Lichen Planus as a Possible Rare Cause of an Ocular Disease

Lichen planus is a relatively common mucocutaneous papulosquamous disorder of unknown etiology that is thought to be immunologically mediated. Ocular involvement of lichen planus (LP) is a rare event, which can lead to irreversible damage to the ocular surface and loss of vision from cicatrizing blepharoconjunctivitis and corneal scarring. Steroids are the first treatment choice. Treatment with topical ciclosporin A is also a possible treatment. We report a case of 79-year-old woman who was treated for long lasting severe inflammatory disease of a ocular surface. It led to blindness of one eye and low vision of the second eye. The diagnosis was made thanks to correlation of biopsy results from oral and ocular surface. The patient was also diagnosed with middle-stage dementia. Negative impact of steroid therapy on mental condition of this patient was considered. On the other hand, dementia could cause worse compliance with recommended treatment regime. Chronic inflammatory disease of ocular surface requires long lasting treatment very often and it is sometimes not as effective as expected. Discovering etiological causes of the disease is a priority for the right treatment. We emphasize also the key role of physical and mental condition in management of ocular surface disease.

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Photo gallery: Lichen planus

Russian Journal of Skin and Venereal Diseases ◽

10.17816/dv59113 ◽

2020 ◽

Vol 23 (5) ◽

pp. 356-360

Author(s):

O. Yu. Olisova ◽

N. P. Teplyuk ◽

O. V. Grabovskaya ◽

Yuliya V. Kolesova

Keyword(s):

Differential Diagnosis ◽

Lichen Planus ◽

Inflammatory Disease ◽

Chronic Inflammatory Disease ◽

Clinical Forms

Lichen planus (LP) is a chronic inflammatory disease of skin and mucous from group of papular dermatosis, less often affecting nails and hair. The article presents photographs of patients with various clinical forms of LP for a more thorough differential diagnosis of this disease.

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Markers of Oral Lichen Planus Malignant Transformation

Disease Markers ◽

10.1155/2018/1959506 ◽

2018 ◽

Vol 2018 ◽

pp. 1-13 ◽

Cited By ~ 13

Author(s):

Mircea Tampa ◽

Constantin Caruntu ◽

Madalina Mitran ◽

Cristina Mitran ◽

Isabela Sarbu ◽

...

Keyword(s):

Quality Of Life ◽

Squamous Cell Carcinoma ◽

Malignant Transformation ◽

Lichen Planus ◽

Oral Lichen Planus ◽

Chronic Inflammatory Disease ◽

Unknown Etiology ◽

Molecular Alterations ◽

Oral Lichen

Oral lichen planus (OLP) is a chronic inflammatory disease of unknown etiology with significant impact on patients’ quality of life. Malignant transformation into oral squamous cell carcinoma (OSCC) is considered as one of the most serious complications of the disease; nevertheless, controversy still persists. Various factors seem to be involved in the progression of malignant transformation; however, the mechanism of this process is not fully understood yet. Molecular alterations detected in OLP samples might represent useful biomarkers for predicting and monitoring the malignant progression. In this review, we discuss various studies which highlight different molecules as ominous predictors of OLP malignant transformation.

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A comparative study of apoptosis in reticular and erosive oral lichen planus

Brazilian Dental Journal ◽

10.1590/s0103-64402012000500016 ◽

2012 ◽

Vol 23 (5) ◽

pp. 564-569 ◽

Cited By ~ 10

Author(s):

Juliana M. C. Brant ◽

Maria Cássia F. Aguiar ◽

Helenice A. M. Grandinetti ◽

Luciana V. Rodrigues ◽

Anilton C. Vasconcelos

Keyword(s):

Lichen Planus ◽

Inflammatory Disease ◽

Oral Lichen Planus ◽

Inflammatory Cell ◽

Chronic Inflammatory Disease ◽

Clinical Presentations ◽

Tunel Reaction ◽

Lymphocytic Infiltrates ◽

Inflammatory Infiltrates ◽

Oral Lichen

The oral lichen planus (OLP) is a chronic inflammatory disease, probably autoimmune, with different clinical forms. The most common types are the reticular and the erosive ones. Apoptosis participates in the destruction of basal keratinocytes, but its role in the perpetuation of the subepithelial lymphocytic infiltrates was not yet investigated. To evaluate the involvement of apoptosis in the epithelium and in subepithelial lymphocytic infiltrates, 15 samples of reticular and erosive OLP and 10 samples of healthy oral mucosa were collected and processed histologically. Apoptosis was quantified in the epithelium and in inflammatory cell infiltrates. TUNEL reaction was used to measure apoptosis in the infiltrates. Erosive OLP showed more intense epithelial apoptosis than reticular OLP and controls. In contrast, apoptosis in the inflammatory cell infiltrates was more frequent in reticular than in erosive OLP. Lymphocytes were the predominant cells within the inflammatory cell infiltrates and were more frequent in erosive OLP than in reticular type. These results suggest that different apoptotic levels are involved in the erosive/reticular switch in OLP, determining different clinical presentations. In conclusion, decreased apoptosis in inflammatory infiltrates may contribute to the persistence of T lymphocytes, worsening the attack to the epithelium in erosive OLP.

