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García-Pola M, Rodríguez-Fonseca L. Role of Vitamin D in Oral Lichen Planus: A Case Control Study. Nutrients 2024; 16:2761. [PMID: 39203896 PMCID: PMC11357441 DOI: 10.3390/nu16162761] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2024] [Revised: 08/13/2024] [Accepted: 08/15/2024] [Indexed: 09/03/2024] Open
Abstract
BACKGROUND It has been reported that vitamin D deficiency may be associated with the development of oral lichen planus (OLP). Given the high prevalence of vitamin D deficiency in many countries, we sought to determine whether it constitutes a comorbidity of OLP. METHODS One hundred and twenty patients clinically and histologically diagnosed with OLP were evaluated for their serum vitamin D levels. The results were compared to results from a control series of the same number of subjects matched for age and sex. RESULTS Vitamin D deficiency was diagnosed in 45% (n = 54) of OLP patients and in 26.7% (n = 32) of the control group. Vitamin D supplements were being taken by 32 (26.7%) OLP patients and 15 (12.5%) subjects in the control group. A multivariate logistic regression model showed that OLP was associated with vitamin D deficiency [OR: 2.24 (1.28-3.98, p = 0.005)] and vitamin D supplementation [OR: 2.51 (1.25-5.22, p = 0.011)], even after controlling for confounding variables such as sex, age ≤60>, tobacco, and alcohol. CONCLUSION The association between OLP patients and vitamin D deficiency or vitamin D supplementation suggests that further research might explore the benefits of vitamin D supplements in managing OLP patients.
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Affiliation(s)
- María García-Pola
- Department of Surgery and Medical-Surgical Specialties, Faculty of Medicine and Sciences of the Health, Oviedo University, 33006 Oviedo, Spain;
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Wongpakorn P, Chantarangsu S, Prapinjumrune C. Factors involved in the remission of oral lichen planus treated with topical corticosteroids. BDJ Open 2024; 10:34. [PMID: 38719818 PMCID: PMC11078943 DOI: 10.1038/s41405-024-00217-4] [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: 03/06/2024] [Revised: 04/10/2024] [Accepted: 04/11/2024] [Indexed: 05/12/2024] Open
Abstract
AIM To determine the factors that affected the complete clinical remission of oral lichen planus (OLP) treated with topical corticosteroids. MATERIAL AND METHODS We retrospectively evaluated the charts of patients diagnosed as OLP. Age, sex, current medical conditions, medications, type of OLP, Thongprasom score, pain level assessed by a numeric rating scale (NRS), Candida infection, topical steroid treatment preparation, duration of treatment until the first complete clinical remission, and follow-up duration were assessed as variables. RESULTS In total 100 patients, after complete remission, 22 patients reported a relapse within 1.5-45 months, with a mean of 15.6 ± 13.2 months. Age, duration, gingiva and vestibule area, hypertension, dyslipidemia, Thongprasom score, preparation and topical corticosteroid potency were factors affecting the remission. Multivariate logistic regression analysis revealed that the patients' age and duration of treatment were significant factors after adjusted for age, sex, and independent factors with a P-value < 0.1 in the univariate analysis. The likelihood of having incomplete remission of the OLP lesion increased by 7.9% for every year increase in age and increased by 2.3% for every month of treatment. CONCLUSIONS There are many different factors between the complete remission and incomplete remission groups. However, age and duration of treatment were significant factors affecting the remission of OLP.
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Affiliation(s)
- Poosit Wongpakorn
- Department of Oral Medicine, Faculty of Dentistry, Chulalongkorn University, Bangkok, 10330, Thailand
| | - Soranun Chantarangsu
- Department of Oral Pathology, Faculty of Dentistry, Chulalongkorn University, Bangkok, 10330, Thailand
| | - Chanwit Prapinjumrune
- Department of Oral Medicine, Faculty of Dentistry, Chulalongkorn University, Bangkok, 10330, Thailand.
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González-Moles MÁ, Ramos-García P. An Evidence-Based Update on the Potential for Malignancy of Oral Lichen Planus and Related Conditions: A Systematic Review and Meta-Analysis. Cancers (Basel) 2024; 16:608. [PMID: 38339358 PMCID: PMC10854587 DOI: 10.3390/cancers16030608] [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: 12/26/2023] [Revised: 01/22/2024] [Accepted: 01/29/2024] [Indexed: 02/12/2024] Open
Abstract
A systematic review and a meta-analysis is presented on published articles on the malignant transformation of oral lichen planus (OLP) and related conditions, which, based on current evidence, updates an earlier systematic review published by our research group that included publications until November 2018. In this updated study (Nov-2023) we searched MEDLINE, Embase, Web of Science, and Scopus. We evaluated the methodological quality of studies (QUIPS tool) and carried out meta-analyses. The inclusion criteria were met by 101 studies (38,083 patients), of which, 20 new primary-level studies (11,512 patients) were published in the last 5 years and were added to our updated study. The pooled malignant transformation ratio was 1.43% (95% CI = 1.09-1.80) for OLP; 1.38% (95% CI = 0.16-3.38) for oral lichenoid lesions; 1.20% (95% CI = 0.00-4.25) for lichenoid reactions; and 5.13% (95% CI = 1.90-9.43) for OLP with dysplasia. No significant differences were found between the OLL or LR groups and the OLP subgroup (p = 0.853 and p = 0.328, respectively), and the malignant transformation was significantly higher for the OLP with dysplasia group in comparison with the OLP group (p = 0.001). The factors that had a significant impact with a higher risk of malignant transformation were the presence of epithelial dysplasia, a higher methodological quality, the consumption of tobacco and alcohol, the location of lesions on the tongue, the presence of atrophic and erosive lesions, and infection by the hepatitis C virus. In conclusion, OLP behaves as an oral potentially malignant disorder (OPMD), whose malignancy ratio is probably underestimated as a consequence essentially of the use of inadequate diagnostic criteria and the low methodological quality of the studies on the subject.
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Affiliation(s)
- Miguel Ángel González-Moles
- School of Dentistry, University of Granada, 18071 Granada, Spain;
- Instituto de Investigación Biosanitaria ibs.GRANADA, 18012 Granada, Spain
| | - Pablo Ramos-García
- School of Dentistry, University of Granada, 18071 Granada, Spain;
- Instituto de Investigación Biosanitaria ibs.GRANADA, 18012 Granada, Spain
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Roberts SL, Bhamra R, Ilankovan V. Malignant transformation rate of erosive oral lichen planus: a retrospective study. Br J Oral Maxillofac Surg 2024:S0266-4356(23)00606-X. [PMID: 39198076 DOI: 10.1016/j.bjoms.2023.11.020] [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: 09/06/2023] [Accepted: 11/28/2023] [Indexed: 09/01/2024]
Abstract
Oral lichen planus (OLP) is a chronic inflammatory oral condition previously known to have a rate of malignant transformation of around 1%. Additionally, erosive lichen planus, a subtype of lichen planus, which is a known risk factor for malignant transformation, has previously been unquantified in a large cohort of patients. In a single unit observation between 2005 and 2021 we retrospectively assessed 1,920 patients who underwent histological analysis for suspected oral lichen planus, and followed the progression of their disease to assess the rate of malignant transformation. In total, 1.39% of OLP transformed to oral squamous cell carcinoma over an average of 5.8 years. However, we found that the transformation rate of erosive OLP into malignancy was 5.98% with an aggressive clinical pathway. To our knowledge the incidence of erosive OLP has not previously been quantified in a large cohort of patients. This retrospective study sheds light on, and raises warning signs about, the seriousness of this condition.
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Affiliation(s)
- S L Roberts
- Oral and Maxillofacial Surgical Registrar, St Richards hospital, University Hospital Sussex NHS Foundation Trust, United Kingdom.
| | - Rameeta Bhamra
- Oral and Maxillofacial SHO, University hospitals Dorset NHS Foundation Trust, United Kingdom
| | - V Ilankovan
- Oral and Maxillofacial Surgeon, University Hospitals Dorset NHS Foundation Trust, United Kingdom
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Mahon-Smith A, Skingley G, Ayala-Nunes L, Batish A, Sharp R, Naujoks C, Schruf E, Compagno N, Moreno SG. Evaluating the Appropriateness of Existing Health-Related Quality of Life Measures in Lichen Planus. Dermatol Ther (Heidelb) 2023; 13:2817-2837. [PMID: 37794275 PMCID: PMC10613190 DOI: 10.1007/s13555-023-00990-4] [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: 05/17/2023] [Accepted: 07/19/2023] [Indexed: 10/06/2023] Open
Abstract
INTRODUCTION Lichen planus (LP) is an inflammatory skin disorder that can present in various forms across the body, including lesions on the skin (cutaneous LP [CLP]), scalp (lichen planopilaris [LPP]) and mucosal regions (mucosal LP [MLP]). Several existing patient-reported outcome measures (PROMs) were identified for potential use in LP clinical development programs. This study aimed to assess the content validity and psychometric measurement properties of the Dermatology Life Quality Index (DLQI), Epworth Sleepiness Scale (ESS), Scalpdex and Oral Lichen Planus Symptom Severity Measure (OLPSSM) in an LP population. METHODS Patients completed the PROs at various time points as part of an international Phase 2 clinical study in adults with MLP (n = 37), LPP (n = 37) and CLP (n = 37). Test-retest reliability, construct validity and sensitivity to change were assessed. In addition, qualitative cognitive debriefing interviews were conducted with adults with MLP (n = 20), LPP (n = 19) and CLP (n = 19) in the USA and Germany to examine the PROM content validity. RESULTS The DLQI demonstrated adequate reliability and validity, although its ability to detect change was modest and most items were considered not relevant in qualitative interviews. The ESS had good reliability but limited evidence of validity and ability to detect change. Conceptual relevance varied according to the qualitative interview data. The Scalpdex was miscellaneous across domains, but the 'Symptoms' domain performed well overall. Overall, Scalpdex concepts were reported as relevant by most LPP patients interviewed. The OLPSSM demonstrated good psychometric properties and strong evidence of content validity. CONCLUSIONS The psychometric and qualitative findings support the use of the OLPSSM and Scalpdex within specific LP subtypes but cautioned use of the DLQI. Administration of the ESS is not recommended in LP because of its poor psychometric performance. Given these limitations, further validation of non-specific disease measures is needed and/or the development of additional LP-specific PROMs. TRIAL REGISTRATION NCT04300296.
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Affiliation(s)
- Aoife Mahon-Smith
- Patient-Centered Outcomes, Adelphi Values Ltd, Bollington, Cheshire, UK.
| | - George Skingley
- Patient-Centered Outcomes, Adelphi Values Ltd, Bollington, Cheshire, UK
| | - Lara Ayala-Nunes
- Patient-Centered Outcomes, Adelphi Values Ltd, Bollington, Cheshire, UK
| | - Anjali Batish
- Patient-Centered Outcomes, Adelphi Values Ltd, Bollington, Cheshire, UK
| | - Rosie Sharp
- Patient-Centered Outcomes, Adelphi Values Ltd, Bollington, Cheshire, UK
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Diagnosis and Management of Pathological Conditions. J Oral Maxillofac Surg 2023; 81:E221-E262. [PMID: 37833025 DOI: 10.1016/j.joms.2023.06.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/15/2023]
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Alsoghier A, AlMadan N, Alali M, Alshagroud R. Clinicohistological Characteristics of Patients with Oral Lichenoid Mucositis: A Retrospective Study for Dental Hospital Records. J Clin Med 2023; 12:6383. [PMID: 37835027 PMCID: PMC10573176 DOI: 10.3390/jcm12196383] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2023] [Revised: 09/26/2023] [Accepted: 10/02/2023] [Indexed: 10/15/2023] Open
Abstract
Oral lichenoid mucositis (OLM) of the oral mucosa is a histological diagnosis mainly characterised by a band of inflammatory infiltrate in lamina propria and basal cell degeneration. These features describe oral lichen planus or oral lichenoid reaction. However, it could be seen in oral dysplasia. The study aimed to assess the demographics and clinicohistological characteristics of patients with OLM and their relevance to dysplastic changes in the oral mucosa. This was a cross-sectional and retrospective study of archived and electronic records of individuals with histological confirmation of OLM at King Saud University Medical City, Saudi Arabia. The descriptive and correlation assessments were used to describe the demographics and clinicohistological characteristics and their associations, respectively [p < 0.05]. The analysis included 140 records of patients with histological confirmation of OLM with a mean age of 47 (±13), and 57% (n = 81) were females. Notably, 40% of patients had at least one medical condition, mainly diabetes mellitus, 74% were asymptomatic, and 52% had lesions in the buccal mucosa. Dysplasia was seen in 18 (12%) of the 140 reviewed records. Regarding the associations between study variables, dysplastic changes were associated with the male gender [p = 0.024] and were of no significance with increased age [p = 0.594]. Moreover, having oral symptoms was associated with older age [p < 0.001], medical history of diabetes [p = 0.0132] and hypertension [p < 0.001]. The present study findings could help indicate the individuals with histologically confirmed OLM who suffer the most from the clinical disease and have an increased risk of dysplastic changes. Therefore, symptomatic management and long-term follow-up can be planned accordingly.
