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  1. The comparative analysis of dermatoscopy picture of lichen planus and psoriasis

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    Sherstobitova K.Yu.

    2016-09-01

    Full Text Available Aim: analysis of different dermatoscopic patterns of lichen planus and psoriasis. Material and methods. We observed 80 patients: 40 with psoriasis, 40 — with lichen planus. Dermatoscopic study was conducted using video-dermatoscope of expert class "MoleMaxHD" (Derma Medical Systems company, Austria, under magnification from хЗО to x80. Results. Comparing the dermotoscopic findings of psoriatic plaque and lichen planus, vascular features were found to be more significant in psoriasis and in lichen planus non-vascular features were more prominant. Conclusion. Dermoscopy can be successfully used in differential diagnosis of these dermatoses.

  2. The coexistence of oral lichen planus and psoriasis vulgaris – a case report

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    Paulina Kiluk

    2016-05-01

    Full Text Available Introduction . Psoriasis and lichen planus are common dermatological conditions, whose coexistence is rarely described. Although the exact etiopathogenesis of both diseases is still unknown, autoimmune factors play an important role in their development. A common feature is also the occurrence of the Köbner phenomenon. The principal differences concern the clinical, histological and immunological events. Objective. To present a patient with oral lichen planus, in whom psoriasis developed. Case report. A 75-year-old patient, with a 3-year history of oral lichen planus, presented itchy erythematous skin lesions initially located in the intertriginous area. Outpatient treatment consisting of topical and oral antifungal medications did not bring significant improvement. Skin biopsy confirmed the diagnosis of psoriasis. Treatment with tar ointment and topical tacrolimus was carried out, resulting in gradual improvement. Conclusions . A review of the literature indicates the existence of possible, but still unexplained, linkages between these two diseases.

  3. Lichen planus

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    van der Waal, I.

    2014-01-01

    Lichen planus komt niet zelden in het mondslijmvlies voor. De meeste tandartsen en mondhygiënisten zullen zich daarbij witte lijntjes beiderzijds op het wangslijmvlies voor de geest halen. Iedereen zal wel zeggen zo’n patiënt in de praktijk in zijn bestand te hebben, maar vermoedelijk wordt het

  4. Lichen planus pigmentosus inversus

    National Research Council Canada - National Science Library

    Barros, Hugo Rocha; Almeida, José Roberto Paes de; Mattos e Dinato, Sandra Lopes; Sementilli, Angelo; Romiti, Ney

    2013-01-01

    .... Lichen planus pigmentosus inversus is a rare subtype of lichen planus characterized by hyperchromic, asymptomatic or mildly pruritic macules, measuring from millimeters to centimeters in diameter...

  5. Esophageal lichen planus.

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    Oliveira, Janine Pichler de; Uribe, Natalia Caballero; Abulafia, Luna Azulay; Quintella, Leonardo Pereira

    2015-01-01

    Lichen planus is a chronic inflammatory disease that affects the skin, mucous membranes, nails and scalp. Esophageal lichen planus is a rarely reported manifestation of lichen planus, presenting itself commonly in middle-aged women, with symptoms such as dysphagia. We report a case of esophageal lichen planus in a 54-year-old woman associated with oral, cutaneous and ungual lichen planus. Although lichen planus is a disorder well known by dermatologists, reports of esophageal lichen planus are rare in dermatologic literature. The esophageal lichen planus is little known and underdiagnosed, with a significant delay between the onset of symptoms and diagnosis.