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Pathogenesis and treatment modalities of localized scleroderma

Medicina ◽

10.3390/medicina46100092 ◽

2010 ◽

Vol 46 (10) ◽

pp. 649 ◽

Cited By ~ 11

Author(s):

Greta Valančienė ◽

Daiva Jasaitienė ◽

Skaidra Valiukevičienė

Keyword(s):

Inflammatory Disease ◽

Viral Infections ◽

Subcutaneous Fat ◽

Morphological Characteristics ◽

Chronic Inflammatory Disease ◽

Treatment Modalities ◽

Localized Scleroderma ◽

Unknown Etiology ◽

Toxic Substances ◽

Pharmaceutical Agents

Localized scleroderma is a chronic inflammatory disease primarily of the dermis and subcutaneous fat that ultimately leads to a scar-like sclerosis of connective tissue. The disorder manifests as various plaques of different shape and size with signs of skin inflammation, sclerosis, and atrophy. This is a relatively rare inflammatory disease characterized by a chronic course, unknown etiology, and insufficiently clear pathogenesis. Many factors may influence its appearance: trauma, genetic factors, disorders of the immune system or hormone metabolism, viral infections, toxic substances or pharmaceutical agents, neurogenic factors, and Borrelia burgdorferi infection. Various therapeutic modalities are being used for the treatment of localized scleroderma. There is no precise treatment scheme for this disease. A majority of patients can be successfully treated with topical pharmaceutical agents and phototherapy, but some of them with progressive, disseminated, and causing disability localized scleroderma are in need of systemic treatment. The aim of this article is not only to dispute about the clinical and morphological characteristics of localized scleroderma, but also to present the newest generalized data about the possible origin, pathogenesis, and treatment modalities of this disease.

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The Characteristics of Patients with Oral Lichen Planus and Malignant Transformation—A Retrospective Study of 271 Patients

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18126525 ◽

2021 ◽

Vol 18 (12) ◽

pp. 6525

Author(s):

Vladimíra Radochová ◽

Romana Koberová Ivančaková ◽

Ondřej Heneberk ◽

Radovan Slezák

Keyword(s):

Retrospective Study ◽

Malignant Transformation ◽

Lichen Planus ◽

Oral Lichen Planus ◽

Chronic Inflammatory Disease ◽

University Hospital ◽

Unknown Etiology ◽

Transformation Rate ◽

Oral Lichen

Introduction: Oral lichen planus (OLP) is a chronic inflammatory disease with an unknown etiology rating among oral potentially malignant disorder. The aim of the study was to determine the epidemiological and clinical characteristics of the patients with OLP and rate of malignant transformation. Patients and methods: Data were obtained from the medical records of 271 patients referred to the Oral Medicine Unit at the University Hospital in Hradec Králové diagnosed with oral lichen planus in the period of 2003–2020. The records were retrospectively analyzed. The following clinical data were retrieved from the medical charts: gender, age, systemic diseases, alcohol and tobacco consumption, localization/clinical appearance of lesions, distribution of the lesions, presence of the symptoms, treatment provided and malignant transformation. Results: A total of 271 charts of patients with confirmed diagnosis of OLP were retrospectively analyzed, of whom, 66.4% (180/271) were women and 33.6% (91/271) were men. The mean age of the patients was 56.0 (18.2–85.0) years. The median follow-up of all patients was 15.2 months. Overall, 2 patients (2/271, 0.74%) meeting the above-mentioned criteria for malignant transformation were identified during the follow-up period. Both patients suffered from erosive type OLP and developed squamous cell carcinoma of the tongue. Conclusions: This retrospective study is in concordance with other studies showing the similar profile and clinical features of the patients with OLP. Malignant transformation rate was 0.74%.

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Systematic Review and Meta-Analysis of Oxidative Stress and Antioxidant Markers in Oral Lichen Planus

Oxidative Medicine and Cellular Longevity ◽

10.1155/2021/9914652 ◽

2021 ◽

Vol 2021 ◽

pp. 1-16

Author(s):

Jia Wang ◽

Jingjing Yang ◽

Chen Wang ◽

Zhibai Zhao ◽

Yuan Fan

Keyword(s):