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Affiliation(s)
- Abdullah Alsoghier
- Department of Oral Medicine and Diagnostic Sciences, College of Dentistry, King Saud University, Riyadh 12372, Saudi Arabia;
- King Saud University Medical City, King Saud University, Riyadh 12372, Saudi Arabia; (N.A.); (M.A.)
| | - Nasser AlMadan
- King Saud University Medical City, King Saud University, Riyadh 12372, Saudi Arabia; (N.A.); (M.A.)
- Dental Center, Prince Sultan Military Medical City, Riyadh 12233, Saudi Arabia
| | - Mohammed Alali
- King Saud University Medical City, King Saud University, Riyadh 12372, Saudi Arabia; (N.A.); (M.A.)
- Dental Center, Prince Sultan Military Medical City, Riyadh 12233, Saudi Arabia
| | - Rana Alshagroud
- Department of Oral Medicine and Diagnostic Sciences, College of Dentistry, King Saud University, Riyadh 12372, Saudi Arabia;
- King Saud University Medical City, King Saud University, Riyadh 12372, Saudi Arabia; (N.A.); (M.A.)
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Mahon-Smith A, Clifford M, Batish A, Sharp R, Panter C, Naujoks C, Schruf E, Compagno N, Moreno SG. Patient Experience of Lichen Planus: A Qualitative Exploration of Signs, Symptoms, and Health-Related Quality of Life Impacts. Dermatol Ther (Heidelb) 2023; 13:2001-2017. [PMID: 37505393 PMCID: PMC10442305 DOI: 10.1007/s13555-023-00968-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2023] [Accepted: 06/14/2023] [Indexed: 07/29/2023] Open
Abstract
INTRODUCTION Lichen planus (LP) is an inflammatory skin disorder that can present in various forms across the body, including lesions on the skin (cutaneous LP [CLP]), scalp (lichen planopilaris [LPP]), and mucosal regions (mucosal LP [MLP]). Qualitative exploration of the patient experience of LP, notably symptoms and impacts on health-related quality of life (HRQoL), is limited. A scarcity of research was also identified relating to emotional wellbeing impacts of CLP patients. Two qualitative studies were conducted with LP patients to address these gaps. METHODS Study 1 consisted of exit interviews conducted with a subset of adult patients with MLP (n = 5), CLP (n = 4), and LPP (n = 4) enrolled in an LP clinical study in the United States (US) to explore the patient experience. Study 2 consisted of independent qualitative interviews conducted with adult CLP patients (n = 13) from the US and Germany to further explore impacts on emotional wellbeing. RESULTS Exit interviews found that itch , pain, and skin lesions were most frequently reported as signs/symptoms of LP. Itch and skin lesions were experienced across all LP subtypes, while pain was only reported by CLP and MLP patients. These signs/symptoms impacted HRQoL including emotional wellbeing (frustration, embarrassment), daily activities (oral hygiene, clothing options), social functioning (intimacy, social activities), and physical functioning (chewing/swallowing, opening/moving mouth). Impacts on activities of daily living (ADL) and physical functioning were mostly experienced by MLP patients. Independent qualitative interviews, which further explored impacts of CLP on patients' emotional wellbeing, identified frustration, worry, sadness, embarrassment, and depression as the most frequently experienced. CONCLUSION The findings contribute to the literature by providing qualitative insights into signs/symptoms and HRQoL impacts of LP, from the adult patient perspective. The findings also highlight the importance of considering assessment of HRQoL impacts in future clinical LP research, particularly impacts on emotional wellbeing when selecting instruments for assessment of HRQoL in the CLP population. TRIAL REGISTRATION NCT04300296.
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Affiliation(s)
- Aoife Mahon-Smith
- Patient-Centered Outcomes, Adelphi Values Ltd, Bollington, Cheshire, UK.
| | - Molly Clifford
- Patient-Centered Outcomes, Adelphi Values Ltd, Bollington, Cheshire, UK
| | - Anjali Batish
- Patient-Centered Outcomes, Adelphi Values Ltd, Bollington, Cheshire, UK
| | - Rosie Sharp
- Patient-Centered Outcomes, Adelphi Values Ltd, Bollington, Cheshire, UK
| | - Charlotte Panter
- Patient-Centered Outcomes, Adelphi Values Ltd, Bollington, Cheshire, UK
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Patigaroo SA, Ali I, Maqbool T, Qadri H, Showkat SA, Latoo MA. Reticular Oral Lichen Planus: A Clinical Experience of ENT Surgeons. Indian J Otolaryngol Head Neck Surg 2023; 75:390-396. [PMID: 37275004 PMCID: PMC10235395 DOI: 10.1007/s12070-022-03267-y] [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: 01/19/2022] [Accepted: 10/26/2022] [Indexed: 11/11/2022] Open
Abstract
Reticular Oral lichen planus (OLP) is a chronic autoimmune disease that presents as fine, white, linear and lace like lesions of the oral cavity referred to as Wickham striae. The clinical characteristics of 30 patients with reticular oral lichen planus is presented so that cases are not missed/misdiagnosed by ENT surgeons. The clinical records noted for each patient were gender, age and clinical presentation of reticular OLP (site affected, presence of symptoms and extraoral manifestations of the disease, smoking habit, and consumption of alcoholic beverages). Twenty patients were females (66.7%) and 10 (33.3%) were males giving a female to male ratio of 2:1. Majority of patients (50%) among both males and females were in the age group of 31-40 years followed by 41-50 years (20%). Oral discomfort/burning sensation was the chief symptom in 24 (80%) patients followed by asymptomatic oral white patches in 5 (16.6%).The buccal (cheek) mucosa was the site most affected (76.8%) followed by the buccal mucosa plus retromolar trigone mucosa (10%) and tongue (6.6%), Extraoral lesions were observed in 2 (6.6%) of patients at presentation with oral lesions and were on the nails in 1 patient and wrist in 1 patient. Tobacco smoking, alcohol use, diabetes and hypertension were reported in 3 (10%), 0%, 2 (6.7%) and 4 (13.3%) patients respectively. ENT surgeons routinely see patients with oral discomfort/oral ulcerations and as such they should be well versed with classical clinical characteristics of reticular oral lichen planus.
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Affiliation(s)
| | - Ihsan Ali
- Department of ENT, Government Medical College, Srinagar, J&K India
| | - Tabish Maqbool
- Department of ENT, Government Medical College, Srinagar, J&K India
| | - Haris Qadri
- Department of ENT, Government Medical College, Srinagar, J&K India
| | | | - Manzoor A. Latoo
- Department of ENT, Government Medical College, Srinagar, J&K India
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Li JW, Li KY, Chan BWA, McGrath CP, Zheng LW. Rate of Malignant Transformation Differs Based on Diagnostic Criteria for Oral Lichenoid Conditions: A Systematic Review and Meta-Analysis of 24,277 Patients. Cancers (Basel) 2023; 15:cancers15092537. [PMID: 37174004 PMCID: PMC10177058 DOI: 10.3390/cancers15092537] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2023] [Revised: 04/20/2023] [Accepted: 04/25/2023] [Indexed: 05/15/2023] Open
Abstract
OBJECTIVES This systematic review and meta-analysis aims to evaluate the evidence on the malignant potential of oral lichenoid conditions (OLCs) including oral lichen planus (OLP), oral lichenoid lesions (OLL), and lichenoid mucositis dysplasia (LMD). In addition, it aims to compare the rate of malignant transformation (MT) in OLP patients diagnosed according to different diagnostic criteria, and to investigate the possible risk factors for OLP MT into OSCC. MATERIALS AND METHODS A standardized search strategy was applied across four databases (PubMed, Embase, Web of Science, and Scopus). Screening, identification and reporting followed the PRISMA framework. Data on MT were calculated as a pooled proportion (PP), subgroup analyses and possible risk factors for MT were pooled as odds ratios (ORs). RESULTS Among 54 studies with 24,277 patients, the PP for OLCs MT was 1.07% (95% CI [0.82, 1.32]). The estimated MT rate for OLP, OLL and LMD was 0.94%, 1.95% and 6.31%, respectively. The PP OLP MT rate using the 2003 modified WHO criteria group was lower than that using the non-2003 criteria (0.86%; 95% CI [0.51, 1.22] versus 1.01%; 95% CI [0.67, 1.35]). A higher odds ratio of MT was observed for red OLP lesions (OR = 3.52; 95% CI [2.20, 5.64]), smokers (OR = 1.79; 95% CI [1.02, 3.03]), alcohol consumers (OR = 3.27, 95% CI [1.11, 9.64]) and those infected with HCV (OR = 2.55, 95% CI [1.58, 4.13]), compared to those without these risk factors. CONCLUSIONS OLP and OLL carry a low risk of developing OSCC. MT rates differed based on diagnostic criteria. A higher odds ratio of MT was observed among red OLP lesions, smokers, alcohol consumers, and HCV-positive patients. These findings have implications for practice and policies.
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Affiliation(s)
- Jing-Wen Li
- Division of Oral & Maxillofacial Surgery, Faculty of Dentistry, The University of Hong Kong, Hong Kong SAR, China
| | - Kar Yan Li
- Clinical Research Centre, Faculty of Dentistry, The University of Hong Kong, Hong Kong SAR, China
| | - Bik Wan Amy Chan
- Department of Anatomical and Cellular Pathology, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Colman Patrick McGrath
- Division of Applied Oral Sciences & Community Dental Care, Faculty of Dentistry, The University of Hong Kong, Hong Kong SAR, China
| | - Li-Wu Zheng
- Division of Oral & Maxillofacial Surgery, Faculty of Dentistry, The University of Hong Kong, Hong Kong SAR, China
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Vijayan AK, Muthukrishnan A, Nair AM, Baby JJ. Demographics, Clinicopathological Profile of Oral Lichen Planus of South Kerala Population: A Cross-Sectional Study. Cureus 2022; 14:e29688. [PMID: 36321043 PMCID: PMC9615481 DOI: 10.7759/cureus.29688] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2022] [Accepted: 09/27/2022] [Indexed: 11/07/2022] Open
Abstract
Background: Oral lichen planus (OLP) is a chronic mucocutaneous inflammatory lesion of unknown cause. The buccal mucosa is the most frequently affected anatomic site and the lesion is bilateral. The objective of this retrospective study was to investigate the epidemiological and clinical characteristics of 250 OLP patients in South Kerala. This was done by figuring out these patients’ epidemiological and clinical characteristics. Materials and methods: In the present study, patients who reported between September 2018 and December 2021 were selected employing the diagnostic criteria consistent with the WHO classification of OLP. Data of all the patient’s characteristic features were collected and evaluated using the Statistical Package for the Social Sciences (SPSS) software for statistical analysis. Results: Out of 250 patients, 52% were females and 48% were males. Reticular (n = 145, 58%) and erosive forms (n = 105, 42%) were the two clinical presentations of the lesions that were most consistently observed. The age group of 25-34 years reported the highest number of cases (n = 71, 28.4%). According to the chi-square test, there were statistically highly significant differences between the hyperpigmentation, age, and type of OLP. While 43.2% (n = 108) of cases reported a burning sensation, pain, or soreness, 56.8% (n = 142) of cases were asymptomatic. There were statistically significant differences between the type of OLP and the reported symptoms (p = 0.001). Mild to moderate dysplastic changes were documented in 5.6% during the follow-up period. A successful treatment outcome with topical steroid administration was recorded in the study sample. Conclusion: It was apparent that patients typically have bilateral lesions involving the buccal and labial mucosa, manifesting with varying degrees of oral discomfort. Although patients frequently have more than one variant of OLP, the lesions are typically reticular or erosive in nature. A meticulous follow-up is crucial to determine its malignant change.
