scholarly journals Evidence of earlier thyroid dysfunction in newly diagnosed oral lichen planus patients: a hint for endocrinologists

2017 ◽  
Vol 6 (8) ◽  
pp. 726-730 ◽  
Author(s):  
Paolo G Arduino ◽  
Dora Karimi ◽  
Federico Tirone ◽  
Veronica Sciannameo ◽  
Fulvio Ricceri ◽  
...  

The association between oral lichen planus (OLP) and hypothyroidism has been debated with conflicting results: some authors detected a statistically significant association between these two, while others did not confirm it. The aim of this study was to evaluate the thyroid status in patients with newly diagnosed OLP to test the null hypothesis that thyroid disease is not associated with an increased incidence of oral lesions, with a prospective case-control approach. A total of 549 patients have been evaluated, of whom 355 were female. Odds ratio (OR) and 95% confidence intervals (CIs) were obtained. Patients suffering from thyroid diseases were associated with an almost 3-fold increased odds of having OLP (OR 2.85, 95% CI: 1.65–4.94), after adjusting this analysis for age, gender, body mass index, smoking status, diabetes, hypertension and hepatitis C infection. It would be appropriate to further investigate the possible concomitance of OLP among patients with thyroid disorder; endocrinologists should be aware of this association, especially because OLP is considered a potentially malignant oral disorder.

2016 ◽  
Vol 2 (1) ◽  
pp. 1-10 ◽  
Author(s):  
Alessandro Villa ◽  
Francesco Nordio ◽  
Laura Strohmenger ◽  
Silvio Abati

Background: Histopathological examination remains the gold standard for the diagnosis of oral mucosal lesions. To date little is known on the clinical–pathologic agreement for oral lesions diagnosed by oral medicine experts.  Objective: This retrospective study attempts to quantify the clinical–pathologic agreement for oral lesions diagnosed by oral medicine experts. Methods: Data were collected retrospectively from the medical records of all new oral medicine consultations. The clinical diagnosis provided by an oral medicine expert was compared to the histopathological diagnosis. Clinical–pathologic agreement was estimated as the percentage agreement and was measured using weighted Kappa. Results: The most common oral lesions were oral lichen planus (34.7%), traumatic fibroma (23.4%), squamous cell carcinoma (SCC) or severe dysplasia (6.7%), mucous membrane pemphigoid (MMP) (5.7%), leukoplakia (5.6%) and squamous papilloma (4.3%). The overall clinical–pathologic agreement for all lesions had a weighted kappa of 0.81 [95%CI 0.78% to 0.85%]. The concordance for the most common oral lesions in the study population was 90.2%, with a weighted kappa of 0.88 [95%CI 0.85% to 0.92%]. The clinical–pathologic agreement for SCC/severe dysplasia was 78.7%, for traumatic fibroma 91.4%, for leukoplakia 97.4%, for oral lichen planus 93.8%, for squamous papilloma 96.7% and for MMP 65%. Conclusions: The overall concordance between clinical and histopathological diagnosis for oral lesions was excellent. Dentists have the unique opportunity to refer patients to oral medicine experts for diagnosis and management of oral diseases. Given their expertise patients may require fewer visits for diagnostic purposes.


2016 ◽  
Vol 2016 ◽  
pp. 1-4 ◽  
Author(s):  
Arpita Kabiraj ◽  
Tanya Khaitan ◽  
Debarati Bhowmick ◽  
Uday Ginjupally ◽  
Aritri Bir ◽  
...  

Objective. Oral exfoliative cytology (OEC) has been implemented in the diagnosis of pathologic lesions for ages. The present study was undertaken to evaluate the cytomorphological features of some of the commonest potentially malignant disorders (leukoplakia, lichen planus, and oral submucous fibrosis) through a simple procedure and illustrate its importance in mass screening.Materials and Method. A total of 160 subjects with 25–50 years of age were included in the study. Among them, 40 were clinically diagnosed with oral leukoplakia, 40 were diagnosed with oral lichen planus, 40 were diagnosed with oral submucous fibrosis, and 40 were in the control group. The prepared smears were subjected to Papanicolaou stain and analyzed microscopically for the evaluation of the cytomorphological features.Results and Discussion. When analyzed microscopically, 36 (90%) out of the 40 oral leukoplakic lesions showed Class II cytological features whereas 4 (10%) revealed Class I features. Among 40 patients with oral lichen planus, 26 (65%) showed Class II features while the remaining 14 (35%) revealed Class I features. In 40 subjects with oral submucous fibrosis, 32 (80%) showed Class II features while the other 8 (20%) showed Class I features. All the 40 control subjects showed Class I features. Thus, OEC can be widely advocated as an addition to clinical conclusion and an adjunct to biopsy.


2020 ◽  
Vol 2020 ◽  
pp. 1-6
Author(s):  
Yassine Oueslati ◽  
Raouaa Belkacem Chebil ◽  
Haifa Regaieg ◽  
Lamia Oualha ◽  
Nabiha Douki

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.