  6. C-Jun expression in lichen planus, psoriasis and cutaneous squamous cell carcinoma, an immunohistochemical study.

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    Abdou, Asmaa Gaber; Marae, Alaa Hassan; Shoeib, Mohammed; Dawood, Ghada; Abouelfath, Enas

    2017-11-16

    The AP-1 transcription factor complex is a key player in regulating inflammatory processes, cell proliferation, differentiation and cell transformation. The aim of the present study is to investigate C-Jun (one of AP-1complex) expression and its proliferative role in skin samples of lichen planus, psoriasis as common inflammatory skin diseases and squamous cell carcinoma using immunohistochemical method. The present study was carried out on skin biopsies of 15 psoriatic patients, 15 lichen planus patients, 15 SCC and 15 normal skin biopsies. Nuclear expression of C-Jun was detected in basal and few suprabasal layers of epidermis of normal skin. C-Jun was expressed in the whole epidermal layers of both psoriasis (14/15) and lichen planus (15/15) in addition to its expression in lymphocytic infiltrate in the latter in about half of cases (8/15). C-Jun was also expressed in 93.3% (14/15) of SCC in a percentage lower than that of psoriasis, lichen planus and normal skin. The percentage of C-Jun expression in SCC was significantly associated with an early stage (p = 0.000), free surgical margins (p = 0.022) and small tumor size (p = 0.003). The marked reduction of C-Jun in SCC in comparison to normal skin and inflammatory skin dermatoses may refer to its tumor suppressor activity. C-Jun expression in SCC carries favorable prognosis. Absence of significant association between C-Jun and Ki-67 either in SCC or inflammatory skin diseases indicates that it does not affect proliferative capacity of cells.

  7. [Superimposed lichen planus pigmentosus].

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    Monteagudo, Benigno; Suarez-Amor, Óscar; Cabanillas, Miguel; de Las Heras, Cristina; Álvarez, Juan Carlos

    2014-05-16

    Lichen planus pigmentosus is an uncommon variant of lichen planus that is characterized by the insidious onset of dark brown macules in sun-exposed areas and flexural folds. Superimposed linear lichen planus is an exceedingly rare disorder, but it has been found in both lichen planopilaris and lichen planus types. A 39-year-old woman is presented showing a segmental and linear lichen planus associated with non-segmental lesions meeting all criteria for the diagnosis of superimposed linear planus pigmentosus. The segmental lesions were always more pronounced.

  8. Erosive Lichen Planus.

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    Mauskar, Melissa

    2017-09-01

    Lichen planus is an inflammatory mucocutaneous condition with a myriad of clinical manifestations. There are 3 forms of lichen planus that effect the vulva: papulosquamous, hypertrophic, and erosive. Erosive lichen planus can progress to vulvar scaring, vaginal stenosis, and squamous cell carcinoma; these long-term sequelae cause sexual distress, depression, and decreased quality of life for patients. Diagnosis is often delayed because of patient embarrassment or clinician misdiagnosis. Early recognition and treatment is essential to decreasing the morbidity of this condition. Multimodal treatment, along with a multidisciplinary approach, will improve outcomes and further clinical advances in studying this condition. Copyright © 2017 Elsevier Inc. All rights reserved.

  9. Oral Lichen Planus

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    ... that compromises your immune system or taking certain medications, though more research is needed. Complications Severe cases of oral lichen planus may increase the risk of: Significant pain Weight loss or nutritional deficiency Stress or anxiety ...

  10. Vulvar lichen planus pemphigoides

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    J. Loyal

    2017-12-01

    Full Text Available Lichen planus pemphigoides (LPP is a rare blistering disease with features of both lichen planus and bullous pemphigoid. LPP typically appears on the extremities and occasionally involves the oral mucosa. Herein, we describe a case of LPP of the vulva of an 80-year-old woman, an uncommon location for this disease process. This clinical scenario can be confused with a number of similarly appearing entities such as erosive vulvar lichen planus, mucous membrane pemphigoid, and erosive lichen sclerosus et atrophicus. In fact, our patient carried a diagnosis of lichen sclerosus by an outside physician for 2 years prior to being properly diagnosed and treated. A detailed discussion of the epidemiology, clinical, and pathogenesis as well as the histologic and immunofluorescence characteristics of this uncommon diagnosis is presented. Our case emphasizes the necessity of microscopic analysis to differentiate lookalike disease states when making a diagnosis and choosing the correct therapeutics.

