Oral lichen planus and its recent management: A review

Background: Oral Lichen Planus (OLP) is one of the most common dermatological disease which is present in the oral cavity. It is a chronic autoimmune, mucocutaneous disease that affects oral mucosa as well as the skin, genital mucosa and other sites of the body.Method: In this review study, various databases such as Google Scholar, PubMed Central, Hinari and Cochrane library were searched for articles with keywords lichen planus, oral lichen planus, premalignant lesions, management of Lichen planus. Articles were searched from January 2015 to 5th November 2020.Result: From the 34 articles obtained after reviewing the abstracts, most relevant 32articles were evaluated in this study.Conclusion: The etiology, pathophysiology, clinical presentation, histopathological features, diagnosis and various management for oral lichen planus is discussed. This article also compares the existing and the most recent treatment modalities that are available throughout the world that are discussed in the literatures. However, more intensive studies must be carried out to find the best treatments which are cost-effective in the long run. Update Dent. Coll. j: 2020; 10 (2): 29-34

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Efficacy evaluation of photodynamic therapy for oral lichen planus: a systematic review and meta-analysis

BMC Oral Health ◽

10.1186/s12903-020-01260-x ◽

2020 ◽

Vol 20 (1) ◽

Author(s):

Yuqing He ◽

Jiaxin Deng ◽

Yi Zhao ◽

Huiqian Tao ◽

Hongxia Dan ◽

...

Keyword(s):

Systematic Review ◽

Methylene Blue ◽

Photodynamic Therapy ◽

Diode Laser ◽

Lichen Planus ◽

Oral Lichen Planus ◽

Meta Analysis ◽

Lesion Size ◽

Cochrane Library ◽

Oral Lichen

Abstract Background Photodynamic therapy (PDT) is a new option for oral lichen planus (OLP) management; however, there are different opinions on the efficacy of PDT for OLP. The aim of this study was to comprehensively assess the efficacy of PDT in the treatment of OLP and compare PDT with steroid therapy. Methods A systematic review and meta-analysis were conducted to assess the curative effect of PDT. Five electronic databases were searched, PubMed, Web of Science, the Cochrane Library, Embase, and EBSCO up to 1 December, 2019. Random and fixed effects models for pooled estimates calculation were used and the Meta package of R was applied. Results Pooled estimates revealed that, after PDT, the lesion size decreased by 1.53 cm2 (95% confidence interval (CI): 0.71–2.35) after PDT and the partial response (PR) was 0.77 (95% CI: 0.65–0.85). The visual analogue scale (VAS) score decreased by 3.82 (95% CI: 2.80–4.85) and the Thongprasom sign score decreased by 1.33 (95% CI: 0.56–2.10) after PDT. Subgroup analyses revealed that the 5-aminolevulinic acid (5-ALA) was more effective than methylene blue (MB), with a PR of 0.87 (95% CI: 0.80–0.91). The topical use of 5-ALA yielded a better response than gargling methylene blue. In terms of VAS, the diode laser showed a better clinical PR in the treatment of OLP. In terms of changes in lesion size, the efficacy of the semiconductor laser was higher than that of the diode laser. PDT had a similar efficacy to topical corticosteroids, as shown by pooled estimates of five randomised controlled trials with 139 lesions. Conclusion This systematic review indicates that PDT is an effective treatment modality for the management of OLP. PDT is as effective as topical corticosteroid in the treatment of OLP and could be used for cases resistant to steroids or when steroids are contraindicated.

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Salivary and Serum Interferon-Gamma/Interleukin-4 Ratio in Oral Lichen Planus Patients: A Systematic Review and Meta-Analysis

Medicina ◽

10.3390/medicina55060257 ◽

2019 ◽

Vol 55 (6) ◽

pp. 257

Author(s):

Hamid Reza Mozaffari ◽

Maryam Molavi ◽

Pia Lopez-Jornet ◽

Masoud Sadeghi ◽

Mohsen Safaei ◽

...