2017 ◽  
Vol 8 (2) ◽  
pp. 73-76 ◽  
Author(s):  
Ruchika Garg ◽  
Arvind V Shetti ◽  
Anjana S Bagewadi

ABSTRACT Introduction Oral squamous cell carcinoma (OSCC) is the most common malignant tumor of the oral cavity. It is preceded by various potentially malignant conditions like oral leukoplakia and oral lichen planus. Survivin is an inhibitor of apoptosis whose levels have been found increased in oral cancer as well as various potentially malignant conditions. Thus survivin can act as a biomarker and help in early detection of potentially malignant conditions which can prevent its transformation into malignancy. Aim To assess and compare the level of total human salivary survivin in oral leukoplakia, oral lichen planus, oral cancer, and control group. Materials and methods A total of 96 subjects were included in the study, which were further grouped into 24 in each group. The saliva was analyzed for survivin level among all the four groups. Survivin concentration (pg/mL) was studied in relation to clinical data. The results were analyzed using Mann—Whitney U test to derive the statistical difference. Results The average of levels of survivin in control group was 0.199 pg/mL, in oral leukoplakia group 0.312 pg/mL, in oral lichen planus group 0.380 pg/mL, and in oral cancer group 0.430 pg/mL. A comparison of all these groups revealed statistically significant difference among the groups. Conclusion Survivin may not be considered as an independent predictor of the malignant transformation for premalignant lesions but it can be an indicator for an increased risk of malignant transformation. How to cite this article Garg R, Shetti AV, Bagewadi AS. Assessment and Comparison of Salivary Survivin Biomarker in Oral Leukoplakia, Oral Lichen Planus, and Oral Cancer: A Comparative Study. World J Dent 2017;8(2):73-76.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Fumihiko Tsushima ◽  
Jinkyo Sakurai ◽  
Atsushi Uesugi ◽  
Yu Oikawa ◽  
Toshimitsu Ohsako ◽  
...  

Abstract Background Oral lichen planus (OLP) is a chronic inflammatory oral mucosa disease that is recognized as an oral potentially malignant disorder. However, the potentially malignant nature of OLP remains unclear. Methods We designed this study to examine the demographic and clinical characteristics of patients with OLP and evaluate the associated malignant transformation rate. A total of 565 patients with a clinical and histopathological diagnosis of OLP who presented at our department between 2001 and 2017 were retrospectively studied. Patients who had clinical and histopathological features of oral lichenoid lesions (OLLs) classified as oral lichenoid contact lesions, oral lichenoid drug reactions and oral lichenoid lesions of graft-versus-host disease were excluded. Results The study population included 123 men and 442 women aged 21–93 years (mean ± standard deviation, 60.5 ± 11.8). The 565 patients were followed up for a duration of 55.9 ± 45.3 months, during which 4 (0.7%) patients developed squamous cell carcinoma (SCC). In three of these 4 patients who developed SCC, the clinical type of OLP was the red type. Conclusions Our results suggested that OLP was associated with a low risk of malignant transformation. We recommend regular follow-up for OLP patients and clear differentiation of oral epithelial dysplasia and OLLs to enable early detection of malignant transformation. Further investigation of the clinical risk factors associated with malignant transformation is necessary.


2021 ◽  
Author(s):  
Fumihiko Tsushima ◽  
Jinkyo Sakurai ◽  
Atsushi Uesugi ◽  
Yu Oikawa ◽  
Toshimitsu Ohsako ◽  
...  

Abstract Objective Oral lichen planus (OLP) is a chronic inflammatory oral mucosa disease that is recognized as an oral potentially malignant disorder. However, the potentially malignant nature of OLP remains unclear.Materials and Methods We designed this study to examine the demographic and clinical characteristics of OLP and evaluate its malignant potential. A total of 565 patients with a clinical and histopathological diagnosis of OLP who presented at our department between 2001 and 2017 were retrospectively studied. Patients who had clinical and histopathological features of oral lichenoid lesions (OLLs) classified as oral lichenoid contact lesions (OLCLs), oral lichenoid drug reactions (OLDRs) and oral lichenoid lesions of graft-versus-host disease (OLL-GVHD) were excluded.Results The study population included 123 men and 442 women aged 21-93 years (median, 62 years). The 565 patients were followed up for an average duration of 55.9 months, during which 4 (0.7%) patients developed squamous cell carcinoma (SCC). In three of these 4 patients who developed SCC, the clinical type of OLP was the red type.Conclusions Our results suggested that OLP was associated with a low risk of malignant transformation. Further investigation of the clinical risk factors associated with malignant transformation is necessary.Clinical relevance We recommend regular follow-up for OLP patients and clear differentiation of oral epithelial dysplasia (OED) and OLLs to enable early detection of malignant transformation.


Author(s):  
Yadira V. Boza Oreamuno ◽  
Fiorella Mora Abarca

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.


2021 ◽  
Vol 10 (5) ◽  
pp. 734-739
Author(s):  
Thaís Torres Barros Dutra ◽  
Thâmara Manoela Marinho Bezerra ◽  
Filipe Nobre Chaves ◽  
Sthefane Gomes Feitosa ◽  
Fábio Wildson Gurgel Costa ◽  
...  