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Adamo D, Calabria E, Canfora F, Coppola N, Lo Muzio L, Spirito F, Giuliani M, Azzi L, Maurino V, Colella G, Colella C, Montebugnoli L, Gissi DB, Gabriele M, Nisi M, Sardella A, Lodi G, Varoni EM, Giudice A, Antonelli A, Arduino PG, Gambino A, Vescovi P, Majorana A, Bardellini E, Campisi G, Panzarella V, Spadari F, Garagiola U, Pentenero M, Sutera S, Biasotto M, Ottaviani G, Gobbo M, Guarda Nardini L, Romeo U, Tenore G, Serpico R, Lucchese A, Lajolo C, Rupe C, Aria M, D'Aniello L, Mignogna MD. Where do you live? North versus Central-South differences in relation to Italian patients with oral lichen planus: a cross-sectional study from the SIPMO (Italian Society of Oral Pathology and Medicine). BMC Oral Health 2022; 22:184. [PMID: 35585582 PMCID: PMC9118829 DOI: 10.1186/s12903-022-02181-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2022] [Accepted: 03/28/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Oral lichen planus (OLP) is an immune-mediated inflammatory chronic disease of the oral mucosa, with different patterns of clinical manifestations which range from keratotic manifestations (K-OLP) to predominantly non-keratotic lesions (nK-OLP). The aim of the study was to analyze the differences in the clinical, psychological profile and symptoms between Italian patients of the North and Central-South with K-OLP and nK-OLP. METHODS 270 K-OLP and 270 nK-OLP patients were recruited in 15 Italian universities. The Numeric Rating Scale (NRS), Total Pain Rating Index (T-PRI), Hamilton Rating Scales for Depression and for Anxiety (HAM-D and HAM-A), Pittsburgh Sleep Quality Index (PSQI), and Epworth Sleepiness Scale (ESS) were administered. RESULTS The Central-South K-OLP (CS-K-OLP) patients reported a higher frequency of pain/burning compared with the K-OLP patients of the North (N-K-OLP) with higher scores in the NRS and T-PRI (p value < 0.001**). The CS-K-OLP and the CS-nK-OLP patients showed higher scores in the HAM-D, HAM-A, PSQI and ESS compared with the Northern patients (p value < 0.001**). Multivariate logistic regression revealed that the NRS and T-PRI showed the greatest increase in the R2 value for the CS-K-OLP (DR2 = 9.6%; p value < 0.001**; DR2 = 9.7% p value < 0.001**; respectively) and that the oral symptoms (globus, itching and intraoral foreign body sensation) and PSQI showed the greatest increase in the R2 value for the CS-nK-OLP (DR2 = 5.6%; p value < 0.001**; DR2 = 4.5% p value < 0.001** respectively). CONCLUSIONS Pain and mood disorders are predominant in patients with OLP in the Central-South of Italy. Clinicians should consider that the geographical living area may explain the differences in oral symptoms and psychological profile in OLP.
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Affiliation(s)
- Daniela Adamo
- Department of Neuroscience, Reproductive Sciences and Dentistry, University of Naples Federico II, Naples, Italy
| | - Elena Calabria
- Department of Neuroscience, Reproductive Sciences and Dentistry, University of Naples Federico II, Naples, Italy.
| | - Federica Canfora
- Department of Neuroscience, Reproductive Sciences and Dentistry, University of Naples Federico II, Naples, Italy
| | - Noemi Coppola
- Department of Neuroscience, Reproductive Sciences and Dentistry, University of Naples Federico II, Naples, Italy
| | - Lorenzo Lo Muzio
- Department of Clinical and Experimental Medicine, University of Foggia, Foggia, Italy
| | - Francesca Spirito
- Department of Clinical and Experimental Medicine, University of Foggia, Foggia, Italy
| | - Michele Giuliani
- Department of Clinical and Experimental Medicine, University of Foggia, Foggia, Italy
| | - Lorenzo Azzi
- Unit of Oral Medicine and Pathology, ASST dei Sette Laghi, Department of Medicine and Surgery, University of Insubria, Varese, Italy
| | - Vittorio Maurino
- Unit of Oral Medicine and Pathology, ASST dei Sette Laghi, Department of Medicine and Surgery, University of Insubria, Varese, Italy
| | - Giuseppe Colella
- Multidisciplinary Department of Medical, Surgical and Dental Specialties, University of Campania Luigi Vanvitelli, Naples, Italy
| | - Chiara Colella
- Multidisciplinary Department of Medical, Surgical and Dental Specialties, University of Campania Luigi Vanvitelli, Naples, Italy
| | - Lucio Montebugnoli
- Department of Biomedical and Neuromotor Sciences, Section of Oral Sciences, University of Bologna, Bologna, Italy
| | - Davide Bartolomeo Gissi
- Department of Biomedical and Neuromotor Sciences, Section of Oral Sciences, University of Bologna, Bologna, Italy
| | - Mario Gabriele
- Department of Surgical Pathology, Medicine, Molecular and Critical Area, University of Pisa, Pisa, Italy
| | - Marco Nisi
- Department of Surgical Pathology, Medicine, Molecular and Critical Area, University of Pisa, Pisa, Italy
| | - Andrea Sardella
- Department of Biomedical, Surgical and Dental Sciences, University of Milan, Milan, Italy
| | - Giovanni Lodi
- Department of Biomedical, Surgical and Dental Sciences, University of Milan, Milan, Italy
| | - Elena Maria Varoni
- Department of Biomedical, Surgical and Dental Sciences, University of Milan, Milan, Italy
| | - Amerigo Giudice
- Department of Health Sciences, Magna Graecia University of Catanzaro, Catanzaro, Italy
| | - Alessandro Antonelli
- Department of Health Sciences, Magna Graecia University of Catanzaro, Catanzaro, Italy
| | - Paolo Giacomo Arduino
- Oral Medicine Section, Department of Surgical Science, CIR Dental School, University of Turin, Turin, Italy
| | - Alessio Gambino
- Oral Medicine Section, Department of Surgical Science, CIR Dental School, University of Turin, Turin, Italy
| | - Paolo Vescovi
- Department of Medicine and Surgery, Oral Medicine and Laser Surgery Unit, University Center of Dentistry, University of Parma, Parma, Italy
| | - Alessandra Majorana
- Department of Medical and Surgical Specialities, Radiological Sciences and Public Health, University of Brescia, Brescia, Italy
| | - Elena Bardellini
- Department of Medical and Surgical Specialities, Radiological Sciences and Public Health, University of Brescia, Brescia, Italy
| | - Giuseppina Campisi
- Department of Surgical, Oncological, and Oral Sciences, University of Palermo, Palermo, Italy
| | - Vera Panzarella
- Department of Surgical, Oncological, and Oral Sciences, University of Palermo, Palermo, Italy
| | - Francesco Spadari
- Department of Biomedical, Surgical and Dental Sciences, Maxillo-Facial and Dental Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, University of Milan, Milan, Italy
| | - Umberto Garagiola
- Department of Biomedical, Surgical and Dental Sciences, Maxillo-Facial and Dental Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, University of Milan, Milan, Italy
| | - Monica Pentenero
- Department of Oncology, Oral Medicine and Oral Oncology Unit, University of Turin, Turin, Italy
| | - Samuele Sutera
- Department of Oncology, Oral Medicine and Oral Oncology Unit, University of Turin, Turin, Italy
| | - Matteo Biasotto
- Department of Medical, Surgical and Health Sciences, University of Trieste, Trieste, Italy
| | - Giulia Ottaviani
- Department of Medical, Surgical and Health Sciences, University of Trieste, Trieste, Italy
| | - Margherita Gobbo
- Department of Medical, Surgical and Health Sciences, University of Trieste, Trieste, Italy.,Unit of Oral and Maxillofacial Surgery, Ca' Foncello Hospital, Treviso, Italy
| | - Luca Guarda Nardini
- Unit of Oral and Maxillofacial Surgery, Ca' Foncello Hospital, Treviso, Italy
| | - Umberto Romeo
- Department of Oral Sciences and Maxillofacial Surgery, University of Rome La Sapienza, Rome, Italy
| | - Gianluca Tenore
- Department of Oral Sciences and Maxillofacial Surgery, University of Rome La Sapienza, Rome, Italy
| | - Rosario Serpico
- Multidisciplinary Department of Medical, Surgical and Dental Specialties, University of Campania Luigi Vanvitelli, Naples, Italy
| | - Alberta Lucchese
- Multidisciplinary Department of Medical, Surgical and Dental Specialties, University of Campania Luigi Vanvitelli, Naples, Italy
| | - Carlo Lajolo
- Head and Neck Department, Fondazione Policlinico Universitario A. Gemelli IRCCS, School of Dentistry, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Cosimo Rupe
- Head and Neck Department, Fondazione Policlinico Universitario A. Gemelli IRCCS, School of Dentistry, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Massimo Aria
- Department of Economics and Statistics, University Federico II of Naples, Naples, Italy
| | - Luca D'Aniello
- Department of Social Sciences, University Federico II of Naples, Naples, Italy
| | - Michele Davide Mignogna
- Department of Neuroscience, Reproductive Sciences and Dentistry, University of Naples Federico II, Naples, Italy
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Kherlopian A, Fischer G. Identifying predictors of systemic immunosuppressive treatment of vulvovaginal lichen planus: A retrospective cohort study of 122 women. Australas J Dermatol 2022; 63:335-343. [PMID: 35500127 DOI: 10.1111/ajd.13851] [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: 01/31/2022] [Revised: 03/09/2022] [Accepted: 04/04/2022] [Indexed: 11/29/2022]
Abstract
BACKGROUND Between 20% and 40% of women with vulvovaginal lichen planus (VLP) fail to respond to first-line ultra-potent topical corticosteroid treatment and require systemic immunosuppression to control disease. No data exist regarding risk factors for patients with severe VLP requiring systemic immunosuppression. We aimed to identify clinical features that predict women with VLP who are at risk of severe, recalcitrant disease requiring eventual escalation to systemic treatment. METHODS A chart review was performed on a cohort of 122 adult women with VLP followed prospectively for 15 years by the same clinician in a private dermatology practice in Australia between 1 January 2004 and 1 October 2021. Uni- and multivariable binary logistical regression analyses were performed to identify clinical features distinguishing women eventually requiring systemic treatment of VLP against those whose VLP was controlled with topical corticosteroids alone. RESULTS The mean age at diagnosis of VLP was 61 years, with 35 women (28.7%) requiring systemic treatment of VLP. A multivariable regression model utilising 'Age at Diagnosis' (adjusted OR = 0.97, 95% CI 0.94-0.99), 'Non-Caucasian Ethnicity' (adjusted OR = 10.3, 95% CI 2.27-73.9) and 'Vulvar Pruritus' (adjusted OR = 2.69, 95% CI 1.11-6.86) demonstrated moderate predictive capacity, with specificity and sensitivity for predicting whether a patient will require systemic treatment for VLP of 95.3% and 40.5%, respectively. CONCLUSIONS Our findings may indicate women with VLP who are younger, of non-Caucasian ethnicity, and presenting with vulval pruritus are the highest risk of severe disease requiring systemic immunosuppressive treatment and may benefit most from earlier initiation of systemic treatment.
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Affiliation(s)
- Ashod Kherlopian
- Department of Dermatology, Dermatology Research Office, Royal North Shore Hospital, St Leonards, New South Wales, Australia
| | - Gayle Fischer
- Department of Dermatology, Royal North Shore Hospital, St Leonards, New South Wales, Australia
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14
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Parvathala P, Baghirath PV, Reddy CN, Vinay BH, Krishna AB, Naishadham PP. Horoscopic role of CD105 (Endoglin) in progression of oral lichen planus: An immunohistochemical study. J Oral Maxillofac Pathol 2021; 25:37-45. [PMID: 34349409 PMCID: PMC8272491 DOI: 10.4103/jomfp.jomfp_82_20] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2020] [Revised: 10/19/2020] [Accepted: 01/19/2021] [Indexed: 11/04/2022] Open
Abstract
Context Role of CD105(Endoglin) in Pathogenesis and progression of OLP. Aim To assess the role of neoangiogenesis in the progression of OLP by determining the expression of CD105 in OLP and normal mucosa. Settings and Design The present study includes a total of 70 formalin-fixed paraffin-embedded blocks of which the study group comprises 50 tissue sections histopathologically confirmed as OLP. They were subdivided into two groups - Group I (Reticular OLP) and Group II (Erosive OLP) - 25 each. The control group (designated as Group III) included 20 sections of normal mucosa. Materials and Methods All the sections were 4 μm thick and stained with CD105 antibodies. After identifying areas of highest vascularity (hot spots) in low power (×10) magnification, individual microvessels were counted manually at high power (×40) magnification. Statistical Analysis Used Analysis of variance test was used to determine the difference of microvessel density (MVD) between variants of OLP and normal mucosa and Cohen's kappa statistic was used to check interobserver variability. Results CD105 staining showed a mean MVD of 1.31 ± 1.8 in the normal mucosa compared to 1.68 ± 1.4 and 4.14 ± 2.7 in the reticular and erosive variants, respectively, with a P = 0.000*, which is statistically significant (*P < 0.05 is statistically significant). Conclusion Based on our observations, it is evident that compared to normal mucosa, MVD is greater in lichen planus. Within the two variants of OLP, MVD is higher in Erosive variant compared with Reticular variant, foreshadowing the role of neoangiogenesis in the progression of OLP and its possible malignant transformation.