Keyword(s):

Lichen Planus ◽

Interferon Gamma ◽

Oral Lichen Planus ◽

Meta Analysis ◽

Interleukin 4 ◽

Cochrane Library ◽

Pathological Effect ◽

Ifn Γ ◽

Oral Lichen

Background and Objectives: Interferon-gamma (IFN-γ)/interleukin-4 (IL-4) ratio may indicate a change in the immune response with a potential pathological effect presented in oral lichen planus (OLP) patients. Herein, this meta-analysis evaluated the role of serum and salivary interferon-gamma/interleukin-4 ratio in the severity and development of OLP. Materials and Methods: The Scopus, Cochrane Library, PubMed, and Web of Science databases were systematically searched to retrieve the relevant studies published up from the database inception to March 2019. The crude mean difference (MD) and 95% confidence interval (CI) were calculated by RevMan 5.3 software using a random-effects model. A sensitivity analysis was performed on the results using the CMA 2.0 software. A total of 98 studies were retrieved from the databases, of which at last seven studies were included in this meta-analysis. Results: The findings showed that the pooled MDs of serum and salivary IFN-γ/IL-4 ratio were −0.22 (95% CI: −1.16, 0.72; p = 0.64) and 0.17 (95% CI: −1.50, 1.84; p = 0.84) in OLP patients compared to controls, respectively. In addition, the pooled MDs of serum and salivary IFN-γ/IL-4 ratio were −0.15 (95% CI: −0.53, 0.23; p = 0.43) and −0.39 (95% CI: −0.63, −0.15; p = 0.001) in patients with erythematous/ulcerative subtype compared to patients with reticular subtype, respectively. Conclusions: In conclusion, the results of meta-analysis demonstrated that serum and salivary IFN-γ/IL-4 ratio cannot play a major role in OLP development and severity.

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Is oral lichen planus a risk factor for peri-implant diseases? A systematic review and meta-analysis

10.21203/rs.3.rs-15960/v3 ◽

2020 ◽

Author(s):

Xiaoqin Xiong ◽

Tiantian Xu ◽

Xinhong Wang ◽

Wenguang Qin ◽

Ting Yu ◽

...

Keyword(s):

Systematic Review ◽

Risk Factor ◽

Lichen Planus ◽

Oral Lichen Planus ◽

Large Scale ◽

Meta Analysis ◽

Healthcare Research ◽

Cochrane Library ◽

Oral Lichen

Abstract Background : To evaluate whether oral lichen planus (OLP) is a risk factor for peri-implant diseases (PIDs) with a systematic review and meta-analysis. Methods : Five electronic databases including Medline, Embase, Web of Science, the Cochrane Library and Scopus were searched. The included studies are observational human studies written in English. The population of interest included those with/without OLP who received dental implant treatment. The follow-up time after implantation was from one month to 20 years. The quality of the included articles regarding risk of bias and methodology were assessed with the Newcastle-Ottawa Scale or the Agency for Healthcare Research and Quality. The data involving exposure (OLP), primary outcomes (implants having PIDs) and secondary outcomes (probing depth/PD, bleeding on probing/BOP and bone loss/BL) and potential confounders were extracted. Heterogeneity was assessed by I² test. Dichotomous data are expressed as the risk ratio (RR) and 95% confidence interval (CI) which were calculated with a fixed effect model. Results : Of the 66 articles, two studies were enrolled and evaluated as high quality, which totally contained 68 participants receiving 222 (OLP vs. non-OLP, 112 vs. 110) implants with 12 to 120-month follow-up time. Proportions of implants with PIDs between OLP and non-OLP groups were as follows: 19.6% (22/112) vs. 22.7% (25/110) for PIM and 17.0% (19/112) vs. 10.9% (12/110) for PI. The meta-analysis revealed no recognizable difference in number of implants with PIDs (PI: RR = 1.49, 95% CI 0.77-2.90, P = 0.24; PIM:RR = 0.88, 95% CI 0.53 -1.46, P = 0.61; PIDs: RR = 1.08, 95% CI 0.75 -1.55, P = 0.68) or BOP (RR = 0.90, 95% CI: 0.70-1.15, P = 0.40) between OLP and non-OLP groups. Conclusions : Available articles regarding the effects of OLP on PIDs remains very limited. Existing evidence does not support OLP as a suspected risk factor for PIDs. Large-scale prospective trials are required to validate the findings.

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Serum and Salivary IgA, IgG, and IgM Levels in Oral Lichen Planus: A Systematic Review and Meta-Analysis of Case-Control Studies

10.20944/preprints201809.0477.v1 ◽

2018 ◽

Author(s):

Hamid Reza Mozaffari ◽

Elisa Zavattaro ◽

Abas Abdolahnejad ◽

Pia Lopez Jornet ◽

Neda Omidpanah ◽

...

