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Childhood oral lichen planus: a case series with review of literature. Eur Arch Paediatr Dent 2022; 23:341-353. [PMID: 35094367 DOI: 10.1007/s40368-021-00690-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2021] [Accepted: 12/14/2021] [Indexed: 01/12/2023]
Abstract
BACKGROUND Oral Lichen Planus (OLP) is a chronic autoimmune mucocutaneous condition, the exact etiology of which is still unknown. It is known to occur chiefly in adults and has a reported prevalence of 0.5-2% in general population and < 2-3% of total in pediatric population. OLP is considered as Oral Potentially Malignant Disorder with a malignant transformation rate of 1-2% in adults. Its occurrence in children is a rare finding with few cases reported in the literature. As a result, it gets misdiagnosed by the general practitioner and hence, there is a need to consider OLP in differential diagnosis of white lesions of oral cavity even in children. Therefore, in this paper, we present six cases of childhood OLP along with their management and follow-up. CASE SERIES We present here six patients aged between 11 and 13 years who presented either as incidental finding or as symptomatic lesions and were diagnosed with OLP. Symptomatic patients were treated with topical steroid ointment and both the symptomatic and asymptomatic patients were followed-up. We have also presented literature review of childhood OLP reported in PubMed, Medline and google scholar from 1980 till December 2020. CONCLUSION OLP is unusual in children and is often left untreated due to low awareness among the patients. Can be often misdiagnosed and should be considered in differential diagnosis of any white lesion of oral cavity. Any such lesions must be correctly diagnosed in time to institute appropriate management and follow-up.
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Bansal D, Kamboj M, Anand R, Pandiar D, Narwal A, Sivakumar N, Devi A. Association of childhood vaccination with pediatric lichen planus: A systematic review. Int J Dermatol 2021; 62:22-31. [PMID: 34870853 DOI: 10.1111/ijd.15974] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/03/2021] [Revised: 09/21/2021] [Accepted: 10/23/2021] [Indexed: 12/23/2022]
Abstract
Lichen planus (LP) is a chronic T-cell-mediated mucocutaneous inflammatory disease, largely recognized in adults. It is uncommon in children, and the literature present still lacks comprehensive understanding mainly due to underreporting of such cases. LP shows atypical clinical features, when seen in children, mainly affecting the flexor aspect of the wrists, legs, and the oral and genital mucosae. It is largely considered an autoimmune response of the body with various etiologic factors. Its association with vaccination is still an interesting field for research. The focus of the present systematic review was to discover the link of vaccine in the pathogenesis of juvenile LP. An electronic search was carried out using MEDLINE by PubMed, Google Scholar, and Web of Science databases. Articles that reported LP in children with prior records for vaccination were selected for the present systematic review. Twenty-three published articles in the English language were included for the quantitative and qualitative syntheses. The demographic data, specific vaccine history, and clinical details of the lesions were recorded. The existing evidence supports that vaccines could play an important role in etiopathogenesis of pediatric LP.
