2.4%), and hypothyroidism (0.78%). Histopathologically epithelial dysplasia was present in 4 cases. Conclusion: Most of the characteristics are consistent with previous studies with differences in few. Lichen planus is a chronic disease where treatment is directed to control of symptoms. Long-term follow-up is essential to monitor for symptomatic flare ups and possible malignant transformation.
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Affiliation(s)
- Anita D Munde
- Department of Oral Medicine and Radiology, Rural Dental College, Pravara Institute of Medical Science, Loni, Maharashtra, India
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Siar CH, Lim JSM, Tang SP, Chia HS, Loh YM, Ng KH. Identifying factors associated with diagnostic concordance/discordance in oral lichen planus. J Oral Maxillofac Surg 2013; 71:1688-93. [PMID: 23773425 DOI: 10.1016/j.joms.2013.04.026] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2013] [Revised: 04/16/2013] [Accepted: 04/19/2013] [Indexed: 10/26/2022]
Abstract
PURPOSE To identify factors associated with concordance and discordance between clinical and histopathologic diagnoses of oral lichen planus lesions. MATERIALS AND METHODS A retrospective analysis was conducted on all study cases derived from archival oral pathology reports generated from all cases of oral lichen planus accessioned by the Faculty of Dentistry, University of Malaya. These study cases were diagnosed from January 1980 through December 2010. Predictor variables were diagnosis year, demographics, experience of the examiner, clinical appearance and diagnosis, and final histopathologic diagnosis; these were recorded for each study case. The outcome variable was agreement between the clinical and histopathologic diagnoses, and this was classified as concordant or discordant. Descriptive statistics and multiple linear regression analyses were computed to identify associations between predictors and outcomes. Statistical significance was set at P ≤ .05. RESULTS The sample was composed of 441 study cases with 593 oral mucosal lesions that met the inclusion criteria. The mean age of the sample was 47.5 ± 13.07 years (range, 12 to 82 yr) and 64.4% were female. The mean concordance was 83.2%. Diagnosis year and demographics showed no influence on concordance or discordance. The multiple linear regression model included experience of the examiner, clinical appearance and diagnosis, and final histopathologic diagnosis (R(2) = 0.82). Except for experience of the examiner (P = .12), clinical appearance and diagnosis and final histopathologic diagnosis were the variables statistically associated with concordance (P ≤ .01). CONCLUSIONS The present results suggest that concordance is governed primarily by the clinical appearance and diagnosis of the lesion and the final histopathologic diagnosis.
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Affiliation(s)
- Chong Huat Siar
- Professor, Department of Oral Pathology, Oral Medicine, and Periodontology, Faculty of Dentistry, University of Malaya, Kuala Lumpur, Malaysia.
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Gümrü B. A retrospective study of 370 patients with oral lichen planus in Turkey. Med Oral Patol Oral Cir Bucal 2013; 18:e427-32. [PMID: 23524413 PMCID: PMC3668868 DOI: 10.4317/medoral.18356] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2012] [Accepted: 11/20/2012] [Indexed: 11/12/2022] Open
Abstract
Objectives: Although several detailed studies concerning the patient profile and clinical features of oral lichen planus have been undertaken all over the world in different populations, a similar study has not yet been conducted in a Turkish population. The purpose of this retrospective study was to describe the demographic and clinical characteristics of a group of patients with oral lichen planus in Turkey.
Study Design: Charts of 370 patients, from the archive of Oral Diagnosis and Radiology Department of Marmara University Faculty of Dentistry (Istanbul, Turkey), with histologically confirmed clinical diagnosis of oral lichen planus in the period 1990-2010 were retrospectively reviewed.
Results: Of the 370 patients, 260 (70.3%) were women and 110 (29.7%) were men. The mean age was 49.84±13.41 years (range of 16-83). The lesions were asymptomatic in 63 patients (17%). Nearly half of the patients (47.6%) had multiple sites of involvement. Predominantly red forms were the most frequent, affecting 60.5% of patients. Approximately 17% of the patients had symptoms of possible extraoral involvement. No evidence suggesting a connection between oral lichen planus and tobacco or alcohol use was found. Only one out of the 370 cases had histologically proven malignant transformation.
Conclusions: The patient profile and clinical features of oral lichen planus in Turkey were generally similar to those described in other populations. The preponderance of the red forms and also the fact that majority of patients referred themselves to our clinic highlighted the lack of awareness among Turkish health care providers about lichen planus.
Key words:Oral lichen planus, clinical features, patient profile.