Keyword(s):

Lichen Planus ◽

Oral Lichen Planus ◽

Meta Analysis ◽

Serum Levels ◽

Inflammatory Factors ◽

Cochrane Library ◽

Healthy Controls ◽

Case Control Studies ◽

Salivary Iga ◽

Oral Lichen

Background and Aim: Immunoglobulins (IgA, IgG, and IgM) are significant anti-inflammatory factors. The meta-analysis aimed to assess the serum and salivary levels of Igs as more important immunoglobulins in patients affected by oral lichen planus (OLP) compared to the healthy controls. Materials and Methods: Four databases, including PubMed/Medline, Scopus, Web of Science, and Cochrane Library as well as Iranian databases were checked up to January 2018 without language restriction. The quality of each involved study was done using the NOS questionnaire. A random-effects model analysis was done by RevMan 5.3 software applying the mean difference (MD) plus 95% confidence intervals (CIs). The CMA 2.0 software was applied to calculate the publication bias among the studies. Results: Out of 70 studies found in the databases, eight studies were involved and analyzed in the meta-analysis. The meta-analysis included 282 OLP patients and 221 healthy controls. The pooled MDs of serum levels of  IgA, IgG, and IgM were -0.13 g/L [95%CI: -0.24, -0.02; P = 0.02], 1.01 g/L [95%CI: -0.91, 2.93; P = 0.30], and -0.06 g/L [95%CI: -0.25, 0.14; P = 0.56], respectively; whereas, the salivary IgA and IgG levels were 71.54 mg/L [95%CI: 12.01, 131.07; P = 0.02] and 0.59 mg/L [95%CI: -0.20, 1.38; P = 0.14], respectively. Conclusions: Considering the few studies performed on saliva, the results suggested that the salivary levels, especially IgA level had a higher diagnostic value than the serum levels. Therefore, the salivary immunoglobulins can play a significant function in the OLP pathogenesis.

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Serum and Salivary IgA, IgG, and IgM Levels in Oral Lichen Planus: A Systematic Review and Meta-Analysis of Case-Control Studies

Medicina ◽

10.3390/medicina54060099 ◽

2018 ◽

Vol 54 (6) ◽

pp. 99 ◽

Cited By ~ 3

Author(s):

Hamid Mozaffari ◽

Elisa Zavattaro ◽

Abas Abdolahnejad ◽

Pia Lopez-Jornet ◽

Neda Omidpanah ◽

...

Keyword(s):

Lichen Planus ◽

Oral Lichen Planus ◽

Meta Analysis ◽

Serum Levels ◽

Inflammatory Factors ◽

Cochrane Library ◽

Healthy Controls ◽

Case Control Studies ◽

Salivary Iga ◽

Oral Lichen

Immunoglobulins (IgA, IgG, and IgM) are significant anti-inflammatory factors. The meta-analysis aimed to assess the serum and salivary levels of Igs as more important immunoglobulins in patients affected by oral lichen planus (OLP) compared to the healthy controls. Four databases, including PubMed/Medline, Scopus, Web of Science, and Cochrane Library as well as Iranian databases were checked up to January 2018 without language restriction. The quality of each involved study was done using the Newcastle–Ottawa Quality Assessment Scale (NOS) questionnaire. A random-effects model analysis was done by RevMan 5.3 software applying the mean difference (MD) plus 95% confidence intervals (CIs). The CMA 2.0 software was applied to calculate the publication bias among the studies. Out of 70 studies found in the databases, 8 studies were involved and analyzed in the meta-analysis. The meta-analysis included 282 OLP patients and 221 healthy controls. The pooled MDs of serum levels of IgA, IgG, and IgM were −0.13 g/L [95% CI: −0.24, −0.02; P = 0.02], 1.01 g/L [95% CI: −0.91, 2.93; P = 0.30], and −0.06 g/L [95% CI: −0.25, 0.14; P = 0.56], respectively; whereas, the salivary IgA and IgG levels were 71.54 mg/L [95% CI: 12.01, 131.07; P = 0.02] and 0.59 mg/L [95% CI: −0.20, 1.38; P = 0.14], respectively. Considering the few studies performed on saliva, the results suggested that the salivary levels, especially IgA level had higher values than the serum levels. Therefore, the salivary immunoglobulins can play a significant function in the OLP pathogenesis.

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Metallothioneins and Megalin Expression Profiling in Premalignant and Malignant Oral Squamous Epithelial Lesions

Cancers ◽

10.3390/cancers13184530 ◽

2021 ◽

Vol 13 (18) ◽

pp. 4530

Author(s):

Ana Zulijani ◽

Andrea Dekanić ◽

Tomislav Ćabov ◽

Hrvoje Jakovac

Keyword(s):