  11. Bullous lichen planus - a review.

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    Liakopoulou, Angeliki; Rallis, Efstathios

    2017-03-31

    Bullous lichen planus is a rare variant of lichen planus. It is characterized by vesicles or bullae, which usually develop in the context of pre-existing LP lesions. It is often misdiagnosed and should be differentiated from other subepidermal bullous diseases especially lichen planus pemphigoides. The diagnosis is based on clinical suspicion and is confirmed by histopathology and immunofluoresence. The clinical features of bullous lichen planus include typical lichen planus lesions, accompanied by the formation of bullae on the affected or perilesional skin. This is evident on histology, with alteration of the dermo-epidermal junction and intrabasal bullae as a consequence of extensive inflammation. The histologic features in conjunction with the negative immunofluoresence indicate that bullous lichen planus is a form of "hyper-reactive lichen planus" rather than a distinct entity. There is no standard treatment of bullous lichen planus. Topical and systemic corticosteroids, dapsone and acitretin have been described as effective choices.

  12. Oral lichen planus

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    Šehalić Meliha

    2014-01-01

    Full Text Available 29 - year Lichen planus is a chronic, inflammatory, autoimmune skin disease, that is often manifested, except on the skin, in the oral cavity in a variety of clinical forms. The prevalence of the disease in the general population is about 1-2%. Etiopathogenesis is not still well understood. Histopathology, in addition to the basic methods, anamnesis and physical examination, is vital for proper diagnosis of oral lichen planus (OLP. Very diverse and loaded histological findings are common for all forms of oral lichen planus. We reported the case of oral lichen planus in a 49 years old male patient, who presented to the Dentistry clinic of Medical faculty of Priština with burning and itching symptoms and changes in the buccal mucosa. Histopathological analysis of biopsy tissue conformed clinical diagnosis of lichen planus. Due to the possibility for malignant transformation of lesions, the long-term follow-up of patients with this disease is of great importance.

  13. Palmoplantar Lichen Planus: Dört olgu sunumu

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    Uçmak, Derya; Azizoğlu, Ruken; Harman, Mehmet

    2015-01-01

    Lichen planus is a benign, inflammatory and itchy dermatosis that is incurred by skin, skin extensions and mucosa. Lichen planus rarely show palmoplantar involvement. Since stratum corneum in palmoplantar lichen planus is extremely thick, lesions can be yellow colored instead of the purple colored papules that are classic lesions. Clinically, it might be confused with psoriasis, secondary syphilis, verruca vulgaris, hyperkeratotic eczema, palmoplantar keratodermas, hyperkeratotic type tinea p...

  14. Differential gene expression in peripheral blood T cells from patients with psoriasis, lichen planus, and atopic dermatitis.

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    Li, Xinhua; Li, Junqin; Yang, Yuanwen; Hou, Ruixia; Liu, Ruifeng; Zhao, Xincheng; Yan, Xin; Yin, Guohua; An, Peng; Wang, Yong; Zhang, Kaiming

    2013-11-01

    Psoriasis, lichen planus (LP), and atopic dermatitis (AD) are common chronic inflammatory skin diseases mediated by immune responses. We used RNA sequencing to investigate messenger RNA expression patterns in peripheral T cells of Chinese patients with psoriasis, LP, or AD and of healthy individuals. After peripheral T-cell proliferation, messenger RNA expression patterns were investigated by RNA sequencing, and 6 randomly selected genes were verified by real-time reverse transcriptase polymerase chain reaction. Six genes were down-regulated and 33 were up-regulated in these diseases. Gene ontology analysis revealed enrichment of genes involved in positive regulation of T-cell activation. Regulation of nuclear premessenger RNA domain containing 1B (RPRD1B) expression was enhanced in psoriasis. The role of hereditary factors in RPRD1B expression in T cells was not considered. Immunomodulators (thymopeptide, levamisole, BCG polysaccharide, nucleic acid injection, and transfer factor) were previously given to patients with psoriasis and LP, but not to patients with AD; the effects of these immunomodulators on gene expression is uncertain. RPRD1B may be involved in T-cell activation in our Chinese psoriatic cohort, and may play a role in stimulating epidermal hyperproliferation. Copyright © 2013 American Academy of Dermatology, Inc. Published by Mosby, Inc. All rights reserved.