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Affiliation(s)
- Poornima Parvathala
- CKS Theja Institute of Dental Sciences and Research, Tirupati, Andhra Pradesh, India
| | - P Venkat Baghirath
- Panineeya Mahavidyalaya Institute of Dental Sciences and Research Centre, Hyderabad, Telangana, India
| | - C Narendra Reddy
- Department of Surgical Oncology, SVIMS, Tirupati, Andhra Pradesh, India
| | - B Hari Vinay
- Panineeya Mahavidyalaya Institute of Dental Sciences and Research Centre, Hyderabad, Telangana, India
| | - A Bhargavi Krishna
- Panineeya Mahavidyalaya Institute of Dental Sciences and Research Centre, Hyderabad, Telangana, India
| | - Parameshwar P Naishadham
- Panineeya Mahavidyalaya Institute of Dental Sciences and Research Centre, Hyderabad, Telangana, India
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15
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Ferri EP, Cunha KRL, Abboud CS, de Barros Gallo C, de Sousa Sobral S, de Fatima Teixeira da Silva D, Horliana ACRT, Franco ALDS, Rodrigues MFSD. Photobiomodulation is effective in oral lichen planus: A randomized, controlled, double-blind study. Oral Dis 2020; 27:1205-1216. [PMID: 33012017 DOI: 10.1111/odi.13662] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2020] [Revised: 08/11/2020] [Accepted: 09/11/2020] [Indexed: 12/13/2022]
Abstract
OBJECTIVES To compare the efficacy of photobiomodulation to that of topical clobetasol 0.05% in patients with symptomatic oral lichen planus (OLP). SUBJECTS Thirty-four patients with symptomatic OLP were randomly allocated into two groups: (a) the Control group (n = 17), application of topical clobetasol propionate 0.05% three times a day for 30 consecutive days with laser placebo applied twice a week to mask the treatment, and (b) the photobiomodulation group (n = 17), laser application twice a week, totalling 8 sessions, and gel placebo for 30 consecutive days to mask the treatment. Evaluations were performed once a week during treatment and 30, 60 and 90 days after treatment. The following parameters were evaluated: pain, clinical scores, clinical resolution and recurrence rate. RESULTS Photobiomodulation and propionate clobetasol 0.05% were able to significantly decrease pain in oral lichen planus patients and improve clinical scores during treatment and follow-up. Both the Control and photobiomodulation groups presented similar clinical resolution and recurrence rates. Most importantly, no difference was observed between treatments during treatment and follow-up. CONCLUSIONS These findings indicate that photobiomodulation twice a week is as effective as corticoid therapy in treating oral lichen planus. Moreover, photobiomodulation is a safe and non-invasive therapy with the remarkable advantage of no adverse effects.
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Affiliation(s)
- Elza P Ferri
- Postgraduate Program in Biophotonics Applied to Health Sciences, Nove de Julho University, UNINOVE, São Paulo, Brazil
| | - Karen R L Cunha
- Postgraduate Program in Biophotonics Applied to Health Sciences, Nove de Julho University, UNINOVE, São Paulo, Brazil
| | - Clery S Abboud
- Postgraduate Program in Biophotonics Applied to Health Sciences, Nove de Julho University, UNINOVE, São Paulo, Brazil
| | - Camila de Barros Gallo
- Department of Stomatology, School of Dentistry, University of São Paulo, São Paulo, Brazil
| | - Sérgio de Sousa Sobral
- Postgraduate Program in Biophotonics Applied to Health Sciences, Nove de Julho University, UNINOVE, São Paulo, Brazil
| | | | - Anna Carolina R T Horliana
- Postgraduate Program in Biophotonics Applied to Health Sciences, Nove de Julho University, UNINOVE, São Paulo, Brazil
| | - Adriana L-D-S Franco
- Postgraduate Program in Biophotonics Applied to Health Sciences, Nove de Julho University, UNINOVE, São Paulo, Brazil
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Abstract
With the projected increase to 1.3 billion people aged 65 years or older by 2040, healthcare professionals are faced with significant challenges in managing this population of patients. In the oral cavity, oral mucosal disease is a significant problem found in older populations. Several facial pain conditions are more likely to be seen in this cohort of patients. Although management of this group of patients may not always be appropriate in general practice, an awareness of the range of oral medicine conditions that may be encountered in older patients is essential to allow prompt referral and treatment.
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Affiliation(s)
- Jayne Patterson
- DCT2 Oral Surgery & Oral Medicine, School of Dentistry, Belfast
| | - Amanda Willis
- Senior Clinical Lecturer/Consultant in Oral Medicine, Department of Oral Medicine, School of Dentistry, Queens University Belfast and Belfast Health and Social Care Trust
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17
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Wiriyakijja P, Porter S, Fedele S, Hodgson T, McMillan R, Shephard M, Riordain RN. Health-related quality of life and its associated predictors in patients with oral lichen planus: a cross-sectional study. Int Dent J 2020; 71:140-152. [PMID: 32875594 PMCID: PMC9275316 DOI: 10.1111/idj.12607] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
OBJECTIVES To investigate levels of quality of life (QoL) and determine associated predictors in patients with oral lichen planus (OLP). MATERIALS AND METHODS A total of 300 patients with OLP at one tertiary Oral Medicine clinic in the UK were recruited in a cross-sectional study from January 2018 to July 2019. The 15-item Chronic Oral Mucosal Disease Questionnaire (COMDQ-15) and 14-item Oral Health Impact Profile (OHIP-14) were used to assess the level of QoL related to OLP. A number of potential determinants were considered, including patient demographics, treatment, the severity of oral symptoms, the clinical activity of the disease, and the patient psychological status, which were measured using the pain-Numerical Rating Scale, the Oral Disease Severity Score, the Hospital Anxiety and Depression Scale, and the 10-item Perceived Stress Scale. Multivariate linear regression was employed to identify independent determinants associated with overall and aspects of QoL. RESULTS On multivariate analyses, after adjusting for confounding variables, the QoL levels in patients with OLP were significantly associated with levels of oral pain, anxiety, stress and use of topical corticosteroids. The COMDQ-15 instrument performed better than OHIP-14 at capturing the association between QoL and pain and disease activity in patients with OLP. CONCLUSION Clinicians should expect reduced QoL in OLP patients with high pain levels, high anxiety levels, high perceived stress and use of topical corticosteroids. The COMDQ-15 is best suited to measure QoL in this population.
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Affiliation(s)
- Paswach Wiriyakijja
- UCL Eastman Dental Institute, London, UK
- Department of Oral Medicine, Faculty of Dentistry, Chulalongkorn University, Bangkok, Thailand
| | | | - Stefano Fedele
- UCL Eastman Dental Institute, London, UK
- NIHR University College London Hospitals Biomedical Research Centre, London, UK
| | - Tim Hodgson
- Royal National ENT & Eastman Dental Hospitals, UCLH Foundation NHS Trust London, London, UK
| | - Roddy McMillan
- Royal National ENT & Eastman Dental Hospitals, UCLH Foundation NHS Trust London, London, UK
| | - Martina Shephard
- Royal National ENT & Eastman Dental Hospitals, UCLH Foundation NHS Trust London, London, UK
| | - Richeal Ni Riordain
- UCL Eastman Dental Institute, London, UK
- Department of Oral Medicine, Cork University Dental School and Hospital, Cork, Ireland
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18
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Guan G, Mei L, Polonowita A, Hussaini H, Seo B, Rich AM. Malignant transformation in oral lichen planus and lichenoid lesions: a 14-year longitudinal retrospective cohort study of 829 patients in New Zealand. Oral Surg Oral Med Oral Pathol Oral Radiol 2020; 130:411-418. [PMID: 32771414 DOI: 10.1016/j.oooo.2020.07.002] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2020] [Revised: 06/12/2020] [Accepted: 07/04/2020] [Indexed: 12/31/2022]
Abstract
OBJECTIVE The aim of this study was to identify the rate of malignant transformation in a longitudinal cohort of patients with oral lichen planus and oral lichenoid lesion (OLP/OLL) and to assess the associations between clinicopathologic aspects and malignant transformation. STUDY DESIGN Data were taken from the records of 829 patients histologically diagnosed with OLP/OLL in the years 2005 to 2018. RESULTS Of the study patients, 548 (66.1%) were females and 281 (33.9%) were males. The average age at diagnosis was 57.3 years. The hyperplastic type was the most frequent (58.5%). Most patients had multiple sites of involvement, with the buccal mucosa being the most frequent site of biopsy. Oral epithelial dysplasia developed in 5 (0.6%) patients with a previous histologic diagnosis of OLP/OLL and developed oral squamous cell carcinoma (OSCC) in 23 patients (2.8%) during the follow-up period. The atrophic/ulcerative forms are 25.8 times more likely to progress to OSCC compared with the hyperplastic types (hazard ratio [HR] 25.8; P < .05). The HR increases by 5% with every year of age (HR 1.05; 95% confidence interval; P < .05). CONCLUSIONS In our study, oral epithelial dysplasia developed in less than 1% of patients with OLP/OLL, and OSCC in 2.8%during the follow-up period. The atrophic/ulcerative forms are 25.8 times more likely to progress to OSCC compared with the hyperplastic types. The HR increases by 5% with every year of age.
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Affiliation(s)
- Guangzhao Guan
- Department of Oral Diagnostic and Surgical Sciences, Faculty of Dentistry, University of Otago, Dunedin, New Zealand.
| | - Li Mei
- Department of Oral Sciences, Faculty of Dentistry, University of Otago, Dunedin, New Zealand
| | - Ajith Polonowita
- Department of Oral Diagnostic and Surgical Sciences, Faculty of Dentistry, University of Otago, Dunedin, New Zealand
| | - Haizal Hussaini
- Department of Oral Diagnostic and Surgical Sciences, Faculty of Dentistry, University of Otago, Dunedin, New Zealand
| | - Benedict Seo
- Department of Oral Diagnostic and Surgical Sciences, Faculty of Dentistry, University of Otago, Dunedin, New Zealand
| | - Alison Mary Rich
- Department of Oral Diagnostic and Surgical Sciences, Faculty of Dentistry, University of Otago, Dunedin, New Zealand
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Osipoff A, Carpenter MD, Noll JL, Valdez JA, Gormsen M, Brennan MT. Predictors of symptomatic oral lichen planus. Oral Surg Oral Med Oral Pathol Oral Radiol 2020; 129:468-477. [DOI: 10.1016/j.oooo.2019.12.019] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2019] [Revised: 12/30/2019] [Accepted: 12/30/2019] [Indexed: 01/07/2023]
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20
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Shavit E, Hagen K, Shear N. Oral lichen planus: a novel staging and algorithmic approach and all that is essential to know. F1000Res 2020; 9. [PMID: 32226613 PMCID: PMC7096219 DOI: 10.12688/f1000research.18713.1] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 03/19/2020] [Indexed: 01/04/2023] Open
Abstract
Lichen planus (LP) is a chronic autoimmune disease. Oral lesions may occur in isolation or in combination with other affected muco-cutaneous sites. Oral LP (OLP) may present as one of the various manifestations of LP or may present as a disease sui generis with a broad range of severity. Despite this disease targeting the oral mucosa, its great impact on quality of life is underrated. In this article, we provide an updated review of the pathophysiology and epidemiology of OLP and offer guidance for its diagnosis and management. We also propose an algorithmic approach to the clinical forms of OLP and a novel staging system to facilitate management decisions.
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Affiliation(s)
- Eran Shavit
- Division of Dermatology, Department of Medicine, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, ON, Canada.,Dermatology Unit, Barzilai University Medical Center, Ashkelon, Israel.,Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheba, Israel
| | - Klieb Hagen
- Department of Dentistry, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, ON, Canada.,Department of Anatomic Pathology, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, ON, Canada
| | - Neil Shear
- Division of Dermatology, Department of Medicine, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, ON, Canada.,Department of Medicine (Dermatology, Clinical Pharmacology, and Toxicology), Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario, Canada.,Department of Pharmacology, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, ON, Canada
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21
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Idrees M, Kujan O, Shearston K, Farah CS. Oral lichen planus has a very low malignant transformation rate: A systematic review and meta‐analysis using strict diagnostic and inclusion criteria. J Oral Pathol Med 2020; 50:287-298. [PMID: 31981238 DOI: 10.1111/jop.12996] [Citation(s) in RCA: 56] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2020] [Accepted: 01/20/2020] [Indexed: 12/27/2022]
Affiliation(s)
- Majdy Idrees
- UWA Dental School The University of Western Australia Nedlands WA Australia
| | - Omar Kujan
- UWA Dental School The University of Western Australia Nedlands WA Australia
| | - Kate Shearston
- UWA Dental School The University of Western Australia Nedlands WA Australia
| | - Camile S. Farah
- Australian Centre for Oral Oncology Research and Education Nedlands WA Australia
- Oral, Maxillofacial and Dental Surgery Fiona Stanley Hospital Murdoch WA Australia
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22
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de Oliveira Leal ML, Alencar LRPJ, Santana SC, de Souza BCA, Athanazio DA. Penile squamous cell carcinoma and lichen planus. SURGICAL AND EXPERIMENTAL PATHOLOGY 2020. [DOI: 10.1186/s42047-019-0053-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
Penile squamous cell carcinoma (PSSC) has some non-PHV associated precursos and lichen planus is not considered one of them.