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Affiliation(s)
- Birsay Gümrü
- Department of Oral Diagnosis and Radiology, Faculty of Dentistry, Marmara University, Buyukciftlik Sok. No: 6 34365, Nisantasi-Sisli/Istanbul, Turkey.
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Tovaru S, Parlatescu I, Gheorghe C, Tovaru M, Costache M, Sardella A. Oral lichen planus: a retrospective study of 633 patients from Bucharest, Romania. Med Oral Patol Oral Cir Bucal 2013; 18:e201-6. [PMID: 23229244 PMCID: PMC3613870 DOI: 10.4317/medoral.18035] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2011] [Accepted: 06/27/2012] [Indexed: 02/03/2023] Open
Abstract
Objective: In this retrospective study, patients’ medical records were reviewed to investigate the profiles of 633 OLP cases in a group of Romania.
Material and Methods: In this retrospective study, the following clinical data were obtained from the medical charts of patients: gender, age, clinical presentation of OLP, site affected, presence of symptoms, extraoral manifestations of lichen planus, presence of systemic diseases, and history of medications.
Results: Most (78.67%) OLP patients were female and the mean age at presentation was 52 years. The white type of the disease (reticular/papular/plaque lesions) was the main form encountered in this sample (48.97%). Among patients with available hepatitis C virus test results, 9.6% were serum-positive. OLP was associated with gallbladder disease (i.e. cholecystitis, cholelithiasis) in 19% of patients. Six patients (0.95%) developed squamous cell carcinoma at a site with confirmed OLP lesions.
Conclusions: To the best of our knowledge, no similar study has been conducted in a Romanian population. The present investigation revealed the predominance of OLP among middle-aged white women and the prevalence of bilateral involvement of the buccal mucosa with reticular white lesions. Anti-HCV circulating antibodies were more common in patients with OLP than in the general population and, notably, OLP was associated with gallbladder disease (cholecystitis, cholelithiasis) in 19% of patients.
Key words:Oral lichen planus, oral mucosal diseases, retrospective study.
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Affiliation(s)
- Serban Tovaru
- Department of Oral Medicine and Oral Pathology, Faculty of Dental Medicine, Carol Davila University of Bucharest, Calea Plevnei. Nr. 19 sector 1, 010221, Bucharest, Romania.
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López-Jornet P, Camacho-Alonso F, Rodríguez-Martínes MA. Alterations in serum lipid profile patterns in oral lichen planus: a cross-sectional study. Am J Clin Dermatol 2012; 13:399-404. [PMID: 22924867 DOI: 10.2165/11633600-000000000-00000] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
BACKGROUND Oral lichen planus (OLP) is a chronic inflammatory disorder. Recently, a case-control study found that lichen planus was associated with dyslipidemia in a large series of patients. However, no data were presented about lipid values in patients and controls. OBJECTIVES The aim of this study was to investigate the hypothetical association between OLP and dyslipidemia. MATERIALS AND METHODS The study included a total of 400 patients (200 with OLP and 200 controls with other oral diseases) and investigated the prevalence of dyslipidemia. The variables analyzed were age, sex, tobacco and alcohol consumption, clinical form of OLP and lipid profiles. RESULTS A 54% prevalence of dyslipidemia was found (58% among the OLP group and 50% in the control group). Statistically significant differences in high-density lipoprotein were found between OLP patients and the control group (p = 0.003). A logistic regression model for presence/absence of cardiovascular risk (Castelli's atherogenic index of ≥ 5.1 for men and ≥ 4.5 for women) found statistically significant differences for sex and tobacco consumption. CONCLUSIONS The study found a higher atherogenic index amongst OLP patients.
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Affiliation(s)
- Pia López-Jornet
- Department of Oral Medicine, Faculty of Medicine and Odontology, University of Murcia, Murcia, Spain.
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Carlson ER, Ghali GE, Herb-Brower KE. Diagnosis and management of pathological conditions. J Oral Maxillofac Surg 2012; 70:e232-71. [PMID: 23128003 DOI: 10.1016/j.joms.2012.07.037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Shen ZY, Liu W, Zhu LK, Feng JQ, Tang GY, Zhou ZT. A retrospective clinicopathological study on oral lichen planus and malignant transformation: analysis of 518 cases. Med Oral Patol Oral Cir Bucal 2012; 17:e943-7. [PMID: 22549677 PMCID: PMC3505714 DOI: 10.4317/medoral.17778] [Citation(s) in RCA: 49] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2011] [Accepted: 11/03/2011] [Indexed: 02/07/2023] Open
Abstract
Objective: To investigate the epidemiological and clinical characteristics of a relatively large cohort of patients with oral lichen planus (OLP) from eastern China.