  15. Lichen planus remission is associated with a decrease of human herpes virus type 7 protein expression in plasmacytoid dendritic cells

    NARCIS (Netherlands)

    de Vries, H.J.C.; Teunissen, M.B.M.; Zorgdrager, F.; Picavet, D.; Cornelissen, M

    2007-01-01

    The cause of lichen planus is still unknown. Previously we showed human herpes virus 7 (HHV-7) DNA and proteins in lesional lichen planus skin, and significantly less in non-lesional lichen planus, psoriasis or healthy skin. Remarkably, lesional lichen planus skin was infiltrated with plasmacytoid

  16. Coexistence of nail lichen planus and lichen planus pigmentosus.

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    Lemes, Luciana Rodino; Verde, Renata Brandão Villa; Durães, Sandra Maria Barbosa; Araripe, Adolpho de Alencar; Pantaleão, Luciana

    2016-01-01

    We describe a fifty-six-year old, Afro-descendent female patient showing dystrophy of her twenty nails and hyperchromic, asymptomatic macule on her face. Histopathological examination of the macule showed vacuolization of the basal layer, melanophages in the superficial dermis and lymphoplasmocytic inflammatory infiltrate. Nail biopsy revealed orthokeratotic hyperkeratosis and lichenoid inflammatory infiltrate. Lichen planus pigmentosus is an uncommon variety of lichen planus. It is characterized by typical hyperpigmented macules on the face and neck. Nail changes might be present in 10% of lichen planus cases, but no associations with lichen planus pigmentosus have been described. We report a case of lichen planus in twenty nails associated with lichen planus pigmentosus on the patient's face.

  17. Zosteriform Lichen Planus: case report of a rare variant of Lichen Planus

    OpenAIRE

    Kanthilatha Pai; Sathish Pai

    2013-01-01

    Since its original description by Devergie in 1854, several cases of linear lichen planus have been described in the literature, but there have been notably few cases of the more rare zosteriform lichen planus. Zosteriform lichen planus needs to be differentiated from linear lichen planus and other linear dermatoses. We present a case of Zosteriform Lichen planus for its rarity and briefly review literature.

  18. A clinicopathological study of cutaneous lichen planus

    OpenAIRE

    Parihar, Asmita; Sharma, Sonal; Bhattacharya, Sambit Nath; Singh, Usha Rani

    2015-01-01

    Background: Lichen planus is an idiopathic subacute or chronic inflammatory disease of the skin, mucous membranes and nails. We studied the clinicopathological profile of lichen planus in Indian population. Methods: A total of 145 cases of histologically diagnosed lichen planus samples were included. Clinical features like age, sex, type of lichen planus, location were recorded in the case record form. Histological features of lichen planus were studied. Results: Out of 145 cases, major...

  19. Erosive lichen planus: a therapeutic challenge.

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    Romero, Williams; Giesen, Laura; Navajas-Galimany, Lucas; Gonzalez, Sergio

    2016-01-01

    Erosive lichen planus is an uncommon variant of lichen planus. Chronic erosions of the soles, accompanied by intense and disabling pain, are some of its most characteristic manifestations. We present the case of a woman who developed oral and plantar erosive lichen planus associated with lichen planus pigmentosus and ungueal lichen planus that were diagnosed after several years. The patient failed to respond to multiple therapies requiring longstanding medication but remained refractory. Knowledge of the treatment options for erosive lichen planus is insufficient. Further research is required to clarify their effectiveness, ideally adopting an evidence-based methodology.