Case presentation
A 78-year-old patient sought the urologist due to a history of erythema on glans for 12 months and growing mass for 6 months treated with different topical medications. Partial penectomy was performed with finding of squamous cell carcinoma usual / keratinizing type with invasion of glans (pT2) and presence of extensive differentiated PeIN in adjacent areas. Adjacent to PeIN areas, there was an inflammatory reaction typical of lichen planus. This lichenoid reaction was present in the periphery of the large mass and also in a separate hyperkeratotic plaque at the glans. No features of HPV infections or balanitis xerotica obliterans were detected on histologic analysis.
Conclusion
We report a case with rapid evolution (6 months) between inflammatory signs of penile disease to mass forming lesion. This report call attention to this potential association – describing the association with invasive squamous carcinoma. Treatment-resistant longstanding cases of lichen planus should be biopsied. Prospective studies of patients with penile lichen planus are warranted to evaluate the magnitude of the risk of progression to penile carcinoma.
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Shekar P, Ramya N, Reddy BR. Reporting frequency of potentially malignant oral disorders and oral cancer: A 10-year retrospective data analysis in a teaching dental institution. JOURNAL OF DR. NTR UNIVERSITY OF HEALTH SCIENCES 2020. [DOI: 10.4103/jdrntruhs.jdrntruhs_6_20] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Iocca O, Sollecito TP, Alawi F, Weinstein GS, Newman JG, De Virgilio A, Di Maio P, Spriano G, Pardiñas López S, Shanti RM. Potentially malignant disorders of the oral cavity and oral dysplasia: A systematic review and meta-analysis of malignant transformation rate by subtype. Head Neck 2019; 42:539-555. [PMID: 31803979 DOI: 10.1002/hed.26006] [Citation(s) in RCA: 230] [Impact Index Per Article: 46.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2019] [Revised: 10/14/2019] [Accepted: 10/18/2019] [Indexed: 12/11/2022] Open
Abstract
IMPORTANCE Potentially malignant disorders of the oral cavity (OPMD) are a heterogeneous group of lesions associated with a variable risk of malignant transformation (MT) to invasive cancer. Leukoplakia (LE), lichen planus (LP), oral lichenoid lesions (OLL), oral erythroplakia (OE), oral submucous fibrosis (OSF), and proliferative verrucous leukoplakia (PVL) are among the most common of these lesions. Oral dysplasia is a mucosal area characterized by cellular and architectural derangement, which may be associated with OPMDs or not. OBJECTIVE To define the MT rate of OPMDs and the risk of development into cancer of mild vs moderate/severe oral dysplasia. This in order to implement adequate follow-up strategies and treatment decisions. STUDY DESIGN We performed a systematic review and meta-analysis on studies reporting the MT rates of OPMDs and oral dysplasia. Ninety-two studies were included for the analysis. Cumulative rates were reported for OPMDs overall and as a subgroup, a comparison was made of mild vs moderate/severe dysplasia. Meta-regression on OPMD and year of publication was also performed. MAIN OUTCOME AND MEASURES Overall MT rates of OPMDs and odds ratio of MT of mild vs moderate/severe dysplasia. RESULTS Overall MT rate across all OPMD groups was 7.9% (99% confidence interval [CI] 4.9%-11.5%). MT rates of the specific OPMD subgroups were as follows: LP 1.4% (99% CI 0.9%-1.9%), LE 9.5 (5.9%-14.00%), OLL 3.8% (99% CI 1.6%-7.00%), OSF 5.2% (99% CI 2.9%-8.00%), OE 33.1% (99% CI 13.6%-56.1%), and PVL 49.5% (99% CI 26.7%-72.4%). Regarding the dysplasia grades comparison, the meta-analysis showed that moderate/severe dysplasia is meaningfully associated to a much greater risk of MT compared to mild dysplasia with an odds ratio of 2.4 (95% CI 1.5-3.8) [Correction added on 27 December 2019, after first online publication: CI updated from 99% to 95%.]. Heterogeneity was not significant. Annual MT rates were approximated based on the average follow-up as reported in the various subgroups. Lichen planus had an annual MT of 0.28%, OLL of 0.57%, leukoplakia of 1.56%, PVL of 9.3%, and OSF of 0.98%. Mild dysplasia had an annual MT of 1.7%, while severe dysplasia of 3.57%. Meta-regression showed a significant negative correlation of PVL MT rate and year of the study (P value <.001). CONCLUSIONS AND RELEVANCE OPMDs and oral dysplasia are relatively common conditions that general practitioners, head and neck, and oral medicine specialists, face in their everyday practice. Our analysis confirms the significant risk of MT of these lesions, although variable among the subgroups. Moderate/severe dysplasia bears a much higher risk of cancer evolution than mild dysplasia. It is important to raise public health awareness on the MT rates of these conditions, at the same time efficacious communication with the patient is of utmost importance. This, coupled with strict follow-up measures and optimal treatment strategies, would help in reducing the transformation of these oral conditions into invasive cancer.
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Affiliation(s)
- Oreste Iocca
- Department of Otorhinolaryngology-Head and Neck Surgery, Humanitas Clinical and Research Center, Rozzano, Milano, Italy
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele (MI), Italy
| | - Thomas P Sollecito
- Department of Oral Medicine, University of Pennsylvania School of Dental Medicine, Philadelphia, Pennsylvania
| | - Faizan Alawi
- Department of Pathology, University of Pennsylvania School of Dental Medicine, Philadelphia, Pennsylvania
| | - Gregory S Weinstein
- Department of Otorhinolaryngology-Head and Neck Surgery, University of Pennsylvania Health System, Philadelphia, Pennsylvania
| | - Jason G Newman
- Department of Otorhinolaryngology-Head and Neck Surgery, University of Pennsylvania Health System, Philadelphia, Pennsylvania
| | - Armando De Virgilio
- Department of Otorhinolaryngology-Head and Neck Surgery, Humanitas Clinical and Research Center, Rozzano, Milano, Italy
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele (MI), Italy
| | - Pasquale Di Maio
- Giovanni Borea Civil Hospital, Department of Otolaryngology-Head and Neck Surgery, Sanremo, Italy
| | - Giuseppe Spriano
- Department of Otorhinolaryngology-Head and Neck Surgery, Humanitas Clinical and Research Center, Rozzano, Milano, Italy
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele (MI), Italy
| | - Simón Pardiñas López
- Periodontology and Oral Surgery, Clínica Médico Dental Pardiñas, Cell Therapy and Regenerative Medicine Group, Centre for Advanced Scientific Research (CICA) and Biomedical Research Institute of A Coruña (INIBIC) Strategic Group, Universidade da Coruña (UDC), University Hospital Complex of A Coruña (CHUAC), Galician Health Service (SERGAS), A Coruña, Spain
| | - Rabie M Shanti
- Department of Otorhinolaryngology-Head and Neck Surgery, University of Pennsylvania Health System, Philadelphia, Pennsylvania
- Department of Oral and Maxillofacial Surgery, University of Pennsylvania School of Dental Medicine, Philadelphia, PA
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Holmstrup P, Plemons J, Meyle J. Non-plaque-induced gingival diseases. J Periodontol 2019; 89 Suppl 1:S28-S45. [PMID: 29926945 DOI: 10.1002/jper.17-0163] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2017] [Revised: 09/04/2017] [Accepted: 09/13/2017] [Indexed: 12/20/2022]
Abstract
While plaque-induced gingivitis is one of the most common human inflammatory diseases, several non-plaque-induced gingival diseases are less common but often of major significance for patients. The non-plaque-induced gingival lesions are often manifestations of systemic conditions, but they may also represent pathologic changes limited to gingival tissues. A classification is proposed, based on the etiology of the lesions and includes: Genetic/Developmental disorders; Specific infections; Inflammatory and immune conditions and lesions; Reactive processes; Neoplasms; Endocrine, Nutritional and metabolic diseases; Traumatic lesions; and Gingival pigmentation.
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Affiliation(s)
- Palle Holmstrup
- Section of Periodontology, Department of Odontology, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Jacqueline Plemons
- Department of Periodontics, Texas A&M University College of Dentistry, Dallas, TX, USA
| | - Joerg Meyle
- Department of Periodontology, University of Giessen, Giessen, Germany
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Holmstrup P, Plemons J, Meyle J. Non-plaque-induced gingival diseases. J Clin Periodontol 2019; 45 Suppl 20:S28-S43. [PMID: 29926497 DOI: 10.1111/jcpe.12938] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2017] [Revised: 09/04/2017] [Accepted: 09/13/2017] [Indexed: 12/16/2022]
Abstract
While plaque-induced gingivitis is one of the most common human inflammatory diseases, several non-plaque-induced gingival diseases are less common but often of major significance for patients. The non-plaque-induced gingival lesions are often manifestations of systemic conditions, but they may also represent pathologic changes limited to gingival tissues. A classification is proposed, based on the etiology of the lesions and includes: Genetic/Developmental disorders; Specific infections; Inflammatory and immune conditions and lesions; Reactive processes; Neoplasms; Endocrine, Nutritional and metabolic diseases; Traumatic lesions; and Gingival pigmentation.
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Affiliation(s)
- Palle Holmstrup
- Section of Periodontology, Department of Odontology, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Jacqueline Plemons
- Department of Periodontics, Texas A&M University College of Dentistry, Dallas, TX, USA
| | - Joerg Meyle
- Department of Periodontology, University of Giessen, Giessen, Germany
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Kaomongkolgit R, Daroonpan P, Tantanapornkul W, Palasuk J. Clinical profile of 102 patients with oral lichen planus in Thailand. J Clin Exp Dent 2019; 11:e625-e629. [PMID: 31516660 PMCID: PMC6730998 DOI: 10.4317/jced.55814] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2019] [Accepted: 06/12/2019] [Indexed: 11/05/2022] Open
Abstract
Background Oral lichen planus (OLP) is a chronic inflammatory disease of the skin and mucous membrane presented with various clinical appearances. The aim of the present study was to elucidate the clinical profile of patients with OLP. Material and Methods The dental records of 102 patients who visited Oral Medicine Clinic, Dental Hospital, Naresuan University during 2002-2018 were retrospectively reviewed. Results There were 75 (73.5%) women and 27 (26.5%) men, giving a female to male ratio of 2.8:1. The age of OLP patients ranged 20-81 years old with the mean age of 56.4 ± 13.2 years old. Seventy-eight patients (76.5%) had the history of systemic diseases and hypertension was the predominantly one. Most patients were non-smokers (98%), non-drinkers (86.3%) and non-betel nut chewers (98%). The atrophic form (93.1%) was the most common OLP. The lesions were mainly symptomatic (92.2%) and involved multiple locations (67.6%) where the buccal mucosa (79.4%) primarily affected. Only 2% were extraoral lesions detected on the skin. Patients had no family history of OLP or malignant transformation. Ninety-one patients (89.2%) were treated with topical steroid and only 4 patients were prescribed a combination of tropical and systemic steroid. Conclusions The results of the study indicated that most of characteristics are in accordance with previous studies. Since, OLP is a chronic inflammatory oral mucosal disease with high recurrence rate, early detection, accurately diagnosis, and long-term follow-up are necessary to evaluate the exacerbation and malignant transformation. Key words:Clinical profile, demographic, oral lichen planus, retrospective study.
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Affiliation(s)
| | - Pissacha Daroonpan
- Department of Oral Diagnosis, Faculty of Dentistry, Naresuan University, Phitsanulok, Thailand
| | - Weeraya Tantanapornkul
- Department of Oral Diagnosis, Faculty of Dentistry, Naresuan University, Phitsanulok, Thailand
| | - Jadesada Palasuk
- Department of Restorative Dentistry, Faculty of Dentistry, Naresuan University, Phitsanulok, Thailand
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González-Moles MÁ, Ruiz-Ávila I, González-Ruiz L, Ayén Á, Gil-Montoya JA, Ramos-García P. Malignant transformation risk of oral lichen planus: A systematic review and comprehensive meta-analysis. Oral Oncol 2019; 96:121-130. [PMID: 31422203 DOI: 10.1016/j.oraloncology.2019.07.012] [Citation(s) in RCA: 138] [Impact Index Per Article: 27.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2019] [Accepted: 07/10/2019] [Indexed: 02/06/2023]
Abstract
OBJECTIVES To evaluate current evidence on the malignant transformation of oral lichen planus (OLP), oral lichenoid lesions (OLLs), and oral lichenoid reactions (LRs) and to determine the variables with greatest influence on cancer development. MATERIAL AND METHODS We searched PubMed, Embase, Web of Science, and Scopus for studies published before November 2018. We evaluated the quality of studies (QUIPS tool). We carried out meta-analyses to fulfill our objectives. We examined the between-study heterogeneity and small-study effects, and conducted sensitivity studies and subgroup analyses. RESULTS Inclusion criteria were met by 82 studies (26,742 patients. The combined malignant transformation rate was 1.14% for OLP (95% CI = 0.84-1.49), 1.88% for OLLs (95% CI = 0.15-4.95) and 1.71% for LRs (95% CI = 0.00-5.46). Subgroup analysis revealed a higher malignant transformation rate in studies when the presence of epithelial dysplasia was not an exclusion criterion (p = 0.001), when both clinical and histopathological criteria were used for diagnosis (p < 0.001), when the follow-up was at least 12 months (p = 0.048), and when there was lower risk of potential bias (p = 0.002). Malignant transformation risk factors were: tongue localization (RR = 1.82, 95% CI = 1.21-2.74, p = 0.004), presence of atrophic-erosive lesions (RR = 4.09, 95% CI = 2.40-6.98, p < 0.001), tobacco use (RR = 1.98, 95% CI = 1.28-3.05, p = 0.002), alcohol consumption (RR = 2.28, 95% CI = 1.14-4.56, p = 0.02), and hepatitis C virus infection (RR = 4.46, 95% CI = 0.98-20.22, p = 0.053). CONCLUSIONS The malignant transformation rates of OLP, OLLs and LRs are underestimated due essentially to restrictive diagnostic criteria, inadequate follow-up periods, and/or low quality of studies.
