SYSTEMIC IMMUNOLOGICAL DISEASES WITH ORAL &MUCOCUTANEOUS MANIFESTATIONS – A FOCUS ON PEMPHIGUS -- AN INSTITUITIONAL STUDY (Preprint)

2021 ◽  
Author(s):  
Karthik SHUNMUGAVELU
Keyword(s):  
Lichen Planus ◽  
Correct Diagnosis ◽  
Clinical Information ◽  
Oral Lesions ◽  
Retrospective Assessment ◽  
Immune Mediated ◽  
Oral Mucosal Lesions ◽  
Immunological Diseases ◽  
To Come ◽  
Oral Involvement

BACKGROUND Oral mucosal lesions manifest as a first sign of immune mediated disorders. Lichen planus, pemphigus &pemphigoid are the most frequent immunologically mediated mucocutaneous diseases with oral involvement OBJECTIVE A dental surgeon is the first person to come across these lesions that have similar clinical characteristics, therefore their identification based solely on oral lesions is a challenging issue for dentists, leading to a delay in the establishment of a correct diagnosis and suitable management of the patient. METHODS Clinical information was retrieved from records and histopathologic features were reviewed from archives dated 1997 – 2018. ( n = 6300 ). RESULTS Out of 6300 specimens, these immunologically mediated diseases accounted for 105 (1.66%) cases, of which 86 (1.36%) were lichen planus, 4 (0.06%) were pemphigus and 15 (0.23%) were pemphigoid. CONCLUSIONS From the results of this study, it can be inferred that immune-mediated diseases with oral manifestations are comparatively scarce among oral lesions. The present study comprises the retrospective assessment of oral immunologically mediated diseases, in which data regarding the 3 diseases were extracted and analyzed altogether

scholarly journals Oral Lichen Planus and Polycythemia: Possible Association

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.

Esophageal Lichen Planus

2008 ◽  
Vol 132 (6) ◽  
pp. 1026-1029
Author(s):  
Vishal S. Chandan ◽  
Joseph A. Murray ◽  
Susan C. Abraham
Keyword(s):  
Older Women ◽  
Lichen Planus ◽  
Correct Diagnosis ◽  
Squamous Carcinoma ◽  
Carcinoma Of The Esophagus ◽  
Therapeutic Implications ◽  
Proximal Esophagus ◽  
Esophageal Strictures ◽  
Oral Involvement ◽  
Progressive Dysphagia

Abstract Esophageal lichen planus is an underrecognized condition, with fewer than 50 cases reported to date. Unlike cutaneous lichen planus, esophageal lichen planus occurs almost exclusively in middle-aged or older women who also have oral involvement. It commonly involves the proximal esophagus and manifests as progressive dysphagia and odynophagia. Endoscopic findings can include lacy white papules, pinpoint erosions, desquamation, pseudomembranes, and stenosis. Histologic features of esophageal lichen planus have only rarely been illustrated. They differ from those of cutaneous disease in several respects, including the presence of parakeratosis, epithelial atrophy, and lack of hypergranulosis. Correct diagnosis of esophageal lichen planus is difficult but bears important therapeutic implications. It is typically a chronic and relapsing condition that can require systemic or local immunosuppressive therapy and repeated endoscopic dilatations for esophageal strictures. Esophageal lichen planus may have malignant potential, as evidenced by 3 patients who developed squamous carcinoma of the esophagus after longstanding disease.

scholarly journals A study on incidence of oral lesions in lichen planus

2019 ◽  
Vol 5 (4) ◽  
pp. 691
Author(s):  
Divya G. ◽  
Jayakar Thomas
Keyword(s):  
Lichen Planus ◽  
Clinical Examination ◽  
Oral Lichen Planus ◽  
Oral Lesions ◽  
Different Types ◽  
Male Preponderance ◽  
Oral Lichen ◽  
Oral Involvement

<p class="abstract"><strong>Background:</strong> This study was done<strong> </strong>to evaluate the incidence of oral lesions in different types of lichen planus.</p><p class="abstract"><strong>Methods:</strong> A total of 30 patients clinically diagnosed with any form of lichen planus were subjected to a clinical examination and evaluated for the presence of oral lesions.<strong></strong></p><p class="abstract"><strong>Results:</strong> Of the 30 patients in this study with predominantly females, oral involvement was seen in 17 patients with a slight male preponderance. Lichen planus was seen commonly between the ages of 20 and 40 with the incidence of oral lesions following the same trend.</p><p class="abstract"><strong>Conclusions:</strong> This study has statistically proven the significance of oral involvement in cutaneous lichen planus and was done to highlight the importance of the same. Oral lichen planus can be a forerunner of genital involvement as well as malignancies and it is important to keep this in mind while examining a case of lichen planus.</p><p class="abstract"> </p>

scholarly journals Oral lichen planus involving the palate: Case report and review of literature

