Histopathological specialized staining of oral lichen planus-induced fibrotic changes and surgical treatment of associated restricted mouth opening: a case report

Abstract Background Oral lichen planus is a chronic inflammatory and immune-mediated disease that affects the oral mucosa. Recent findings have suggested that oral lichen planus is often associated with submucosal fibrotic changes. Fibrotic changes in the buccal submucosa may cause restricted mouth opening. This report discusses the histopathological examination (including specialized staining) and surgical treatment for oral lichen planus-induced fibrotic changes. Case presentation Here, we describe a 63-year-old woman who had oral lichen planus with fibrotic changes. Her maximum mouth opening distance was approximately 30 mm due to submucosal fibrotic changes, and she exhibited gradual fibrosis progression. Histological examinations were performed to assess the oral lichen planus-induced fibrotic changes. Then, double Z-plasty were performed as treatment for restricted mouth opening. The immunohistochemical staining results were negative for cytokeratin 13 and positive in some layers for cytokeratin 17 and Ki-67/MIB-1. Masson's trichrome staining showed enhanced collagen formation. Postoperative mouth opening training enabled the patient to achieve a mouth opening distance of > 50 mm. Conclusion Our findings suggest that histopathological examination with specialized staining can aid in the evaluation of oral lichen planus-induced fibrotic changes, and that Z-plasty is effective for the treatment of restricted mouth opening due to oral lichen planus.

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Oral Verruciform Xanthoma within Lichen Planus: A Case Report and Literature Review

Case Reports in Dentistry ◽

10.1155/2018/1615086 ◽

2018 ◽

Vol 2018 ◽

pp. 1-5 ◽

Cited By ~ 1

Author(s):

Vasileios I. Theofilou ◽

Alexandra Sklavounou ◽

Prokopios P. Argyris ◽

Evanthia Chrysomali

Keyword(s):

Case Report ◽

Lichen Planus ◽

Oral Lichen Planus ◽

Cell Damage ◽

Final Diagnosis ◽

Verruciform Xanthoma ◽

Immune Mediated ◽

Wide Range ◽

Oral Lichen

Background. Verruciform xanthoma is an uncommon benign tumor, which exhibits a wide range of clinical patterns. The occurrence of the lesion in patients with immune-mediated mucocutaneous diseases may suggest a role of localized epithelial cell damage and chronic inflammation in its pathogenesis. Case Report. A case of verruciform xanthoma on the tongue of a 56-year-old female with oral lichen planus is reported. An asymptomatic pink-white lesion with a granular surface was observed in the left lateral lingual border, which was closely associated with a white plaque and striae. An incisional biopsy was performed, and histologically, epithelial projections in a verrucous pattern were observed. In the subepithelial connective tissue, aggregates of foamy cells that exhibited immunoreactivity for CD68 were noted. The final diagnosis was verruciform xanthoma. The mucosa adjacent to the lesion demonstrated histopathological features consistent with lichen planus. Conclusions. A total of twelve cases of oral verruciform xanthomas in patients with oral lichen planus including the present case have been reported in the literature. The clinician should be aware that verruciform xanthoma may mimic malignancy, and therefore, biopsy is required for definitive diagnosis to be established, especially when this tumor develops within conditions that show potential for malignant transformation.

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Role Of Efferocytosis In Oral Lichen Planus

10.1101/2021.08.09.455749 ◽

2021 ◽

Author(s):

Rooban Thavarajah ◽

Kannan Ranganathan

Keyword(s):

Lichen Planus ◽

Oral Lichen Planus ◽

Differential Analysis ◽

Cell Debris ◽

Exclusion Criteria ◽

Normal Tissues ◽

Immune Mediated ◽

Key Genes ◽

Oral Lichen

Background: Oral lichen planus (OLP) is a chronic, immune mediated interface mucositis of oral mucosa. Though the apoptosis of keratinocytes is a feature of OLP, not much is known about the clearance of cell debris (efferocytosis) resulting from apoptosis. We postulate that there is a defective or delayed efferocytosis in OLP, which may have a role in modulating the immune response in OLP. Methods: Published mRNA expression of tissue of 14 patients with OLP and 14 cases of normal tissues were subjected to differential analysis (DE) and a list of DE genes identified. From this list, the genes that involved in efferocytosis were collated, compared and their interactions are typed. Result: In all, two studies fulfilled the inclusion and exclusion criteria. On combining the data, 1486 genes were significantly different between OLP and normal tissues. 28 of these 1486 genes are were associated with efferocytosis of which the suppression of LRP1, LDLR, ANAX2, C2, PBX1, PDCD4, S1PR5, CX3CL1, STAT6 and Wnt3A is indicative of defective or delayed efferocytosis in OLP. The role of pathways and associations were analyzed and is presented here. Discussion and Conclusion: The study revealed that certain key genes mRNAs that are associated with efferocytosis are altered in OLP. They could delay or lead to defective efferocytosis. Studying such genes in detail could provide deeper understanding of the pathogenesis of the disease and the discovery of therapeutic targets.