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Affiliation(s)
- Miguel Ángel González-Moles
- School of Dentistry, University of Granada, Granada, Spain; Instituto de Investigación Biosanitaria. Granada, Spain.
| | - Isabel Ruiz-Ávila
- Instituto de Investigación Biosanitaria. Granada, Spain; Servicio de Anatomía Patológica, Complejo Hospitalario Universitario de Granada, Granada, Spain.
| | - Lucía González-Ruiz
- Servicio de Dermatología, Hospital General Universitario de Ciudad Real, Ciudad Real, Spain.
| | - Ángela Ayén
- School of Medicine, University of Granada, Granada, Spain.
| | - José Antonio Gil-Montoya
- School of Dentistry, University of Granada, Granada, Spain; Instituto de Investigación Biosanitaria. Granada, Spain.
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Shearston K, Fateh B, Tai S, Hove D, Farah CS. Oral lichenoid dysplasia and not oral lichen planus undergoes malignant transformation at high rates. J Oral Pathol Med 2019; 48:538-545. [DOI: 10.1111/jop.12904] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2019] [Accepted: 06/05/2019] [Indexed: 01/06/2023]
Affiliation(s)
- Kate Shearston
- UWA Dental School University of Western Australia Nedlands Western Australia Australia
| | - Behrooz Fateh
- UWA Dental School University of Western Australia Nedlands Western Australia Australia
| | - Shixiong Tai
- UWA Dental School University of Western Australia Nedlands Western Australia Australia
| | - Dzikamai Hove
- UWA Dental School University of Western Australia Nedlands Western Australia Australia
| | - Camile S. Farah
- UWA Dental School University of Western Australia Nedlands Western Australia Australia
- Australian Centre for Oral Oncology Research & Education Nedlands Western Australia Australia
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30
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Dawoud BES, Mohamed SH, Wareing J. Lichen Planus − the role of the general dental practitioner. ACTA ACUST UNITED AC 2019. [DOI: 10.12968/denu.2019.46.6.573] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Oral lichen planus is frequently encountered in primary and secondary dental care. The soft tissues of the mouth should always be examined carefully at check-ups and any abnormality be palpated to detect change in consistency (induration) along with any changes in colour or general appearance. Such changes should prompt a referral for specialist review.CPD/Clinical Relevance: The general dental practitioner (GDP) can play a simple yet effective role in the management of lichen planus by removing obvious traumatic stimuli, improving oral hygiene and advising on simple topical treatment.
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Affiliation(s)
- Basim ES Dawoud
- Academic Foundation Doctor, Leeds General Infirmary/University of Leeds Medical School
| | - Samira H Mohamed
- General Dental Practitioner, MyDentist 2, Manston Lane, Crossgates, Leeds, LS15 8HZ
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Vilar‐Villanueva M, Gándara‐Vila P, Blanco-Aguilera E, Otero-Rey EM, Rodríguez-Lado L, García‐García A, Blanco-Carrión A. Psychological disorders and quality of life in oral lichen planus patients and a control group. Oral Dis 2019; 25:1645-1651. [DOI: 10.1111/odi.13106] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2018] [Revised: 04/07/2019] [Accepted: 04/09/2019] [Indexed: 12/11/2022]
Affiliation(s)
- Marta Vilar‐Villanueva
- Oral Medicine, Oral Surgery and Implantology Unit Faculty of Medicine and Dentistry Santiago de Compostela Spain
| | - Pilar Gándara‐Vila
- Oral Medicine, Oral Surgery and Implantology Unit Faculty of Medicine and Dentistry, Instituto de Investigación Sanitaria de Santiago (IDIS) Santiago de Compostela Spain
| | - Elena Blanco-Aguilera
- Oral Medicine, Oral Surgery and Implantology Unit Faculty of Medicine and Dentistry Santiago de Compostela Spain
| | - Eva María Otero-Rey
- Oral Medicine, Oral Surgery and Implantology Unit Faculty of Medicine and Dentistry Santiago de Compostela Spain
| | | | - Abel García‐García
- Oral Medicine, Oral Surgery and Implantology Unit Faculty of Medicine and Dentistry, Instituto de Investigación Sanitaria de Santiago (IDIS) Santiago de Compostela Spain
| | - Andrés Blanco-Carrión
- Oral Medicine, Oral Surgery and Implantology Unit Faculty of Medicine and Dentistry Santiago de Compostela Spain
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32
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Balsaraf S, Bhambal A, Chole R. Study of oral potentially malignant disorders related to various risk factors amongst the patients attending hospitals in Bhopal, India. Med Pharm Rep 2019; 92:66-71. [PMID: 30957089 PMCID: PMC6448500 DOI: 10.15386/cjmed-906] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2017] [Revised: 12/20/2017] [Accepted: 01/12/2018] [Indexed: 11/23/2022] Open
Abstract
Background and aims Oral potentially malignant disorders constitute one of the major oral health problems in India. Few studies have been undertaken on potentially malignant disorders in central India, specifically in Bhopal. Hence the present study was conducted to assess the oral potentially malignant disorders in the patients attending hospitals of Bhopal, India. Methods Four hundred subjects diagnosed with oral potentially malignant disorders were included in this study. Detailed information was gathered in a proforma and emphasis was given to the various addictions and clinical findings. Results Among the 400 oral potentially malignant disorders diagnosed during the study period, males constituted 78% (n=312) and females 22% (n=88). The mean age of the patients was 33.50 ± 13.24 years for males and 42.60 ± 14.18 years for females. The most commonly affected age group was 21-30 years (37.5%), followed by 31-40 years (25%) and 41-50 years (13%). 87.75% patients were addicted to chewing of betel nut and/or tobacco and/or betel quid, 15.25% were addicted to smoking bidi and/or cigarette, 15.25% were addicted to chewing and smoking, 1% was addicted to chewing and alcohol, and 0.25% was addicted to alcohol and smoking. Conclusion In this study, an increase in clinical grading of oral potentially malignant disorders was found with severity and duration of addiction habit. In order to decrease the prevalence of these disorders, it is imperative to continue educational campaigns at national and international level to impart education to the public about the risk factors and early signs and symptoms of the oral potentially malignant disorders.
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Affiliation(s)
- Swati Balsaraf
- Department of Public Health Dentistry, College of Dental Sciences and Hospital, Rau, Indore, India
| | - Ajay Bhambal
- Department of Public Health Dentistry, People's College of Dental Sciences Bhopal, India
| | - Revant Chole
- Department of Oral Medicine and Radiology, College of Dental Sciences and Hospital, Amargadh, District - BhavnagarGujarat, India
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Laniosz V, Torgerson RR, Ramos-Rodriguez AJ, Ma JE, Mara KC, Weaver AL, Bruce AJ. Incidence of squamous cell carcinoma in oral lichen planus: a 25-year population-based study. Int J Dermatol 2019; 58:296-301. [PMID: 30216435 PMCID: PMC6922303 DOI: 10.1111/ijd.14215] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/08/2017] [Revised: 05/14/2018] [Accepted: 08/06/2018] [Indexed: 01/20/2023]
Abstract
BACKGROUND Oral lichen planus (OLP) is a chronic inflammatory condition of the oral mucosa. Multiple studies have shown that approximately 1% of patients with OLP will develop oral squamous cell carcinoma (OSCC), however, no study has taken a population-based multicenter approach to demonstrate this association. Our main objective was to determine the incidence of OSCC in OLP in a specific population and secondarily to assist physicians regarding appropriate long-term monitoring of patients with OLP. METHODS We conducted a population-based retrospective cohort study. Patients with OLP from 1986 through 2010 were identified using the Rochester Epidemiology Project (REP) for Olmsted County, Minnesota. For each OLP case (n = 303), we randomly selected two age- and gender-matched referents (n = 606). OLP diagnosis was established based on the World Health Organization (WHO) criteria. Medical records were reviewed for development of OSCCafter the OLP diagnosis (index date). The association between OLP and development of OSCC was assessed. RESULTS In total, 303 patients with incident OLP were identified; the overall incidence of OLP per 100,000 person-years was 11.4 (95% CI, 10.1-12.7). Among the OLP cohort, 7 had OSCC (incidence of OSCC, 3.1%; 95% CI, 0.6-6.4%) at 20 years after OLP diagnosis. Three OSCC cases were identified among the referents. Patients with OLP were 4.8 times more likely to have OSCC than the matched referents. The median time to OSCC development was 14.7 years earlier for the OLP cohort. CONCLUSIONS Patients with OLP, particularly the erosive type, have an increased incidence of OSCC development and should be monitored closely.
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Affiliation(s)
- Valerie Laniosz
- Department of Dermatology and Division of Biomedical Statistics and Informatics, Mayo Clinic, Rochester, MN, USA
| | - Rochelle R Torgerson
- Department of Dermatology and Division of Biomedical Statistics and Informatics, Mayo Clinic, Rochester, MN, USA
| | - Alvaro J Ramos-Rodriguez
- Department of Dermatology and Division of Biomedical Statistics and Informatics, Mayo Clinic, Rochester, MN, USA
| | - Janice E Ma
- Department of Dermatology and Division of Biomedical Statistics and Informatics, Mayo Clinic, Rochester, MN, USA
| | - Kristin C Mara
- Department of Dermatology and Division of Biomedical Statistics and Informatics, Mayo Clinic, Rochester, MN, USA
| | - Amy L Weaver
- Department of Dermatology and Division of Biomedical Statistics and Informatics, Mayo Clinic, Rochester, MN, USA
| | - Alison J Bruce
- Department of Dermatology and Division of Biomedical Statistics and Informatics, Mayo Clinic, Rochester, MN, USA
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Alamir AWH, Arakeri G, Patil S, Awan KH, Kujan O, Aljabab A, Fonseca F, Brennan PA. Association of nitric oxide with oral lichen planus. J Oral Pathol Med 2019; 48:345-350. [PMID: 30725513 DOI: 10.1111/jop.12837] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/06/2019] [Indexed: 11/28/2022]
Abstract
BACKGROUND The small signalling molecule nitric oxide (NO) has been postulated to have a mediator role in the pathogenesis of several diseases including oral lichen planus (OLP). This systematic review aimed to quantify the existing literature and assess the association of NO and OLP. METHODS The focused question being addressed was "Is there an association between nitric oxide and OLP?" PubMed, EMBASE, Scopus, and Web of Science, and grey literature from January 1990 to August 2018 were searched. Two independent reviewers performed the study selection using specified eligibility criteria. RESULTS Seven studies that met the eligibility criteria were included. All of these were case-control studies and 151 patients with OLP were evaluated (mostly females), with an age ranged from 20 to 75 years. The included studies showed a significant higher NO levels in OLP patients compared to the healthy controls, with two studies demonstrated a higher NO levels in erosive OLP compared to non-erosive OLP. CONCLUSION These findings support that an association exists between higher NO concentration and OLP. However, larger high-quality studies with refined methodological design are needed to confirm the role of NO in the aetiology and pathogenesis of OLP.