2020 ◽  
Vol 3 (2) ◽  
pp. 89-92
Author(s):  
Shaheen Ahmed ◽  
Ali Alzubaidee
Keyword(s):  
Lichen Planus ◽  
Buccal Mucosa ◽  
Oral Lichen Planus ◽  
Chief Complaint ◽  
Burning Sensation ◽  
Oral Lesions ◽  
Review Of Literature ◽  
Spicy Food ◽  
Immune Mediated ◽  
Oral Lichen

planus is a mucocutaneous disease affecting approximately 1.5 to 2% of the world popu-lation. Women are most of ten affected and lichen planus is usually reported in individuals over 50 years of age The etiology of lichen planus is unknown at present and the disorder has been classified as a chronic disease of immune-mediated pathogenesis. The oral lesions are usually bilateral and involve the buccal mucosa in about 90 per cent of all cases. In descending order of frequency the tongue, gingivae, alveolar ridge, lips, and less commonly the palate may also be affected. In this paper , we are presented a case , 65-year-old female patient who came to de-partment of Oral and Maxillofacial Medicine in Khanzad Center with a chief complaint of burn-ing sensation of the mouth especially hard palate, bilateral buccal mucosa and lower anterior gingiva for about 10 years duration, aggravated by hot and spicy food. The diagnosis was con-firmed by biopsy as lichen planus. The skin was not involved lesion. Keywords: Oral lichen planus, Palatal lichen planus, Burning sensation, Buccal mucosa

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.

scholarly journals Multi-omics approach to precision medicine for immune-mediated diseases

2021 ◽  
Vol 41 (1) ◽  
Author(s):  
Mineto Ota ◽  
Keishi Fujio
Keyword(s):  
Treatment Response ◽  
High Throughput Sequencing ◽  
Disease Risk ◽  
Clinical Information ◽  
Clinical Settings ◽  
Social Significance ◽  
Sequencing Technologies ◽  
Immune Mediated ◽  
Recent Innovation ◽  
Future Direction

AbstractRecent innovation in high-throughput sequencing technologies has drastically empowered the scientific research. Consequently, now, it is possible to capture comprehensive profiles of samples at multiple levels including genome, epigenome, and transcriptome at a time. Applying these kinds of rich information to clinical settings is of great social significance. For some traits such as cardiovascular diseases, attempts to apply omics datasets in clinical practice for the prediction of the disease risk have already shown promising results, although still under way for immune-mediated diseases. Multiple studies have tried to predict treatment response in immune-mediated diseases using genomic, transcriptomic, or clinical information, showing various possible indicators. For better prediction of treatment response or disease outcome in immune-mediated diseases, combining multi-layer information together may increase the power. In addition, in order to efficiently pick up meaningful information from the massive data, high-quality annotation of genomic functions is also crucial. In this review, we discuss the achievement so far and the future direction of multi-omics approach to immune-mediated diseases.

scholarly journals Prevalence Of Developmental Oral Mucosal Lesions Among A Sample Of Denture Wearing Patients Attending College Of Dentistry Clinics In Aljouf University

2016 ◽  
Vol 12 (24) ◽  
pp. 352 ◽  
Author(s):  
Abdalwhab M.A . Zwiri ◽  
Santosh Patil ◽  
Fadi AL- Omair ◽  
Mohammed Assayed Mousa ◽  
Ibrahim Ali Ahmad
Keyword(s):  
Personal Information ◽  
Statistical Tests ◽  
Later Life ◽  
Oral Lesions ◽  
Ministry Of Health ◽  
Dental Patients ◽  
Oral Mucosal Lesions ◽  
Mucosal Lesions ◽  
And Gender ◽  
Fissured Tongue

