Update On Oral Lichen Planus: Etiopathogenesis and Management

1998 ◽  
Vol 9 (1) ◽  
pp. 86-122 ◽  
Author(s):  
C. Scully ◽  
M. Beyli ◽  
M. C. Ferreiro ◽  
G. Ficarra ◽  
Y. Gill ◽  
...  
Keyword(s):  
Lichen Planus ◽  
Oral Lichen Planus ◽  
Dental Materials ◽  
Definitive Treatment ◽  
Environmental Aspects ◽  
New Associations ◽  
Increased Risk ◽  
Oral Lichen ◽  
Selection Of

Lichen planus (LP) is a relatively common disorder of the stratified squamous epithelia, which is, in many ways, an enigma. This paper is the consensus outcome of a workshop held in Switzerland in 1995, involving a selection of clinicians and scientists with an interest in the condition and its management. The oral (OLP) eruptions usually have a distinct clinical morphology and characteristic distribution, but OLP may also present a confusing array of patterns and forms, and other disorders may clinically simulate OLP. Lesions may affect other mucosae and/or skin. Lichen planus is probably of multifactorial origin, sometimes induced by drugs or dental materials, often idiopathic, and with an immunopathogenesis involving T-cells in particular. The etiopathogenesis appears to be complex, with interactions between and among genetic, environmental, and lifestyle factors, but much has now been clarified about the mechanisms involved, and interesting new associations, such as with liver disease, have emerged. The management of lichen planus is still not totally satisfactory, and there is as yet no definitive treatment, but there have been advances in the control of the condition. There is no curative treatment available; immunomodulation, however, can control the condition. Based on the observed increased risk of malignant development, OLP patients should be offered regular follow-up examination from two to four times annually and asked to report any changes in their lesions and/or symptoms. Follow-up may be particularly important in patients with atrophic/ulcerative/erosive affections of the tongue, the gingiva, or the buccal mucosa. Much more research is required into the genetic and environmental aspects of lichen planus, into the premalignant potential, and into the possible associations with chronic liver, and other, disorders. More clinical studies are required into the possible efficacy of immunomodulatory drugs such as pentoxifylline and thalidomide.

scholarly journals Familial oral lichen planus in a 3-year-old boy: a case report with eight years of follow-up

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Fang Wang ◽  
Ya-Qin Tan ◽  
Jing Zhang ◽  
Gang Zhou
Keyword(s):  
Lichen Planus ◽  
Oral Mucosa ◽  
Buccal Mucosa ◽  
Oral Lichen Planus ◽  
Familial Aggregation ◽  
Pediatric Population ◽  
Case Presentation ◽  
Oral Lichen

Abstract Background Oral lichen planus (OLP) is a chronic mucocutaneous disease characterized by adult predominance and a prolonged course. However, it is rare in the pediatric population with familial aggregation. Case presentation A 3-year-old boy presented with pain and irritation on the oral mucosa while contacting spicy food for 2 months. Oral examination showed widespread whitish reticular and papular lesions on the lips, the dorsum of the tongue, and bilateral buccal mucosa, with diffuse erosions covered with pseudomembrane on the buccal mucosa. The boy’s parents were examined to exhibit white reticular and plaque-like lesions on their oral mucosa. The three patients were clinically diagnosed as affected by OLP and histopathologically confirmed. The boy underwent topical treatment with recombinant bovine basic fibroblast growth factor (rb-bFGF) gel, and oral lesions gradually resolved and healed. Neither of his parents received treatment. During the subsequent follow-ups, none of three patients underwent any medical treatment. Fortunately, their lesions had almost faded over 8 years. Conclusions Our case emphasizes that pediatric OLP should be recorded with family history. Besides, long-term periodic follow-up is recommended in pediatric patients with OLP for monitoring any changes in lesions.

Epithelial Loss Correlated with Decreased Beta Defensins and Increased Risk of Candida Infections in Oral Lichen Planus

2015 ◽  
Vol 119 (3) ◽  
pp. e111
Author(s):  
Jeyaseelan Augustine ◽  
Chiranjit Maity ◽  
Priya Kumar ◽  
Shalini Gupta ◽  
Dipankar Ghosh ◽  
...  
Keyword(s):  
Lichen Planus ◽  
Oral Lichen Planus ◽  
Increased Risk ◽  
Beta Defensins ◽  
Candida Infections ◽  
Oral Lichen

scholarly journals GRINSPAN SYNDROME: THE TRIAD

2020 ◽  
Vol 4 (10) ◽  
Author(s):  
Seema M ◽  
Shruti Srinivasan
Keyword(s):  
Diabetes Mellitus ◽  
Early Detection ◽  
Malignant Transformation ◽  
Lichen Planus ◽  
Oral Lichen Planus ◽  
Clinical Manifestations ◽  
Prevention And Early Detection ◽  
Burning Mouth ◽  
Oral Lichen