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Photodynamic therapy of oral lichen planus

Photochemical & Photobiological Sciences ◽

10.1039/d0pp00249f ◽

2020 ◽

Vol 19 (10) ◽

pp. 1271-1279

Author(s):

Juliane Hesse ◽

Andreas Schmalfuss ◽

Sigrid. I. Kvaal

Keyword(s):

Photodynamic Therapy ◽

Lichen Planus ◽

Oral Mucosa ◽

Oral Lichen Planus ◽

Immune Mediated ◽

Oral Lichen

Oral lichen planus (OLP) is a chronic inflammatory and immune-mediated disease affecting the oral mucosa.

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Oral Lichen Planus and Polycythemia: Possible Association

Case Reports in Dentistry ◽

10.1155/2020/8820114 ◽

2020 ◽

Vol 2020 ◽

pp. 1-6

Author(s):

Yassine Oueslati ◽

Raouaa Belkacem Chebil ◽

Haifa Regaieg ◽

Lamia Oualha ◽

Nabiha Douki

Keyword(s):

Lichen Planus ◽

Oral Lichen Planus ◽

Scientific Literature ◽

Early Stage ◽

Cell Mass ◽

Chronic Inflammatory Disease ◽

Oral Lesions ◽

Immune Mediated ◽

Immune Dysfunctions ◽

Oral Lichen

Oral lichen planus is a chronic inflammatory disease of established immune-mediated pathogenesis that affects the oral mucosa. Polycythemia is a nonaggressive myeloproliferative disorder, characterized by an increase in red blood cell mass, often with uncontrolled production of granulocytes and platelets. Their association was rarely mentioned in the scientific literature. The aim of this paper was to report their occurrence in a 52-year-old male patient. Although a casual connection cannot be excluded, both diseases share many similarities in the immune dysfunctions involved in their pathogenesis and their clinical features. Such a hypothesis remains to be demonstrated by further studies. The presence of oral lesions should alert the clinicians in the process of identifying and early diagnosing these diseases. Thus, complications can be prevented and treatment can be started at an early stage, avoiding further damage.

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Clinical-pathological characterization and study of polymorphisms of T-helper-1 and 2 (Th1 / 2) responses in immune-mediated diseases with oral manifestations: oral lichen planus and amalgam-associate oral lichenoid reaction

Oral Surgery Oral Medicine Oral Pathology and Oral Radiology ◽

10.1016/j.oooo.2012.08.032 ◽

2012 ◽

Vol 114 (4) ◽

pp. e48

Keyword(s):

Lichen Planus ◽

Oral Lichen Planus ◽

Oral Manifestations ◽

T Helper ◽

T Helper 1 ◽

Immune Mediated ◽

Oral Lichen ◽

Lichenoid Reaction

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Immunohistochemical Evaluation of Ki-67 Expression in Erosive andNon-Erosive Oral Lichen Planus

Avicenna Journal of Dental Research ◽

10.17795/ajdr-25372 ◽

2016 ◽

Vol 8 (2) ◽

pp. 1-1

Author(s):

Narges Gholizadeh ◽

Masoumeh Mehdipour ◽

Esmaiil Dadgar ◽

Ayla Bahramian ◽

Delaram Ebrahimpour Moghaddas

Keyword(s):

Lichen Planus ◽

Oral Lichen Planus ◽

Ki 67 ◽

Oral Lichen

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Difficulties in the Treatment of Oral Lichen Planus in a Systemically Compromised Patient: Case Report and Review of the Literature

Odovtos - International Journal of Dental Sciences ◽

10.15517/ijds.2021.48070 ◽

2021 ◽

pp. 167-176

Author(s):

Yadira V. Boza Oreamuno ◽

Fiorella Mora Abarca

Keyword(s):

Lichen Planus ◽

Oral Lichen Planus ◽

Gastrointestinal Diseases ◽

Clinical Appearance ◽

Immune Mediated ◽

Clinical Presentations ◽

Potentially Malignant ◽

Ulcerative Lesions ◽

Oral Lichen

Oral lichen planus (OLP) is a chronic inflammatory and immune-mediated disease that presents as bilateral, symmetrical oral lesions with three main clinical presentations: reticular, atrophic, and erosive. It is clinically characterized by pain, burning sensation, and discomfort for sufferers. Currently OLP is classified as a potentially malignant oral disorder. It has been associated with numerous systemic connotations such as diabetes mellitus, hypertension, metabolic syndrome, thyroid diseases, psychosomatic ailments, chronic liver disease, and gastrointestinal diseases. Diagnosis is made by clinical and histological examinations. It is a non-curable disease, the treatments are applied seeking the reduction or disappearance of the associated pain, as well as improving the clinical appearance of erosive-ulcerative lesions. The objective of this work was to present through a clinical case the difficulties in the treatment of OLP in a systemically compromised patient, highlighting the comprehensive assessment of the same, failed pharmacological therapies, until the symptomatology diminished and the patient's quality of life improved.

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