  20. Oral lichen planus: An overview

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    Krupaa, R. Jayasri; Sankari, S. Leena; Masthan, K. M. K.; Rajesh, E.

    2015-01-01

    Lichen planus is an immunologically mediated mucocutaneous disease that is triggered by varied etiological agents. The oral lichenoid reaction is considered a variant of the disease that needs to be clearly diagnosed as a separate entity from oral lichen planus and treated. They follow a strict cause-effector relationship, protocols that suggest the differentiation. Lichen planus has varied clinical forms in the oral mucosa and cutaneously that has different prognosis. This condition also arises in association with various other systemic conditions such as hypertension, diabetes mellitus. There have been cases reported in the esophagus, larynx, scalp, nail, cutaneous areas, especially arms and wrists, trunk. There is reported malignant transformation that essentiates careful examination, treatment protocol and regular follow-up sessions. This article throws light on the disease condition of oral lichen planus and oral lichenoid reaction that is essential for the differentiation and treatment. PMID:26015696

  1. Oral lichen planus preceding concomitant lichen planopilaris.

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    Stoopler, Eric T; Alfaris, Sausan; Alomar, Dalal; Alawi, Faizan

    2016-09-01

    Lichen planus (LP) is an immune-mediated mucocutaneous disorder with a wide array of clinical presentations. Oral lichen planus (OLP) is characterized clinically by striae, desquamation, and/or ulceration. Lichen planopilaris (LPP), a variant of LP, affects the scalp, resulting in perifollicular erythema and scarring of cutaneous surfaces accompanied by hair loss. The association between OLP and LPP has been reported previously with scant information on concomitant or sequential disease presentation. We describe a patient with concomitant OLP and LPP, and to the best of our knowledge, this is the first report on OLP preceding the onset of LPP. Copyright © 2016 Elsevier Inc. All rights reserved.

  2. Lichen planus hypertrophicus of the vulva - a rare entity.

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    Job, Anupa Mary; Kaimal, Sowmya

    2017-09-01

    Vulvovaginal lichen planus is a type of chronic inflammatory dermatosis of the vulva, usually seen as a part of widespread lichen planus. The common clinical types of vulval lichen planus include papulosquamous, erosive and pigmented types. Hypertrophic lichen planus of the vulva is a rare entity. We report a case of hypertrophic lichen planus of the vulva which clinically simulated genital warts.

  3. Linear lichen planus in children - Case report*

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    Horowitz, Marcia Raquel; Vidal, Marcela de Lima; Resende, Manuela Oliveira; Teixeira, Márcia Almeida Galvão; Cavalcanti, Silvana Maria de Morais; de Alencar, Eliane Ruth Barbosa

    2013-01-01

    Lichen planus is an uncommon disease in children, and only 2 to 3% of affected patients are under twenty years of age. This dermatosis may appear in several clinical forms, which vary according to the morphology and distribution of lesions. In less than 0.2% of all lichen planus cases, the lesions are distributed along the lines of Blaschko, and is a variant called linear lichen planus. This is a case report of a patient aged two years and eight months, who presented keratotic violaceous papules, affecting the abdomen, buttocks and right thigh, distributed along the lines of Blaschko. Histopathological examination confirmed a diagnosis of linear lichen planus. PMID:24346902

  4. Verrucous Lichen Planus: A Rare Presentation of a Common Condition

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    Audhya, Moutusi; Varughese, Jenny S.; Nakhwa, Yuti C.

    2014-01-01

    Lichen planus is a chronic papulosquamous dermatoses in which both skin and mucosae are involved. There are various morphological forms of lichen planus. Hypertrophic lichen planus is one of the rare clinical variants. Herein, we report a very unusual presentation of hypertrophic lichen planus. A similar presentation has not been reported in literature yet, to the best of our knowledge. PMID:25386324

  5. A Case of Lichen Planus Pigmentosus-Inversus

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    Belkız Uyar

    2012-09-01

    Full Text Available Lichen planus pigmentosus is a rare subtype of lichen planus. Because of its rarity, we present the case of a patient diagnosed as lichen planus pigmentosus-inversus based on clinical and histopatological findings, which clinical appearance did not resemble lichen planus at initial examination.