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Affiliation(s)
- Deepty Bansal
- Department of Oral and Maxillofacial Pathology and Microbiology, Post Graduate Institute of Dental Sciences, Pt B.D. Sharma University of Health Sciences, Rohtak, India
| | - Mala Kamboj
- Department of Oral and Maxillofacial Pathology and Microbiology, Post Graduate Institute of Dental Sciences, Pt B.D. Sharma University of Health Sciences, Rohtak, India
| | - Rahul Anand
- Department of Oral and Maxillofacial Pathology and Microbiology, Post Graduate Institute of Dental Sciences, Pt B.D. Sharma University of Health Sciences, Rohtak, India
| | - Deepak Pandiar
- Department of Oral and Maxillofacial Pathology, Saveetha Dental College and Hospitals, Saveetha University (Tamil Nadu), Chennai, India
| | - Anjali Narwal
- Department of Oral and Maxillofacial Pathology and Microbiology, Post Graduate Institute of Dental Sciences, Pt B.D. Sharma University of Health Sciences, Rohtak, India
| | - N Sivakumar
- Department of Oral and Maxillofacial Pathology and Microbiology, Post Graduate Institute of Dental Sciences, Pt B.D. Sharma University of Health Sciences, Rohtak, India
| | - Anju Devi
- Department of Oral and Maxillofacial Pathology and Microbiology, Post Graduate Institute of Dental Sciences, Pt B.D. Sharma University of Health Sciences, Rohtak, India
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Agel M, Al-Chihabi M, Zaitoun H, Thornhill MH, Hegarty AM. Lichen planus in children. ACTA ACUST UNITED AC 2018. [DOI: 10.12968/denu.2018.45.3.227] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Mona Agel
- Specialty Dentist in Paediatric Dentistry, Charles Clifford Dental Hospital, Sheffield, UK
| | - Mamdouh Al-Chihabi
- Specialty Trainee in Paediatric Dentistry, Charles Clifford Dental Services, Sheffield, UK
| | - Halla Zaitoun
- Consultant in Paediatric Dentistry, Charles Clifford Dental Services, Sheffield, UK
| | - Martin H Thornhill
- Professor of Translational Research in Dentistry, School of Clinical Dentistry, University of Sheffield, UK
| | - Anne M Hegarty
- Consultant in Oral Medicine, Charles Clifford Dental Services, Sheffield, UK
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Tarakji B, Ashok N, Alakeel R, Azzeghaibi S, Umair A, Darwish S, Mahmoud R, Elkhatat E. Hepatitis B vaccination and associated oral manifestations: a non-systematic review of literature and case reports. Ann Med Health Sci Res 2014; 4:829-36. [PMID: 25506472 PMCID: PMC4250977 DOI: 10.4103/2141-9248.144870] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
Hepatitis B vaccine has been administered in children and adults routinely to reduce the incidence of the disease. Even though, hepatitis B vaccine is considered as highly safe, some adverse reactions have been reported. A literature search was carried out in PubMed, accessed via the National Library of Medicine PubMed interface, searching used the following keywords: Hepatitis B vaccine and complications from 1980 to 2014. A total of 1147 articles were obtained out of which articles, which discuss the complications occurring orally or occurring elsewhere in the body, which have the potential to manifest orally after hepatitis B vaccination were selected. A total of 82 articles were identified which included 58 case series or case reports, 15 review articles, 4 cross sectional studies, 3 prospective cohort studies, one retrospective cohort study and a case control study. After reviewing the literature, we observed that complications seen after Hepatitis B vaccination are sudden infant death syndrome, multiple sclerosis, chronic fatigue syndrome, idiopathic thrombocytopenic purpura, vasculititis optic neuritis, anaphylaxis, systemic lupus erytymatosus, lichen planus and neuro-muscular disorder. Of these complications, some are manifested orally or have the potential to manifest orally. Although, most of the complications are self-limiting, some are very serious conditions, which require hospitalization with immediate medical attention.
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Affiliation(s)
- B Tarakji
- Department of Oral Maxillofacial Sciences, Alfarabi College of Dentistry and Nursing, Riyadh, Saudi Arabia
| | - N Ashok
- Department of Oral Maxillofacial Sciences, Alfarabi College of Dentistry and Nursing, Riyadh, Saudi Arabia
| | - R Alakeel
- Department of Clinical Laboratory Sciences, King Saud University, Alfarabi College of Medicine, Riyadh, Saudi Arabia
| | - Sn Azzeghaibi
- Department of Oral Maxillofacial Sciences, Alfarabi College of Dentistry and Nursing, Riyadh, Saudi Arabia
| | - A Umair
- Department of Oral Maxillofacial Sciences, Alfarabi College of Dentistry and Nursing, Riyadh, Saudi Arabia
| | - S Darwish
- Department of Oral Maxillofacial Sciences, Alfarabi College of Dentistry and Nursing, Riyadh, Saudi Arabia
| | - Rs Mahmoud
- Department of Restorative Dentistry Sciences, Alfarabi College of Dentistry and Nursing, Saudi Arabia
| | - E Elkhatat
- Department of Restorative Dentistry Sciences, Alfarabi College of Dentistry and Nursing, Saudi Arabia
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Woo V, Bonks J, Borukhova L, Zegarelli D. Oral lichenoid drug eruption: a report of a pediatric case and review of the literature. Pediatr Dermatol 2009; 26:458-64. [PMID: 19689525 DOI: 10.1111/j.1525-1470.2009.00953.x] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Lichenoid drug eruptions are seen most frequently on the skin and seldomly affect the mucosal surfaces. Oral involvement-known as oral lichenoid drug eruption-is more common in the adult population and has been associated with numerous medications. Pediatric-onset oral lichenoid drug eruption is an exceptionally rare finding with only isolated cases published in the literature. The nonspecific appearance and latent presentation of pediatric oral lichenoid drug eruption can cause confusion in diagnosis and treatment. We report a case of oral lichenoid drug eruption occurring in a 15-year-old and explore challenges in the clinical and histologic recognition of this condition.