Lichen Planus ◽

Oral Lichen Planus ◽

Pearson Correlation ◽

Premalignant Lesions ◽

Proximity Ligation Assay ◽

Cancer Tissue ◽

Cellular Division ◽

Epithelial Lesions ◽

Imagej Software ◽

Oral Lichen

This study aimed to assess the relationship and possible interactions between metallothioneins (MTs) and megalin (LRP-2) in different grades of oral squamous cell carcinoma (OSCC) and premalignant lesions of the oral mucosa (oral leukoplakia and oral lichen planus). The study included archived samples of 114 patients and control subjects. Protein expression was examined by immunohistochemistry and immunofluorescence, and staining quantification was performed by ImageJ software. Protein interaction in cancer tissue was tested and visualized by proximity ligation assay. Mann-Whitney and Kruskal-Wallis tests were used to determine the significance of differences between each group, whereas Pearson correlation coefficient was performed to test correlation. Expression of both proteins differed significantly between each group showing the same pattern of gradual increasing from oral lichen planus to poorly differentiated OSCC. Moreover, MTs and megalin were found to co-express and interact in cancer tissue, and their expression positively correlated within the overall study group. Findings of prominent nuclear and chromosomal megalin expression suggest that it undergoes regulated intramembrane proteolysis upon MTs binding, indicating its ability to directly affect gene expression and cellular division in cancer tissue. The data obtained point to the onco-driving potential of MTs-megalin interaction.

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Expression of HER2/neu in premalignant lesions of oral cavity

10.1101/2020.07.24.20161489 ◽

2020 ◽

Author(s):

Vansh Verma ◽

Dr. Ashesh Kumar Jha ◽

Dr. Karsing Patiri ◽

Dr. Nikhil Arora

Keyword(s):

Oral Cancer ◽

Oral Cavity ◽

Lichen Planus ◽

Oral Lichen Planus ◽

Normal Mucosa ◽

Premalignant Lesions ◽

Severe Dysplasia ◽

Positive Contribution ◽

Cytoplasmic Staining ◽

Oral Lichen

Context: Molecular alterations in premalignant lesions of oral cavity are not well known, many reports and have found increased HER2 expression to be correlated with poor prognosis in oral cancer. However,literature on expression of HER2 in premalignant lesions is limited and data is conflicting in nature. Overexpression of HER2 in premalignant lesions may denote its positive contribution in malignant transformation of these lesions. Aims: To evaluate the expression of HER2 in premalignant lesions of oral cavity. Settings and Design: In this prospective observational study of 2 months, patients attending OPD at Department of ENT and meeting the inclusion criteria were included. Methods and Material: 23 samples of Leukoplakia and 1 sample of oral lichen planus were stained by routine H&E to confirm clinical diagnosis and assess dysplasia if any, 5 samples of normal mucosa were used as control. Immunohistochemical staining for HER2 was done. ASCO/CAP 2018 guidelines were used for reporting the results. Statistical analysis used: Percentage of lesions expressing cytoplasmic or membranous expression was calculated. Results: 1 sample of Leukoplakia with severe dysplasia expressed focal membranous staining. 20% leukoplakia lesions expressed cytoplasmic staining. Staining was not observed in oral lichen planus and leucoplakia without dysplasia. Conclusions: Membranous expression in Severe dysplasia and higher expression in oral cancer is in concordance with the multistep theory of carcinogenesis. Larger studies are needed if HER2 is to be proposed as a marker for oral premalignant lesions. Significance of cytoplasmic staining in oral premalignant lesions needs to be elucidated.

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Oral Lichen Planus as a Preneoplastic Inflammatory Model

Journal of Biomedicine and Biotechnology ◽

10.1155/2012/759626 ◽

2012 ◽

Vol 2012 ◽

pp. 1-8 ◽

Cited By ~ 43

Author(s):

Eleni A. Georgakopoulou ◽

Marina D. Achtari ◽

Michael Achtaris ◽

Periklis G. Foukas ◽

Athanassios Kotsinas

Keyword(s):

Lichen Planus ◽

Oral Lichen Planus ◽

Malignant Potential ◽

World Health ◽

Unknown Etiology ◽

The Past ◽

Long Run ◽

Potentially Malignant ◽

Health Organization ◽

Oral Lichen

Oral lichen planus (OLP) is a chronic oral inflammatory disease of unknown etiology. According to reports, 1-2% of OLP patients develop oral squamous cell carcinoma (OSCC) in the long run. While World Health Organization (WHO) classifies OLP as “a potentially malignant disorder,” it is still a matter of debate which mechanisms drive OLP to such a condition. The current hypothesis connecting OLP and OSCC is that chronic inflammation results in crucial DNA damage which over time results in cancer development. Initial studies investigating the OLP and OSCC link were mainly retrospective clinical studies. Over the past years, several amount of information has accumulated, mainly from molecular studies on the OLP malignant potential. This article is a critical review of whether OLP has a malignant potential and, therefore, represents a model of preneoplastic inflammation.

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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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