Oxidative Stress ◽

Lichen Planus ◽

Oral Lichen Planus ◽

Meta Analysis ◽

Chronic Inflammatory Disease ◽

Cochrane Library ◽

Unknown Etiology ◽

Antioxidant Systems ◽

Antioxidant Markers ◽

Oral Lichen

Background. Oral lichen planus (OLP) is a relatively common chronic inflammatory disease of unknown etiology, which might be caused by oxidative stress and impaired antioxidant defense. Objective. To systematically investigate the markers of oxidative stress and antioxidant systems in the saliva and blood from OLP patients and healthy controls. Methods. The PubMed, Cochrane Library, and Embase were systematically queried to collect data from studies in which oxidative stress/antioxidant markers from OLP and healthy subjects had been evaluated until March 10, 2021. Results. A total of 28 studies fulfilled inclusion criteria, and 25 of them, having 849 OLP patients and 1,052 control subjects and analyzing 12 oxidative stress and antioxidant state marker levels, were subjected to meta-analysis. We found a significant decrease in total antioxidant capacity (TAC) and uric acid (UA) and a significant increase in malondialdehyde (MDA) and nitric oxide (NO) levels in the saliva and serum/plasma of OLP patients. Moreover, a significant elevation of 8-hydroxy-deoxyguanosine (8-OHdG) and advanced oxidation protein product (AOOP) level and a decrease in vitamin C were also observed in the saliva of the OLP group. In contrast, salivary vitamin A, zinc, glutathione peroxidase (GPx), vitamin E, and nitrite were not significantly different between the two groups. In single studies, markers of oxidative stresses such as superoxide dismutase (SOD) and 8-isoprostanelevels were elevated in OLP, and antioxidant parameters such as glutathione (GSH) and total protein (TP) levels were dysregulated. Conclusion. This meta-analysis helps to clarify the profile of oxidative stress and antioxidant state markers in OLP patients although existing evidence is rather heterogeneous and many studies are affected by several limitations. Larger and more standardized studies are warranted to ascertain whether these markers are potential causes or effects of OLP and whether antioxidant therapy improving oxidative stress will be useful.

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Kimura Disease: A case report and review of literature

Bangladesh Journal of Medical Science ◽

10.3329/bjms.v17i1.35297 ◽

2018 ◽

Vol 17 (1) ◽

pp. 152-154

Author(s):

Partha Pratim Sinha Roy ◽

Parthasarathi Ghosh ◽

Dwaipayan Samaddar ◽

Gautam Das

Keyword(s):

Case Report ◽

Inflammatory Disease ◽

Medical Science ◽

Neck Region ◽

Chronic Inflammatory Disease ◽

Unknown Etiology ◽

Review Of Literature ◽

Kimura Disease ◽

Head And Neck Region ◽

Blood Eosinophilia

Kimura disease is a rare chronic inflammatory disease with angiolymphatic proliferation of unknown etiology predominantly seen among young Asian males. It classically shows a triad of non-tender subcutaneous masses predominantly in head and neck region with tissue and blood eosinophilia and raised serum IgE level. Here we present a case report of a 24 years male with bilateral pre-auricular and post-auricular swelling for 6 years. The diagnosis of Kimura disease was made on the basis of clinical and histopathological examination.Bangladesh Journal of Medical Science Vol.17(1) 2018 p.152-154

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Ocular Manifestations in Psoriasis Screening (OcMaPS) Questionnaire: A Useful Tool to Reveal Misdiagnosed Ocular Involvement in Psoriasis

Journal of Clinical Medicine ◽

10.3390/jcm10051031 ◽

2021 ◽

Vol 10 (5) ◽

pp. 1031

Author(s):

Angelo Ruggiero ◽

Gabriella Fabbrocini ◽

Sara Cacciapuoti ◽

Eleonora Cinelli ◽

Lucia Gallo ◽

...

Keyword(s):

Dry Eye ◽

Inflammatory Disease ◽

Chronic Inflammatory Disease ◽

Ocular Involvement ◽

Ophthalmological Examination ◽

Ocular Manifestation ◽

Ocular Manifestations ◽

Ocular Symptoms ◽

Immune Mediated ◽

Ocular Disorders

Psoriasis is an immune-mediated, chronic inflammatory disease, which mainly affects the skin, although it has systemic pathological effects. Comorbidities of psoriasis include ocular disorders, which are often nonspecific or mildly symptomatic. The aim of this study was to show the importance of ocular-disease screening in psoriatic patients using the Ocular Manifestations in Psoriasis Screening (OcMaPS) questionnaire. Patients suffering from moderate-to-severe psoriasis referring at our outpatient-clinic were consecutively enrolled. Each patient was asked to complete a screening questionnaire (OcMaPS). Patients reporting ocular symptoms were referred for an ophthalmological examination. A total of 372 patients were enrolled in the study. Ocular symptoms were detected in 39 patients (10.5%), and 37 patients were referred to ophthalmological examination which confirmed the presence of ocular manifestation in 30 patients. There were three cases (10%) of uveitis, 14 (46.6%) of dry eye and 13 (43.3%) of cataract, in progress or already treated with surgery. In the remaining seven patients, no ocular manifestations were found. Ocular manifestations in psoriatic patients are not rare. It is important to be aware of ocular symptoms in psoriatic patients, screening patients (with a consultation or OcMaPS questionnaire), which leads to earlier diagnosis and treatment.

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