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Affiliation(s)
- Victoria Woo
- School of Dental Medicine, University of Nevada, Las Vegas, Nevada, USA
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Abstract
Oral lichen planus which is one of the most common oral
mucosal diseases in adults, it has been rarely described in
children. There are very reports in the literature regarding
oral lichen planus in children, here we report a case of intraoral
lesions of lichen planus. Lichen planus should be
considered in the differential diagnosis of hyperkeratotic or
erosive lesions of the oral mucosa in children.
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Affiliation(s)
- Usha Mohan Das
- Professor and Head, Dean, Department of Pedodontics and Preventive Dentistry, VS Dental College and Hospital, KR Road VV Puram, Bengaluru, Karnataka, India
| | - Beena Jp
- Lecturer, Department of Pedodontics and Preventive Dentistry, VS Dental College and Hospital, KR Road, VV Puram, Bengaluru Karnataka, India
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Kirtschig G, Wakelin SH, Wojnarowska F. Mucosal vulval lichen planus: outcome, clinical and laboratory features. J Eur Acad Dermatol Venereol 2005; 19:301-7. [PMID: 15857455 DOI: 10.1111/j.1468-3083.2004.01167.x] [Citation(s) in RCA: 51] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
BACKGROUND Mucosal lichen planus of the vulva is a rare but increasingly recognized condition. It has potentially severe complications such as fusion of the labia and vagina; the risk of developing squamous cell carcinoma (SCC) may be increased. An association between hepatitis B and C infection and skin or oral lichen planus appears to exist in certain geographical areas. OBJECTIVE To investigate the course of mucosal vulval lichen planus, its response to treatment and associated laboratory features. SUBJECTS AND METHODS Forty-four women with mucosal vulval lichen planus were studied between 1997 and 2000 and laboratory data were collected. RESULTS Thirty of 44 patients had additional oral lesions, only nine had cutaneous findings compatible with lichen planus. We did not find an association with antibodies to hepatitis B or C virus in this British study population. All women were treated with potent to very potent topical corticosteroids; however, in the majority of patients symptoms persisted. In seven (16%) patients vulval lichen planus was in remission after a disease duration between 2 and 18 years (mean 10.6 years). One patient developed a vulval SCC. CONCLUSIONS Screening for hepatitis B and C in women with mucosal vulval lichen planus in the UK seems unnecessary. We recommend long-term follow-up, and that all non-healing ulcerative and papular lesions should be biopsied.
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Affiliation(s)
- G Kirtschig
- Department of Dermatology, University Hospital Vrije Universiteit, De Boelelaan 1117, Amsterdam, the Netherlands.
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Abstract
Lichen planus is a common mucocutaneous condition in which the occurrence of oral lesions has been cited as between 0.5 and 1.9% of the adult population. It is rare in childhood. Here we report three cases of children with intra oral lesions of lichen planus. Lichen planus, although reportedly rare in childhood, should be considered in the diagnosis of hyperkeratotic or erosive lesions of the oral mucosa in children.