Introduction: developmental oral lesions represent a group of normal lesions that can be found at birth or evident in later life. These lesions include fissured and geographic tongue, Fordyce’s granules and leukoedema. Study aims: to investigate the prevalence of some developmental oral mucosal lesions among dental patients wearing dentures who were attending college of dentistry clinics in Aljouf University, and specialized dental center of ministry of health. Methods and subjects: a retrospective design was conducted to collect data from 344 wearing denture dental patients who were attending college of dentistry clinics in Aljouf University, and specialized dental center of ministry of health. A working excel sheet was created for patients and included data related to personal information such as age and gender; and oral developmental lesions. The software SPSS version 20 was used to analyze data. Statistical tests including frequency, percentages, and One way Anova were used to describe data. Significance was considered at alpha level <0.05. Study findings: the majority of participants were males (86%), the mean age was 51.60+ 3.51years. The prevalence of fissured tongue was 10.2%, geographic tongue 11.3%, Fordyce’s granules 7%, and leukoedema 7.3%. Age was significantly associated with fissured tongue (p=0.04), and Fordyce’s granules (p=0.003). Gender was not associated significantly with any of the studied lesions. Conclusion: developmental oral lesions among dental patients wearing dentures exist with varying rates of prevalence as well as it provides valuable basic data about the prevalence of oral mucosal lesions among patients seeking dental care in Aljouf area.

scholarly journals Hypertrophic Lichen Planus versus Well-Differentiated Squamous Cell Carcinoma: A Histological Challenge 

2017 ◽  
Vol 1 (2) ◽  
pp. 91
Author(s):  
Samuel P Haslam ◽  
Lindy S Ross ◽  
Alison C Lowe ◽  
Brent C Kelly
Keyword(s):  
Squamous Cell Carcinoma ◽  
Cell Carcinoma ◽  
Multiplex Pcr ◽  
Lichen Planus ◽  
Squamous Cell ◽  
Correct Diagnosis ◽  
Pseudoepitheliomatous Hyperplasia ◽  
Lichen Simplex Chronicus ◽  
Well Differentiated

Differentiating hypertrophic lichen planus (LP) from well-differentiated squamous cell carcinoma (SCC) is a histological challenge given the numerous histopathologic similarities between SCC and pseudoepitheliomatous hyperplasia (PEH) arising in the setting of hypertrophic LP. Multiple reports have shown that SCC can arise from hypertrophic LP not infrequently, but that the LP-to-SCC sequence is poorly understood, and many cases defy diagnosis due to histologic similarities. However, there are several clinical clues and histopathologic details that have shown to have some value when trying to ascertain the correct diagnosis. To the contrary, immunohistochemical tests have shown little promise in differentiating hypertrophic LP from SCC. Although multiplex PCR has shown some potential in differentiating PEH from SCC, this has only been in the setting of patients diagnosed with prurigo and lichen simplex chronicus, but not necessarily in the case hypertrophic LP. 

Anaphylaxis: how to recognise and manage in primary care

2021 ◽  
Vol 32 (6) ◽  
pp. 232-236
Author(s):  
Hannah Kramer ◽  
Rebecca Batt
Keyword(s):  
Primary Care ◽  
Practice Nurse ◽  
Correct Diagnosis ◽  
Insect Sting ◽  
Vulnerable Patients ◽  
Immune Mediated ◽  
Emergency Medication ◽  
Life Threatening ◽  
Systemic Hypersensitivity

Anaphylaxis is a life-threatening emergency. Hannah Kramer and Rebecca Batt explain how correct diagnosis, avoidance and patient education are fundamental in reducing risk Anaphylaxis is a serious systemic hypersensitivity reaction that is usually rapid in onset and can cause death. It is an immune-mediated reaction, which typically occurs when a person is exposed to a trigger, for example a food, drug, or insect sting. This article aims to assist with the recognition of symptoms and to guide management of anaphylaxis in primary care. Beyond the acute, the practice nurse can play a key role in helping patients to manage their allergies in the long-term, particularly for those who are most vulnerable. Patients should be supported in understanding how best to avoid their triggers, in managing their emergency medication, and in the importance of good asthma control.

Clinical–pathologic Agreement for Oral Lesions in an Oral Medicine Setting

2016 ◽  
Vol 2 (1) ◽  
pp. 1-10 ◽  
Author(s):  
Alessandro Villa ◽  
Francesco Nordio ◽  
Laura Strohmenger ◽  
Silvio Abati
Keyword(s):  
Lichen Planus ◽  
Oral Lichen Planus ◽  
Weighted Kappa ◽  
Mucous Membrane Pemphigoid ◽  
Histopathological Diagnosis ◽  
Severe Dysplasia ◽  
Oral Lesions ◽  
Oral Medicine ◽  
Squamous Papilloma ◽  
Oral Lichen

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.

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