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Affiliation(s)
- Abdul Wahab H Alamir
- Department of Maxillofacial Surgery and Diagnostic Sciences, College of Dentistry, Jazan University, Jazan, Saudi Arabia
| | - Gururaj Arakeri
- Department of Oral and Maxillofacial Surgery, King Fahad Medical City, Riyadh, Saudi Arabia.,Department of Maxillofacial Surgery, Navodaya Dental College and Hospital, Raichur, Karnataka
| | - Shankargouda Patil
- Department of Maxillofacial Surgery and Diagnostic Sciences, College of Dentistry, Jazan University, Jazan, Saudi Arabia
| | - Kamran Habib Awan
- College of Dental Medicine, Roseman University of Health Sciences, South Jordan, Utah
| | - Omar Kujan
- College of Dental Medicine, Roseman University of Health Sciences, South Jordan, Utah.,UWA Dental School, The University of Western Australia, Nedlands, WA, Australia
| | - Abdulsalam Aljabab
- Department of Oral and Maxillofacial Surgery, King Fahad Medical City, Riyadh, Saudi Arabia
| | - Felipe Fonseca
- Department of Oral Surgery and Pathology, School of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Peter A Brennan
- Department of Oral & Maxillofacial Surgery, Queen Alexandra Hospital, Portsmouth, UK
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Mouth cancer: presentation, detection and referral in primary dental care. Br Dent J 2018; 225:833-840. [DOI: 10.1038/sj.bdj.2018.931] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/04/2018] [Indexed: 12/26/2022]
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Humberto JSM, Pavanin JV, Rocha MJAD, Motta ACF. Cytokines, cortisol, and nitric oxide as salivary biomarkers in oral lichen planus: a systematic review. Braz Oral Res 2018; 32:e82. [PMID: 30110084 DOI: 10.1590/1807-3107bor-2018.vol32.0082] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2018] [Accepted: 05/05/2018] [Indexed: 12/11/2022] Open
Abstract
The etiopathogenesis of oral lichen planus (OLP) is still not fully elucidated, and it is believed that its development could involve a neuro-immune-endocrine profile. This systematic review investigated the relationship between cytokines, cortisol, and nitric oxide (NO) in the saliva of OLP patients. An electronic search was conducted in Pubmed/Medline, Scopus, LIVIVO, and Web of Science databases with no restriction of language to identify studies published up to December 2017. Data extraction was performed using the Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA) guidelines. A total of 140 articles were retrieved, and 32 articles fulfilled the inclusion criteria (cytokines = 17; cortisol = 9; NO = 6). The most studied cytokines in the saliva of OLP patients were interleukins IL-4, IL-6, IL-8, IFN-ү, and TNF-α, which were higher in OLP patients than in healthy controls (HC). Salivary cortisol was found to be higher in OLP than in HC in most (55.5%) of the selected studies, and all studies related to NO found higher levels of this marker in OLP than in HC. Despite controversial results, our review suggests that OLP patients have an increased inflammatory response, as indicated by the proinflammatory profile of salivary cytokines. In addition, we conclude that salivary cytokine and NO measurements may have significant diagnostic and prognostic potential for monitoring disease activity and therapeutic responses in OLP.
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Affiliation(s)
- Janaina Silva Martins Humberto
- Universidade de São Paulo - USP, School of Dentistry of Ribeirão Preto, Department of Morphology, Physiology, and Basic Pathology, Ribeirão Preto, SP, Brazil
| | - Jefferson Veronezi Pavanin
- Universidade de São Paulo - USP, School of Dentistry of Ribeirão Preto, Department of Stomatology, Ribeirão Preto, SP, Brazil
| | - Maria José Alves da Rocha
- Universidade de São Paulo - USP, School of Dentistry of Ribeirão Preto, Department of Morphology, Physiology, and Basic Pathology, Ribeirão Preto, SP, Brazil
| | - Ana Carolina Fragoso Motta
- Universidade de São Paulo - USP, School of Dentistry of Ribeirão Preto, Department of Stomatology, Ribeirão Preto, SP, Brazil
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Giuliani M, Troiano G, Cordaro M, Corsalini M, Gioco G, Lo Muzio L, Pignatelli P, Lajolo C. Rate of malignant transformation of oral lichen planus: A systematic review. Oral Dis 2018; 25:693-709. [PMID: 29738106 DOI: 10.1111/odi.12885] [Citation(s) in RCA: 141] [Impact Index Per Article: 23.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2018] [Revised: 04/09/2018] [Accepted: 04/26/2018] [Indexed: 02/06/2023]
Abstract
OBJECTIVE The aim of this study was to systematically review the literature to determine: (a) the malignant transformation rate (TR) of oral lichen planus (OLP) and its risk factors; (b) whether or not oral lichenoid lesions (OLL) have a different malignant TR. MATERIALS AND METHODS PubMed, Scopus, and Web of Science were used as search engines: only observational, full-length, English language studies were investigated. PRISMA protocol was used to evaluate and present results. PROSPERO registration code is CRD42016048529. RESULTS Among 7,429 records screened, only 21 were included in this review. Ninety-two of 6,559 patients developed oral squamous cell carcinoma, with an overall TR of 1.40% (1.37% for OLP and 2.43% for OLL), an annual TR of 0.20%. Female gender, red clinical forms, and tongue site seem to slightly increase the transformation risk. CONCLUSIONS This systematic review confirms that both OLP and OLL, the latter with a slightly higher TR, may be considered potentially malignant disorders and suggest that erosive type, female gender and tongue site should be considered as risk factors for OLP transformation. Major efforts should be done to establish strict clinical and histological criteria to diagnose OLP and to perform sounder methodological observational studies.
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Affiliation(s)
- Michele Giuliani
- Department of Clinical and Experimental Medicine, University of Foggia, Foggia, Italy
| | - Giuseppe Troiano
- Department of Clinical and Experimental Medicine, University of Foggia, Foggia, Italy
| | - Massimo Cordaro
- School of Dentistry, Catholic University of the Sacred Heart, Rome, Italy
| | - Massimo Corsalini
- Interdisciplinary Department of Medicine (DIM), University of Bari, Bari, Italy
| | - Gioele Gioco
- School of Dentistry, Catholic University of the Sacred Heart, Rome, Italy
| | - Lorenzo Lo Muzio
- Department of Clinical and Experimental Medicine, University of Foggia, Foggia, Italy
| | - Pamela Pignatelli
- Department of Medical, Oral and Biotechnological Sciences, University of Chieti-Pescara, Chieti, Italy
| | - Carlo Lajolo
- School of Dentistry, Catholic University of the Sacred Heart, Rome, Italy
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Nosratzahi T, Raiesi M, Shahryari B. Lack of Association between Oral Lichen Planus and Hepatitis B and C Virus Infection - a Report from Southeast Iran. Asian Pac J Cancer Prev 2018; 19:1633-1637. [PMID: 29936791 PMCID: PMC6103594 DOI: 10.22034/apjcp.2018.19.6.1633] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Background: Oral lichen planus (OLP) is a chronic autoimmune disease with an unknown etiology. Dentists
are usually the first medical practitioners to diagnose this condition although it also affects body parts other than
the oral mucosa. Several studies have reported an association between the OLP and hepatitis B and C infections.
This study aimed to determine the prevalence of hepatitis B virus (HBV) antigen and hepatitis C virus (HCV) antibodies
in patients with OLP compared with healthy controls. Methods: In this case‒control study, 50 patients with clinical
and histopathological characteristics of OLP, and 50 age- and sex-matched healthy controls supplied serum samples
(5 mL) for evaluation by ELISA. Data were analyzed using SPSS Software, version 21. Chi-square test was applied as
appropriate. Results: In this study, the 50 patients with OLP (33 females and 17 males) had a mean age of 42.0 ± 14.5
years, and the 50 healthy subjects (33 females and 17 males) a mean age of 41.9 ± 13.7 years. None demonstrated any
evidence of HBV antigen or HCV antibodies. Discussion: We could not detect any association between OLP and viral
hepatitis. This could be attributed to a lower prevalence of hepatitis viruses compared to other countries or genotypic
variation or other etiological factors contributing in our cases.
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Affiliation(s)
- Tahereh Nosratzahi
- Dental Research Center, Faculty of Dentistry, Zahedan University of Medical Sciences, Zahedan, Iran.
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Masquijo-Bisio PA, Gandolfo MS, Keszler A, Itoiz ME, Paparella ML. Usefulness of a direct immunofluorescence in the diagnosis of plaque type oral lichen planus. Ann Diagn Pathol 2017; 31:20-22. [PMID: 29146053 DOI: 10.1016/j.anndiagpath.2017.05.008] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2017] [Accepted: 05/15/2017] [Indexed: 11/17/2022]
Affiliation(s)
- Patricia Alejandra Masquijo-Bisio
- Cátedra de Clínica Estomatológica, Facultad de Odontología, Universidad de Buenos Aires, Argentina; Cátedra de Anatomía Patológica, Facultad de Odontología, Universidad de Buenos Aires, Argentina.
| | - Mariana Silvia Gandolfo
- Cátedra de Clínica Estomatológica, Facultad de Odontología, Universidad de Buenos Aires, Argentina
| | - Alicia Keszler
- Cátedra de Anatomía Patológica, Facultad de Odontología, Universidad de Buenos Aires, Argentina
| | - Maria Elina Itoiz
- Cátedra de Anatomía Patológica, Facultad de Odontología, Universidad de Buenos Aires, Argentina.
| | - María Luisa Paparella
- Cátedra de Anatomía Patológica, Facultad de Odontología, Universidad de Buenos Aires, Argentina
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McCoy JM, Oreadi D. Diagnosis and Management of Pathological Conditions. J Oral Maxillofac Surg 2017; 75:e224-e263. [DOI: 10.1016/j.joms.2017.04.024] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Wiriyakijja P, Fedele S, Porter SR, Mercadante V, Ni Riordain R. Patient-reported outcome measures in oral lichen planus: A comprehensive review of the literature with focus on psychometric properties and interpretability. J Oral Pathol Med 2017. [DOI: 10.1111/jop.12604] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Affiliation(s)
- Paswach Wiriyakijja
- UCL Eastman Dental Institute; London UK
- Department of Oral Medicine; Faculty of Dentistry; Chulalongkorn University; Bangkok Thailand
| | - Stefano Fedele
- UCL Eastman Dental Institute; London UK
- NIHR University College London Hospitals Biomedical Research Centre; London UK
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Adamo D, Cascone M, Celentano A, Ruoppo E, Leuci S, Aria M, Mignogna MD. Psychological profiles in patients with symptomatic reticular forms of oral lichen planus: A prospective cohort study. J Oral Pathol Med 2017; 46:810-816. [DOI: 10.1111/jop.12577] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/06/2017] [Indexed: 01/03/2023]
Affiliation(s)
- Daniela Adamo
- University Federico II of Naples; Department of Neurosciences, Reproductive and Odontostomatological Sciences; Naples Italy
| | - Marco Cascone
- University Federico II of Naples; Department of Neurosciences, Reproductive and Odontostomatological Sciences; Naples Italy
| | - Antonio Celentano
- Melbourne Dental School; University of Melbourne; Carlton, Vic Australia
| | - Elvira Ruoppo
- University Federico II of Naples; Department of Neurosciences, Reproductive and Odontostomatological Sciences; Naples Italy
| | - Stefania Leuci
- University Federico II of Naples; Department of Neurosciences, Reproductive and Odontostomatological Sciences; Naples Italy
| | - Massimo Aria
- Department of Economics and Statistics; University Federico II of Naples; Naples Italy
| | - Michele D. Mignogna
- University Federico II of Naples; Department of Neurosciences, Reproductive and Odontostomatological Sciences; Naples Italy
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Bandyopadhyay A, Behura SS, Nishat R, Dash KC, Bhuyan L, Ramachandra S. Clinicopathological Profile and Malignant Transformation in Oral Lichen Planus: A Retrospective Study. J Int Soc Prev Community Dent 2017; 7:116-124. [PMID: 28584781 PMCID: PMC5452564 DOI: 10.4103/jispcd.jispcd_103_17] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2017] [Accepted: 03/27/2017] [Indexed: 01/10/2023] Open
Abstract
OBJECTIVES The aim of this study was to analyze the histopathologically diagnosed cases of oral lichen planus (OLP) in terms of age, gender, clinical variant, site, hyperpigmentation, systemic illness, grade of dysplasia, and associated malignant transformation. This study also intended to do a review of reported cases of OLP with malignant transformation. MATERIALS AND METHODS One hundred and forty-three cases of histopathologically diagnosed OLP between 2010 and 2016 were retrospectively reviewed. Demographic and clinicopathological data including malignant transformation were obtained. The data obtained were analyzed using the Statistical Package for the Social Sciences (SPSS) software for Windows version 20.0 (IBM SPSS, SPSS Inc., Chicago, IL, USA). A review of published literature on OLP with malignant transformation was also done from 1988 to 2017 and tabulated. RESULTS OLP in this study showed a male predilection with most of the patients in the third decade. The buccal mucosa (bilateral presentation) was the most common site (79.72%), and reticular type was the most common clinical type (79.02%) followed by erosive type (20.98%). The majority (92.31%) of cases were diagnosed with OLP without dysplasia. The rest (7.69%) of dysplastic cases were predominantly seen in the buccal mucosa of 58 years and above, female patients manifesting mainly as erosive type. Two patients (1.4%) previously diagnosed clinically and histopathologically as OLP developed oral squamous cell carcinoma. CONCLUSION The present investigation revealed the predominance of OLP among middle-aged male population and the prevalence of bilateral involvement of buccal mucosa. Two of our cases showed malignant transformation over an average period of 3.5 years. The outcome of this study emphasizes the role of clinical follow-up of patients with OLP.
