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

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.

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

2021 ◽  
Vol 45 (1) ◽  
Author(s):  
Atsushi Shudo
Keyword(s):  
Surgical Treatment ◽  
Lichen Planus ◽  
Oral Lichen Planus ◽  
Histopathological Examination ◽  
Mouth Opening ◽  
Ki 67 ◽  
Collagen Formation ◽  
Immune Mediated ◽  
Cytokeratin 13 ◽  
Oral Lichen

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.

Oral Lichen Planus, 2 Varied Clinical Presentations and Its Therapeutic Intervention

2017 ◽  
Vol 10 (1) ◽  
pp. 53-56
Author(s):  
S. Jayachandran ◽  
◽  
K. Sarala ◽  
Priyanka Khobre ◽  
◽  
...  
Keyword(s):  
Lichen Planus ◽  
Therapeutic Intervention ◽  
Oral Lichen Planus ◽  
Clinical Presentations ◽  
Oral Lichen

Oral health–related quality of life in different clinical forms of oral lichen planus

2019 ◽  
Vol 24 (1) ◽  
pp. 301-308 ◽  
Author(s):  
Ioanina Parlatescu ◽  
Mihaela Tovaru ◽  
Carmen Larisa Nicolae ◽  
Ruxandra Sfeatcu ◽  
Andreea Cristiana Didilescu
Keyword(s):  
Quality Of Life ◽  
Oral Health ◽  
Lichen Planus ◽  
Oral Lichen Planus ◽  
Health Related Quality ◽  
Clinical Forms ◽  
Related Quality ◽  
Health Related ◽  
Oral Lichen

scholarly journals FoxP3+ T regulatory cells in oral lichen planus and its correlation with the distinct clinical appearance of the lesions

2012 ◽  
Vol 93 (4) ◽  
pp. 287-294 ◽  
Author(s):  
Joabe S. Pereira ◽  
Bárbara V. Monteiro ◽  
Cassiano F. Nonaka ◽  
Éricka J. Silveira ◽  
Márcia C. Miguel
Keyword(s):  
Lichen Planus ◽  
Oral Lichen Planus ◽  
T Regulatory Cells ◽  
Regulatory Cells ◽  
Clinical Appearance ◽  
Oral Lichen

scholarly journals Screening of Oral Potentially Malignant Disorders Using Exfoliative Cytology: A Diagnostic Modality

2016 ◽  
Vol 2016 ◽  
pp. 1-4 ◽  
Author(s):  
Arpita Kabiraj ◽  
Tanya Khaitan ◽  
Debarati Bhowmick ◽  
Uday Ginjupally ◽  
Aritri Bir ◽  
...  
Keyword(s):  
Lichen Planus ◽  
Oral Lichen Planus ◽  
Oral Submucous Fibrosis ◽  
Class Ii ◽  
Class I ◽  
Exfoliative Cytology ◽  
Potentially Malignant Disorders ◽  
Potentially Malignant ◽  
Submucous Fibrosis ◽  
Oral Lichen

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.

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

2018 ◽  
Vol 2018 ◽  
pp. 1-5 ◽  
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.

scholarly journals Role Of Efferocytosis In Oral Lichen Planus

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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