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Affiliation(s)
- S Patel
- Department of Oral Medicine, Charles Clifford Dental Hospital, Sheffield, UK
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Affiliation(s)
- Emel Fetil
- Department of Dermatology, Faculty of Medicine, University of Dokuz Eylül, and Karşiyaka State Hospital, Izmir, Turkey.
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Abstract
In May 1996, as part of his routine antihepatitis B (hepB) vaccination plan, a 28-year-old HbsAg-negative man, hospital worker, received his first dose (20 microg) of a recombinant vaccine (EngerixB-B, Smith Kline and Beecham, Belgium), administered via deltoid injection. The patient was otherwise healthy and taking no medication. Thirty days after the 2nd booster dose, several pruritic, polygonal, purple, papules appeared on the volar aspect of the patient's wrists. New lesions gradually spread to the arms and trunk (Fig. 1). The clinical diagnosis of lichen planus (LP) was confirmed by histology, which revealed hyperorthokeratosis, hypergranulosis, vacuolar degeneration of the basal layer cells and a dense, band-like lymphocytic infiltrate in the superficial dermis. The disease started to heal after treatment with topical clobetasol propionate 0.05% and sun exposure during the following summer. Five days after the 3rd booster dose, in November 1996, the dermatosis relapsed on the forearms, trunk, and legs. On that occasion, routine laboratory tests, including a complete blood count, blood chemistry and liver function tests, were within normal limits. Screening serologic tests for autoantibodies including antinuclear antibodies, antidouble-stranded DNA, anti-SS-A, anti-SS-B and anti-Sm were all negative. As a result of the inadequate levels of antihepatitis B antibodies, less than 10 IU/l in May 1998, in a high-risk patient who was frequently exposed to blood and its products, an additional booster dose was performed. Three days later a new recurrence of disseminated lichen planus occurred. The patient was successfully treated with prednisone 1 mg/kg/day for 2 weeks. There was no recurrence the following year.
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Affiliation(s)
- Donato Calista
- Department of Dermatology, M. Bufalini Hospital, Cesena, Italy.
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Büyükgebiz B, Arslan N, Oztürk Y, Soyal C, Lebe B. Drug reaction to ursodeoxycholic acid: lichenoid drug eruption in an infant using ursodeoxycholic acid for neonatal hepatitis. J Pediatr Gastroenterol Nutr 2002; 35:384-6. [PMID: 12352534 DOI: 10.1097/00005176-200209000-00030] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/10/2022]
Abstract
Lichenoid drug eruptions are skin reactions associated with a number of drugs and chemicals. They are rare in infants. We report here an infant who presented with neonatal hepatitis and who was being treated with ursodeoxycholic acid. The infant developed lichenoid skin eruptions in the third week of the therapy. The lesions have resolved two months after the discontinuation of the drug. To our knowledge, this is the first infant case of lichenoid drug eruption associated with ursodeoxycholic acid.
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Affiliation(s)
- Benal Büyükgebiz
- Dokuz Eylül University Medical Faculty, Department of Pediatrics, Izmir, Turkey
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12
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Abstract
Lichen planus (LP) has been reported as a complication of hepatitis B vaccination in both adults and children. According to published observations, an autoimmune reaction may be triggered by the viral S epitope. In children, LP is uncommon and, because of its atypical clinical presentation, definitive diagnosis may require biopsy. We investigated the possible association of recombinant hepatitis B virus (HBV) vaccines with childhood LP or LP-like eruptions seen in our hospital over the last 3 years. Only biopsy-confirmed cases in which the clinical history could be thoroughly scrutinized were included. We report five patients less than 16 years of age in whom such an association could be supported by relevant data. Thirteen similar pediatric and 15 adult cases have been reported from various countries in the last 5 years. The data indicate that LP is a complication that rarely occurs in children receiving the HBV vaccine. It appears without known predisposing factors and has variable clinical presentations while the histologic findings are consistent and, with minor variations, typical of LP.
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Affiliation(s)
- Catherine Limas
- Department of Dermatopathology, Andreas Sygros Hospital, Athens, Greece
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