Study design: A total of 518 patients with histologically confirmed OLP in a long-term follow-up period (6 months-21.5 years) were retrospectively reviewed in our clinic.
Results: Of the 518 patients, 353 females and 165 males were identified. The average age at diagnosis was 46.3 years (range 9-81 years) with the buccal mucosa being the most common site (87.8%). At initial presentation, white lichen and red lichen was seen in 52.3% and 47.7% patients, respectively. Of these, 5 (0.96%) patients previously diagnosed clinically and histopathologically as OLP developed oral cancer. All of them were the females with no a history of smoking or alcohol use.
Conclusions: Clinical features of eastern Chinese OLP patients were elucidated. Notably, approximately 1% of OLP developed into cancer, which provides further evidence of potentially malignant nature of OLP.
Key words:Oral lichen planus, clinical features, malignant transformation, oral cancer.
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Affiliation(s)
- Zheng-Yu Shen
- Shanghai Key Laboratory of Stomatology, Department of Oral Mucosal Diseases, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
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Nagao Y, Sata M. Oral verrucous carcinoma arising from lichen planus and esophageal squamous cell carcinoma in a patient with hepatitis C virus-related liver cirrhosis-hyperinsulinemia and malignant transformation: A case report. Biomed Rep 2012; 1:53-56. [PMID: 24648893 DOI: 10.3892/br.2012.14] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2012] [Accepted: 09/27/2012] [Indexed: 12/23/2022] Open
Abstract
Oral lichen planus (OLP) is a potentially malignant disorder associated with an increased risk of oral cancer. In Japan, the association of OLP with hepatitis C virus (HCV) infection is well documented. In the present study, a case of oral verrucous carcinoma arising from OLP coexisting vulvo-vaginal-gingival syndrome and esophageal squamous cell carcinoma (SCC) in a patient with HCV-related liver cirrhosis is reported. A 71-year old, non-smoking Japanese woman presented with lesions of OLP affecting the bilateral buccal mucosa, tongue, gingival, palate, oral floor and lower lip. Ten years later, an exophytic mass developed in the mandibular alveolar mucosa, the right buccal mucosa and the right lower lip. Pathological diagnosis confirmed the presence of verrucous carcinoma. However, she developed esophageal rather than oral cancer. The oral cancer was resected surgically three times and the patients underwent radiotherapy. The esophageal cancer was removed by endoscopic submucosal dissection. The risk of carcinogenesis increased as hyperinsulinemia continued. The results suggested that it is necessary to monitor for malignant changes in patients with OLP lesions and HCV infection. In addition, treatment requires the cooperation of various medical specialists, as well as an oral surgeon.
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Affiliation(s)
- Yumiko Nagao
- Department of Digestive Disease Information and Research
| | - Michio Sata
- Department of Digestive Disease Information and Research; ; Division of Gastroenterology, Department of Medicine, Kurume University School of Medicine, Kurume, Fukuoka 830-0011, Japan
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Taghavi Zenouz A, Mehdipour M, Attaran R, Bahramian A, Emamverdi Zadeh P. Squamous cell carcinoma arising from an oral lichenoid lesion: a case report. J Dent Res Dent Clin Dent Prospects 2012; 6:29-32. [PMID: 22991632 PMCID: PMC3442445 DOI: 10.5681/joddd.2012.007] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2011] [Accepted: 11/05/2011] [Indexed: 11/17/2022] Open
Abstract
Lichenoid reactions represent a family of lesions with different etiologic factors and a common clinical and histologic ap-pearance. Lichen planus is included with lichenoid reactions and is a relatively common chronic mucocutaneous disorder. The most important complication of lichenoid reactions is the possibility of malignant transformation. That is why it has been considered a precancerous condition. Although the malignant transformation rate varies widely in the literature, from 0.4 to 6.5 percent, in most studies it does not exceed 1%. The aim of this paper is to report a rare case of squamous cell car-cinoma (SCC) arising within an oral lichenoid lesion in a 17-year-old woman, where SCC is very uncommon. The patient did not have any risk factors and was healthy. The lesion was located on the border of the tongue. In view of thecommon occurrence of OLP (oral lichen planus) and the unresolved issues regarding its premalignant potential, this case report illus-trates the need for histologic confirmation and a close follow-up of clinical lesions with lichenoid features.