Lichen Planus is a chronic immunologically mediated mucocutaneous disorder with varied clinical manifestations. The condition might be associated with multiple causative or exacerbation factors. An interesting association of Oral Lichen Planus with Diabetes Mellitus and vascular hypertension is called as Grinspan's syndrome. Since its inception has been an arena of interest. It has appeared very lucrative to many researchers as it lacks clarity and enhanced ambiguity. A 65 year female patient came with a complaint of burning mouth and difficulty in swallowing since 1 year with H/O Diabetes Mellitus since 8years and hypertension since 2 years. Malignant transformation is the most significant complication of long standing and non healing Lichen Planus. Repeated follow up and biopsies are mandatory for prevention and early detection of malignant transformation. Keywords: Grinspan Syndrome, Hypertrophic Lichen Planus, Esophageal Lichen Planus

scholarly journals Photobiomodulation Therapy vs. Corticosteroid for the Management of Erosive/Ulcerative and Painful Oral Lichen Planus. Assessment of Success Rate during One-Year Follow-Up: A Retrospective Study

Healthcare ◽  
2021 ◽  
Vol 9 (9) ◽  
pp. 1137
Author(s):  
Samir Nammour ◽  
Marwan El Mobadder ◽  
Aldo Brugnera ◽  
Melanie Namour ◽  
Saad Houeis ◽  
...  
Keyword(s):  
Retrospective Study ◽  
Recurrence Rate ◽  
Lichen Planus ◽  
Oral Lichen Planus ◽  
Continuous Wave ◽  
Clinical Aspects ◽  
Complete Disappearance ◽  
Significant Difference ◽  
Oral Lichen

Photobiomodulation (PBM) therapy is a promising approach for the management of inflammatory conditions and autoimmune lesions, such as oral lichen planus (OLP). The aim of this retrospective study was to assess the effectiveness of PBM in the management of painful and erosive/ulcerative OLP and to compare it with the standard of care that is the topical application of corticosteroids. 96 patients were included with erosive and painful OLP. 48 patients received PBM therapy and 48 received corticosteroids. Data was collected retrospectively on pain using the visual analogue scale; clinical aspects of lesions were assessed with the REU score, and the recurrence rate was noted. One session of PBM therapy with a helium-neon red light (635 nm) was carried out every 48 h for 6 weeks. Treatments were mainly made in contact mode, using a fiber with a diameter of 600 µm (0.6 mm). The output power of the laser beam was calibrated by a power meter. A delivered power of 0.1 W was used for 40 s in a continuous wave (CW), corresponding to a delivered energy of 4 J. The delivered energy density related to the fiber diameter was 1415 J/cm2. Each treated point was considered as 1 cm2 of diameter. PBM therapy within these parameters was carried out on each point until the totality of the lesion was covered, including the non-erosive OLP area. Furthermore, healthy mucosa within 5 mm of the lesion was also irradiated with the same conditions. This PBM treatment was performed during 6 consecutive weeks. The topical corticosteroid treatment consisted of cortisone application to cover the OLP 3 times/day for 6 weeks. Follow-up was made at 6 weeks and at 3, 6 and 12 months. After 6 weeks, both groups showed complete absence of pain, and a complete disappearance of ulcerative/erosive areas. No significant difference was found for both groups concerning the recurrence rate of erosive OLP during the follow-up period; values were 0% at 6 weeks for both groups and 79% and 87.5% for the corticosteroid and PBM group, respectively, at 12 months of follow-up. PBM is effective for managing OLP and is significantly similar to topical corticosteroids without any need for the use of medication and with no reported side effects.

scholarly journals Is oral lichen planus a risk factor for peri-implant diseases? A systematic review and meta-analysis

2020 ◽  
Author(s):  
Xiaoqin Xiong ◽  
Ting Yu ◽  
Tiantian Xu ◽  
Xinhong Wang ◽  
Wenguang Qin ◽  
...  
Keyword(s):  
Systematic Review ◽  
Risk Factor ◽  
Lichen Planus ◽  
Oral Lichen Planus ◽  
Large Scale ◽  
Meta Analysis ◽  
Fixed Effect Model ◽  
Healthcare Research ◽  
Oral Lichen

Abstract Background : To evaluate whether oral lichen planus (OLP) is a risk factor for peri-implant diseases (PIDs) with a systematic review and meta-analysis. Methods : Six electronic databases including Medline, Web of Science, etc. were searched. Included studies are observational human studies written in English. Population of interest were those with/without OLP who received dental implant treatment. Follow-up time after implantation is from one month to 20 years. The quality of the included literature regarding risk of bias and methodology was assessed with Newcastle-Ottawa Scale or the Agency for Healthcare Research and Quality. The data involving exposure (OLP), primary outcomes (implants having PIDs) and secondary outcomes (probing depth/PD, bleeding on probing/BOP and bone loss/BL) and potential confounders were extracted. Heterogeneity was assessed by I² tests. Dichotomous data were expressed as risk ratio (RR) and 95% confidence interval (CI) which were calculated with a fixed effect model. Results : Of 139 literatures, two studies were enrolled and evaluated as high quality, which totally contained 68 participants receiving 222 (OLP vs. non-OLP, 112 vs. 110) implants with 12 to 120-month follow-up time. Proportions of implants with PIDs between OLP and non-OLP groups were as follows: 19.6% (22/112) vs. 22.7% (25/110) for PIM; 17.0% (19/112) vs. 10.9% (12/110) for PI. Meta-analysis found no recognizable difference in number of implants with PIDs (PI: RR = 1.49, 95% CI 0.77-2.90, P = 0.24; PIM:RR = 0.88, 95% CI 0.53 -1.46, P = 0.61; PIDs: RR = 1.08, 95% CI 0.75 -1.55, P = 0.68) or BOP (RR = 0.90, 95% CI: 0.70-1.15, P = 0.40) between OLP and non-OLP groups. Conclusions : Available literature regarding the effects of OLP on PIDs remains very limited. Existing evidence seems not support OLP as a suspected risk factor for PIDs. Large-scale prospective trials are required to test the findings. Keywords : dental implants; peri-implant diseases; oral lichen planus; systematic review; meta-analysis.