Oral Lichen Planus (OLP) is considered a potentially malignant lesion (PML), although its rate of transformation is controversial. New treatments have been introduced recently, for example calcipotriene (D3 vitamin analog). Its incremental action with glucocorticoids is observed and isolated lip lesions may respond positively to combined topical therapy. Thus, objective of this case report is to show a therapeutic alternative for isolated and persistent OLP lip lesions. An 18-year-old teenager was referred to evaluate an erythematous lower lip lesion with approximately 10 years of evolution. The inspection revealed multiple erythematous areas surrounded by thin whitish streaks located in the vermilion of the lower lip. No abnormalities in the skin, nails, scalp or other areas of oral mucosa were observed. The incisional biopsy was performed and the microscopic exam showed areas of basal layer degeneration with intense mononuclear inflammatory infiltrate banded and predominantly subepithelial. The therapeutic proposal was topical application of Daivobet®, a combination of topical corticosteroids and vitamin D derivative. The lesion had remission after the fifteen days, medication was suspended and indicated when there was a relapse. During follow-up, no recurrences or complications were observed. That combination therapy may be a new approach in treating OLP.


2016 ◽  
Vol 2 (3) ◽  
pp. 147
Author(s):  
Indah Suasani Wahyuni ◽  
Tenny Setiana Dewi ◽  
Erna Herawati ◽  
Dewi Zakiawati

Oral lesion’s profi le in autoimmune disease. Oral lesions are commonly found in patients with autoimmune diseases as manifestations of the disease or a side effect of the treatment. Oral lesions must be handled properly to prevent secondary infection, relieve pain and improve the patient’s quality of life. The aim of this study is to describe oral lesions profile in patients with autoimmune diseases, including clinical characteristics and location of oral lesions as well as the distribution of age and sex of the patient. The methods were retrospective observation by describing the secondary data from patients with autoimmune handled by Oral Medicine Specialist, Faculty of Dentistry, University of Padjadjaran in dr. Hasan Sadikin Hospital Dental Clinic. Patient files from August 2010 untill August 2014 (n = 66) were used, with the most often diagnosis were Systemic Lupus erythematosus (SLE), Oral lichen planus (OLP) and Pemphigus vulgaris (PV). It is revealed that, the age of patients varied between 9 to 68 years old and there was predominance of female patients. Patients diagnosed with SLE were 26 (39.4%), 12 patients with OLP (18.2%) and 28 patients with PV (42.4%). Based on the clinical feature, the most commonly found type of oral lesion was erosion (n=52/78,8%), while the most commonly predilection was in the buccal mucosa (n = 46/69,7%). In conclusion, intra-oral examination should be used as a routine procedure in the comprehensive management of patients with autoimmune diseases. Dentist have a professional role in the diagnosis of oral lesions and provide appropriate therapy in order to improve the quality of life of patients with autoimmune diseases.ABSTRAKLesi oral biasa ditemukan pada penderita penyakit autoimun sebagai manifestasi penyakit atau efek samping pengobatan kortikosteroid jangka panjang. Lesi oral harus ditangani dengan baik untuk mencegah terjadinya infeksi sekunder, mengatasi rasa sakit dan meningkatkan kualitas hidup penderita. Pengumpulan data gambaran profil lesi oral penderita penyakit autoimun, meliputi karakteristik klinis dan lokasi lesi oral serta distribusi usia dan jenis kelamin penderita belum pernah dilakukan. Metode yang digunakan adalah non eksperimen, retrospektif dan deskripsi data sekunder penderita autoimun yang ditangani oleh bagian Ilmu Penyakit Mulut FKG Universitas Padjadjaran di SMF Gigi dan Mulut RS dr. Hasan Sadikin Bandung. Data pasien yang dipergunakan antara bulan Agustus 2010 sampai Agustus 2014 (n=66), dengan diagnosis penyakit autoimun yang paling sering adalah Sistemic Lupus Erythematous (SLE), Oral Lichen Planus  (OLP) dan Pemphigus Vulgaris (PV). Semua pasien memberikan persetujuan pada saat dilakukan pemeriksaan dan  pengumpulan data melalui informed consent. Hasil penelitian ini menunjukkan usia penderita bervariasi antara 9 hingga 68 tahun dan jumlah penderita wanita lebih banyak daripada pria. Penderita yang didiagnosis SLE 26 orang (39,4%), OLP 12 orang (18,2%) dan PV 28 orang (42,4%). Berdasarkan gambaran klinisnya jenis lesi oral yang banyak ditemukan adalah erosi (n = 52/ 78,8%) dan berdasarkan lokasi lesi oral banyak ditemukan pada mukosa bukal (n = 46/69,7% penderita). Kesimpulannya, pemeriksaan intra oral disarankan menjadi prosedur rutin dalam tatalaksana komprehensif penderita penyakit autoimun. Dokter gigi diharapkan dapat berperan dalam mendiagnosis lesi oral dan memberikan terapi yang tepat sehingga dapat meningkatkan kualitas hidup penderita penyakit autoimun. 


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