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Affiliation(s)
- Ali Taghavi Zenouz
- Associate Professor, Department of Oral Medicine, Faculty of Dentistry, Tabriz University of Medical Sciences, Tabriz, Iran
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García-García V, Bascones-Martínez A, García-Kass AI, Martinelli-Kläy CP, Küffer R, Álvarez-Fernández E, Lombardi T. Analysis of the expression of heat-shock protein 27 in patients with oral lichen planus. Oral Dis 2012; 19:65-72. [DOI: 10.1111/j.1601-0825.2012.01951.x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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López-Jornet P, Camacho-Alonso F, Sánchez-Siles M. Dental Implants in Patients with Oral Lichen Planus: A Cross-Sectional Study. Clin Implant Dent Relat Res 2012; 16:107-15. [DOI: 10.1111/j.1708-8208.2012.00455.x] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
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Zhang WY, Liu W, Zhou YM, Shen XM, Wang YF, Tang GY. Altered microRNA expression profile with miR-27b down-regulation correlated with disease activity of oral lichen planus. Oral Dis 2011; 18:265-70. [PMID: 22077423 DOI: 10.1111/j.1601-0825.2011.01869.x] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
BACKGROUND Increasing evidence indicates that microRNAs (miRNAs) play a vital role in the pathogenesis of inflammatory and autoimmune diseases. The objective of this study was to investigate the altered miRNA expression profile in patients with oral lichen planus (OLP) and determine the miR-27b expression. METHODS We compared miRNA expression patterns in oral biopsy specimens from patients with OLP (n=3) with those from normal controls (n=3) using microarray technology. We further assessed the miR-27b expression in specimens from patients with OLP (n=53) against controls (n=34) using real-time quantitative PCR (RT-QPCR), and miR-27b expression in specimens from patients with OLP (n=15) against controls (n=12) using in situ hybridization (ISH). RESULTS Using microarray analysis, a total of 46 differentially expressed miRNAs with more than 2-fold change were identified, including 8 up-regulated and 38 down-regulated miRNAs. Both RT-QPCR and ISH analyses revealed that miR-27b was significantly down-regulated in OLP tissue, and miR-27b expression was even more suppressed in atrophic-erosive OLP than in reticular OLP. In addition, miR-27b was found to be expressed in the epithelial keratinocyte layer of both normal and OLP tissues. CONCLUSION These data indicate that miRNAs may be the novel candidate biomarkers for the implication of miRNAs in the pathogenesis of OLP.
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Affiliation(s)
- W-Y Zhang
- Department of Oral Mucosal Diseases, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai Key Laboratory of Stomatology, Shanghai, China
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Scardina GA, Ruggieri A, Maresi E, Messina P. Angiogenesis in oral lichen planus: an in vivo and immunohistological evaluation. Arch Immunol Ther Exp (Warsz) 2011; 59:457-62. [PMID: 21964862 DOI: 10.1007/s00005-011-0150-1] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2010] [Accepted: 02/21/2011] [Indexed: 12/29/2022]
Abstract
Oral lichen planus (OLP) is an autoimmune disease with an inflammatory pathogenesis. The angiogenetic phenomenon is a mechanism at the base of the pathogenesis of chronic inflammatory processes. The aim of this research is to evaluate the angiogenetic phenomenon, comparing an in vitro method with an in vivo one. Thirty OLP patients and 30 healthy subjects were enrolled in the study. Immunohistochemical analysis of the vascular-endothelial growth factor (VEGF) and vascular-endothelial adhesion molecules were carried out by the means of primary antibodies and anti-CD34, anti-VEGF, anti-CD106 antigen (VCAM-1) and anti-CD54 antigen (ICAM-1). Capillary density and others capillaroscopic parameters were tested in vivo using oral videocapillaroscopy. The results reveal the presence of a significant angiogenesis in OLP patients through the immunoexpression of VEGF, CD34, CD106 and CD54 (p < 0.001). Capillaroscopic analysis demonstrates significant value for the following parameters: density, tortuosity, loop diameter, afferent and efferent capillary loop diameter. The in vivo and in vitro investigation in OLP reveals a significant angiogenesis.
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Sanchez-Siles M, Ros-Llor I, Camacho-Alonso F, Lopez-Jornet P. A novel application of the buccal micronucleus cytome assay in oral lichen planus: A pilot study. Arch Oral Biol 2011; 56:1148-53. [DOI: 10.1016/j.archoralbio.2011.02.019] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2010] [Revised: 02/08/2011] [Accepted: 02/26/2011] [Indexed: 11/29/2022]
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