scholarly journals Photodynamic Treatment of Oral Lichen Planus: A Literature Review

2021 ◽  
Vol 8 ◽  
Author(s):  
Asma Azzouzi ◽  
Karima El Harti
Keyword(s):  
Photodynamic Therapy ◽  
Lichen Planus ◽  
Oral Lichen Planus ◽  
Signs And Symptoms ◽  
First Line ◽  
Photodynamic Treatment ◽  
Randomized Controlled ◽  
Oral Lichen ◽  
Exact Origin

Lichen planus (LP) is a chronic, relapsing, non-infectious inflammatory disease affecting the skin and mucous membranes. The exact origin of oral lichen planus (OLP) is not well known. Complete spontaneous healing is rare. The treatment of oral lichen planus is palliative, and there is no curative treatment so far, which is a therapeutic challenge for practitioners. The goals of treatment are the control of pain, signs, and symptoms. Local corticosteroids remain the first-line treatment. In case of failure of drug therapy, other treatments can be considered, such as photodynamic therapy. Material and methods: Our work was carried out using the PubMed, ScienceDirect, and EBSCO search engines to explore the literature on the efficacy of photodynamic therapy in the treatment of lichen planus. Conclusion: Photodynamic therapy appears to have some effect in the treatment of OLP in adult patients. However, further randomized controlled trials with a long follow-up period, standardized PDT parameters, and comparison of PDT efficacy with steroid therapy are warranted to obtain firm conclusions in this regard.

scholarly journals Is oral lichen planus a risk factor for peri-implant diseases? A systematic review and meta-analysis

2020 ◽  
Author(s):  
Xiaoqin Xiong ◽  
Tiantian Xu ◽  
Xinhong Wang ◽  
Wenguang Qin ◽  
Ting Yu ◽  
...  
Keyword(s):  
Systematic Review ◽  
Risk Factor ◽  
Lichen Planus ◽  
Oral Lichen Planus ◽  
Large Scale ◽  
Meta Analysis ◽  
Healthcare Research ◽  
Cochrane Library ◽  
Oral Lichen

Abstract Background : To evaluate whether oral lichen planus (OLP) is a risk factor for peri-implant diseases (PIDs) with a systematic review and meta-analysis. Methods : Five electronic databases including Medline, Embase, Web of Science, the Cochrane Library and Scopus were searched. The included studies are observational human studies written in English. The population of interest included those with/without OLP who received dental implant treatment. The follow-up time after implantation was from one month to 20 years. The quality of the included articles regarding risk of bias and methodology were assessed with the Newcastle-Ottawa Scale or the Agency for Healthcare Research and Quality. The data involving exposure (OLP), primary outcomes (implants having PIDs) and secondary outcomes (probing depth/PD, bleeding on probing/BOP and bone loss/BL) and potential confounders were extracted. Heterogeneity was assessed by I² test. Dichotomous data are expressed as the risk ratio (RR) and 95% confidence interval (CI) which were calculated with a fixed effect model. Results : Of the 66 articles, two studies were enrolled and evaluated as high quality, which totally contained 68 participants receiving 222 (OLP vs. non-OLP, 112 vs. 110) implants with 12 to 120-month follow-up time. Proportions of implants with PIDs between OLP and non-OLP groups were as follows: 19.6% (22/112) vs. 22.7% (25/110) for PIM and 17.0% (19/112) vs. 10.9% (12/110) for PI. The meta-analysis revealed no recognizable difference in number of implants with PIDs (PI: RR = 1.49, 95% CI 0.77-2.90, P = 0.24; PIM:RR = 0.88, 95% CI 0.53 -1.46, P = 0.61; PIDs: RR = 1.08, 95% CI 0.75 -1.55, P = 0.68) or BOP (RR = 0.90, 95% CI: 0.70-1.15, P = 0.40) between OLP and non-OLP groups. Conclusions : Available articles regarding the effects of OLP on PIDs remains very limited. Existing evidence does not support OLP as a suspected risk factor for PIDs. Large-scale prospective trials are required to validate the findings.

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