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Affiliation(s)
- Alokenath Bandyopadhyay
- Department of Oral Pathology and Microbiology, Kalinga Institute of Dental Sciences, KIIT University, Bhubaneswar, Odisha, India
| | - Shyam Sundar Behura
- Department of Oral Pathology and Microbiology, Kalinga Institute of Dental Sciences, KIIT University, Bhubaneswar, Odisha, India
| | - Roquaiya Nishat
- Department of Oral Pathology and Microbiology, Kalinga Institute of Dental Sciences, KIIT University, Bhubaneswar, Odisha, India
| | - Kailash Chandra Dash
- Department of Oral Pathology and Microbiology, Kalinga Institute of Dental Sciences, KIIT University, Bhubaneswar, Odisha, India
| | - Lipsa Bhuyan
- Department of Oral Pathology and Microbiology, Kalinga Institute of Dental Sciences, KIIT University, Bhubaneswar, Odisha, India
| | - Sujatha Ramachandra
- Department of Oral Pathology and Microbiology, Kalinga Institute of Dental Sciences, KIIT University, Bhubaneswar, Odisha, India
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Aghbari SMH, Abushouk AI, Attia A, Elmaraezy A, Menshawy A, Ahmed MS, Elsaadany BA, Ahmed EM. Malignant transformation of oral lichen planus and oral lichenoid lesions: A meta-analysis of 20095 patient data. Oral Oncol 2017; 68:92-102. [PMID: 28438300 DOI: 10.1016/j.oraloncology.2017.03.012] [Citation(s) in RCA: 155] [Impact Index Per Article: 22.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2017] [Accepted: 03/25/2017] [Indexed: 12/11/2022]
Abstract
OBJECTIVES For over a century, a heated debate existed over the possibility of malignant transformation of oral lichen planus (OLP). We performed this meta-analysis to evaluate the malignant potential of OLP and oral lichenoid lesions (OLL) and investigate the possible risk factors for OLP malignant transformation into oral squamous cell carcinoma (OSCC). MATERIALS AND METHODS We searched Medline, Scopus, and Web of Knowledge for relevant observational studies. Data on OLP malignant transformation were calculated as a pooled proportion (PP), using the Der-Simonian Liard method. We performed subgroup analyses by OLP diagnostic criteria, site, and clinical type, using Open Meta[Analyst] software. Data on possible risk factors for malignant transformation were pooled as odds ratios (ORs), using Comprehensive Meta-Analysis software. RESULTS Pooling data for OLP malignant transformation from 57 studies (19,676 patients) resulted in an overall PP of 1.1% [95% CI: 0.9%, 1.4%], while pooling data from 14 recent studies that used the World Health Organization-2003 diagnostic criteria resulted in an overall-PP of 0.9% [95% CI: 0.5%, 1.3%]. The risk of malignant transformation was higher (PP=2.5%, 95% CI [1%, 4%]) in OLL patients (419 patients). A significant increase of malignant transformation risk was noted among smokers (OR=2, 95% CI [1.25, 3.22]), alcoholics (OR=3.52, 95% CI [1.54, 8.03]), and HCV-infected patients (OR=5, 95% CI [1.56, 16.07]), compared to patients without these risk factors. CONCLUSION A small subset of OLP patients (1.1%) develop OSCC; therefore, regular follow-up for these patients is recommended. A higher incidence of malignant transformation was found among smokers, alcoholics, and HCV-infected patients; however, these associations should be further investigated.
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Affiliation(s)
| | | | - Attia Attia
- Faculty of Medicine, Al-Azhar University, Cairo, Egypt
| | | | - Amr Menshawy
- Faculty of Medicine, Al-Azhar University, Cairo, Egypt
| | | | | | - Eman Magdy Ahmed
- Faculty of Oral and Dental Medicine, Beni Suef University, Beni Suef, Egypt
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Siponen M, Huuskonen L, Kallio-Pulkkinen S, Nieminen P, Salo T. Topical tacrolimus, triamcinolone acetonide, and placebo in oral lichen planus: a pilot randomized controlled trial. Oral Dis 2017; 23:660-668. [PMID: 28168769 DOI: 10.1111/odi.12653] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2016] [Revised: 12/26/2016] [Accepted: 01/15/2017] [Indexed: 01/06/2023]
Abstract
OBJECTIVE To carry out a double-blind randomized controlled trial (RCT) to compare the effectiveness of topical tacrolimus (TAC), triamcinolone acetonide (TRI), and placebo (PLA) in symptomatic oral lichen planus (OLP). SUBJECTS AND METHODS A clinical score (CS, range 0-130) was developed to measure the clinical signs and symptoms of OLP. Twenty-seven OLP patients with a CS of ≥20 were randomly allocated to receive 0.1% TAC ointment (n = 11), 0.1% TRI paste (n = 7), or Orabase® paste as PLA (n = 9) for 3 weeks. If the CS dropped ≥20% (interpreted as response), the patients continued the same medication for another 3 weeks. If the CS dropped <20% or increased (non-response), the patients were switched to TAC for 6 weeks. A 6-month follow-up period ensued. The primary outcome variable was the change in CS from baseline to week 3. In primary outcome analysis, CS values between the treatment arms were compared. RESULTS Tacrolimus and TRI were more effective (P = 0.012 and 0.031, respectively) than PLA in reducing the CS at week 3. No difference in the efficacy was noted between TAC and TRI (P = 0.997). CONCLUSIONS This pilot RCT provides evidence for the effectiveness of TAC and TRI over PLA in the management of OLP.
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Affiliation(s)
- M Siponen
- Institute of Dentistry, University of Oulu, Oulu, Finland.,Cancer and Translational Medicine Research Unit, University of Oulu, Oulu, Finland.,Department of Oral and Maxillofacial Diseases, Kuopio University Hospital, Kuopio, Finland
| | - L Huuskonen
- Institute of Dentistry, University of Oulu, Oulu, Finland
| | | | - P Nieminen
- Medical Informatics and Statistics Research Group, University of Oulu, Oulu, Finland
| | - T Salo
- Institute of Dentistry, University of Oulu, Oulu, Finland.,Cancer and Translational Medicine Research Unit, University of Oulu, Oulu, Finland.,Department of Oral and Maxillofacial Diseases, University of Helsinki, Helsinki, Finland.,Medical Research Center, Oulu University Hospital, Oulu, Finland
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Mankapure PK, Humbe JG, Mandale MS, Bhavthankar JD. Clinical profile of 108 cases of oral lichen planus. J Oral Sci 2017; 58:43-7. [PMID: 27021539 DOI: 10.2334/josnusd.58.43] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
Abstract
Oral lichen planus (OLP) is a T cell-mediated chronic inflammatory disease with a varied clinical presentation. The present clinical study was carried out to clarify the demographic and clinical profile of 108 patients with OLP. The patients were identified based on the diagnostic criteria proposed by van der Meij et al. (2003) modified from the WHO (1978) clinical and histopathologic definition of OLP. Information such as age, gender, clinical presentation and type of OLP, site of involvement, symptoms, extraoral involvement, history of systemic disease, familial occurrence and risk factors like chewing and smoking tobacco, chewing betel quid, alcohol consumption were obtained. Mean age of OLP patients was 45.4 years, and among the identified patients, 70.4% were females. The most frequent clinical type was the reticular form (80.6%). The OLP lesions were symptomatic in 77.8% of the patients. The buccal mucosa was the most affected site (87.9%) and multiple oral lesions were observed in 41.7% of the patients. Among the OLP patients, 36.1% and 4.7% reported chewing tobacco and smoking tobacco, respectively. Histopathologically, epithelial dysplasia was seen in two cases. The chronic nature of OLP warrants patient education, psychological support and long-term follow up. (J Oral Sci 58, 43-47, 2016).
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Affiliation(s)
- Pritam K Mankapure
- Department of Oral Pathology and Microbiology, Government Dental College and Hospital
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Anderson JG, Peralta S, Kol A, Kass PH, Murphy B. Clinical and Histopathologic Characterization of Canine Chronic Ulcerative Stomatitis. Vet Pathol 2017; 54:511-519. [PMID: 28113036 DOI: 10.1177/0300985816688754] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
Canine chronic ulcerative stomatitis, also known as chronic ulcerative paradental stomatitis, is a painful condition of the oral cavity. The purpose of this study was to determine if there are commonalities in clinical and radiographic features among patients, whether the histopathologic evaluation might inform the pathogenesis, and whether the condition appears similar to human oral mucosal diseases. To do this, we prospectively collected clinical, radiographic, and histopathologic data from 20 dogs diagnosed with the disease. Clinical data were based on a clinical disease activity index, oral and periodontal examination parameters, and full-mouth dental radiographs. The histopathological and immunohistochemical data were based on oral mucosal samples obtained from erosive or ulcerated areas. Our findings revealed that canine chronic stomatitis is clinically characterized by painful oral mucosal ulcers of varying size, pattern, appearance, and distribution, most often associated with teeth with early periodontitis. Histologic examination revealed a subepithelial lichenoid band (interface mucositis) where B cells, T cells, and Forkhead-box protein 3 (FoxP3)- and interleukin-17-expressing cells were present. These cells might play a role in the underlying immune response and an immune-mediated pathogenesis is suspected. The clinical and histopathologic features of this chronic inflammatory mucosal disease in dogs resemble those of oral lichen planus in humans.
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Affiliation(s)
- J G Anderson
- 1 Sacramento Veterinary Dental Services, Rancho Cordova, CA, USA
| | - S Peralta
- 2 Department of Clinical Sciences, College of Veterinary Medicine, Cornell University, Ithaca, NY, USA
| | - A Kol
- 3 Department of Pathology, Microbiology and Immunology, University of California, Davis, School of Veterinary Medicine, Davis, CA, USA
| | - P H Kass
- 4 Department of Analytic Epidemiology, School of Veterinary Medicine and School of Medicine, University of California, Davis, CA, USA
| | - B Murphy
- 3 Department of Pathology, Microbiology and Immunology, University of California, Davis, School of Veterinary Medicine, Davis, CA, USA
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Ferreira SJ, Machado MÂN, de Lima AAS, Johann ACBR, Grégio AMT, Azevedo-Alanis LR. Identification of AgNORs and cytopathological changes in oral lichen planus lesions. Acta Histochem 2017; 119:32-38. [PMID: 27916273 DOI: 10.1016/j.acthis.2016.11.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2016] [Revised: 09/17/2016] [Accepted: 11/10/2016] [Indexed: 11/17/2022]
Abstract
OBJECTIVE To evaluate cytopathological changes in epithelial cells of the oral mucosa of patients with oral lichen planus (OLP) compared with patients without OLP. SUBJECTS AND METHODS Swabs were collected from the oral mucosa of 20 patients with OLP (case group) and 20 patients without OLP (control group) using liquid-based cytology. After Papanicolaou staining, the smears were characterized based on Papanicolaou classification and degree of maturation. Nuclear area (NA) measurements, cytoplasmic area (CA) measurements, and the NA/CA ratio were determined from 50 epithelial cells per slide. For quantification of argyrophilic nucleolar organizer regions (AgNORs), the smears were stained with silver nitrate, and the number of AgNORs was counted in 100 cells. RESULTS In both groups, there was a predominance of Papanicolaou Class I nucleated cells in the superficial layer. The average values of NA (p>0.05) and CA (p=0.000) were greater in the case group (NA=521.6, CA=22,750.3) compared with the control group (NA=518.9, CA=18,348.0). The NA/CA ratio was 0.025 for the case group and 0.031 for the control group (p=0.004). There was no significant difference between the mean AgNORs values of both groups (p>0.05). CONCLUSION The oral mucosa of patients with OLP exhibited significant cytomorphometric changes. However, there was no evidence of malignancy.
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Affiliation(s)
- Stefânia Jeronimo Ferreira
- Graduate Program in Dentistry, School of Health and Biosciences, Pontifícia Universidade Católica do Paraná, Rua Imaculada Conceição, 1155, Curitiba, Pr 80215-901, Brazil.
| | | | | | - Aline Cristina Batista Rodrigues Johann
- Graduate Program in Dentistry, School of Health and Biosciences, Pontifícia Universidade Católica do Paraná, Rua Imaculada Conceição, 1155, Curitiba, Pr 80215-901, Brazil.
| | - Ana Maria Trindade Grégio
- Graduate Program in Dentistry, School of Health and Biosciences, Pontifícia Universidade Católica do Paraná, Rua Imaculada Conceição, 1155, Curitiba, Pr 80215-901, Brazil.
| | - Luciana Reis Azevedo-Alanis
- Graduate Program in Dentistry, School of Health and Biosciences, Pontifícia Universidade Católica do Paraná, Rua Imaculada Conceição, 1155, Curitiba, Pr 80215-901, Brazil.
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Pigmented oral lichen planus: A case report. SCIENTIFIC DENTAL JOURNAL 2017. [DOI: 10.26912/sdj.2017.01.01-03] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
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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: 36] [Impact Index Per Article: 4.5] [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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