  6. A CLINICAL AND HISTOPATHOLOGICAL STUDY OF LICHEN PLANUS

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    Ch. Madhu Babu; Padmaja, P.; M. Roopa Shree

    2016-01-01

    BACKGROUND Lichen planus is an idiopathic subacute or chronic inflammatory disease of the skin, mucous membranes, and nails. We studied the clinicopathological profile of 50 cases of Lichen planus in Osmania General Hospital from September 2010-April 2012. METHODS A total of 50 cases Lichen planus attending DVL OPD at OGH were studied. Clinical features like age, sex, type of Lichen planus, location were recorded in the case record form. Histological features of Lichen planus...

  7. Hyperkeratotic palmoplantar lichen planus in a child

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    Bhushan Madke

    2013-01-01

    Full Text Available Lichen planus (LP is a common idiopathic inflammatory disorder that affects the flexor aspect of the wrists, the legs, and the oral and genital mucosa. Depending upon the site of involvement, LP can be divided into mucosal, nail, scalp, or palmoplantar types. Palmoplantar LP can pose a diagnostic problem to the clinician as it resembles common dermatoses like psoriasis, verruca, corn, calluses, lichenoid drug eruption, and papular syphilide of secondary syphilis. In this case report, we describe a 4-year-old male child who presented with highly pruritic erythematous to violaceous hyperkeratotic papules and plaques on his palms and soles. Typical LP papules were noted on the upper back. Histopathology of the papular lesion showed features of LP. Dermatoscopy of a papule from the back showed the characteristic Wickham striae. We report this rare involvement of palm and soles in a case of childhood LP.

  8. Humoral Immuno-deficiency in Lichen Planus

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    Pramod K Nigam

    1988-01-01

    Full Text Available Serum immunouglobulin levels were studied in 41 histopathologically proven idiopathic lichen planus patients and 25 normal healthy individuals. No difference was observed in IgG levels, though, IgA and IgM levels were significantly reduced ′m patients with lichen planus as compared to normal controls. There was no association between the mucosal involvement and the reduced levels of IgA and IgM. These results suggest the possibility of humoral immuno-deficiency, in lichen planus patients.

  9. Lichen planus pigmentosus in a blaschkoid distribution.

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    Droms, Rebecca J; Snadecki, Haley; Deng, April; Levin, Nikki A

    2017-06-15

    Lichen planus pigmentosus is a pigmentary disorder of unknown etiology, with diffuse hyperpigmentation of sun-exposed areas, more commonly seen in some ethnic and racial groups. We report an unusual case of lichen planus pigmentosus in a 40-year-old man with Fizpatrick type III skin that was present in a blaschkoid distribution on the trunk, a distribution that has been rarely reported. This unique presentation of lichen planus pigmentosus may contribute to better understanding of the etiology, as the blaschkoid distribution may reflect underlying cutaneous mosaicism that renders those cells more susceptible to an insult that results in lichen planus pigmentosus. This disorder should be considered in the differential diagnosis of macular hyperpigmentation, especially in those from more commonly affected ethnic and racial groups, even when the distribution is atypical and in the absence of history of sun exposure.

  10. Treatment modalities of palmoplantar lichen planus: a brief review.

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    Feily, Amir; Yaghoobi, Reza; Nilforoushzadeh, Mohammad Ali

    2016-12-01

    Palmoplantar lichen planus is a localized and uncommon variant of lichen planus which is mostly resistant to treatment. Our purpose was to discuss all treatment modalities proposed and tested for palmoplantar lichen planus in the literature. A systematic review of the literature was conducted to evaluate evidence regarding all treatment modalities proposed and tested for palmoplantar lichen planus in the literature. Two major databases (PubMed, Google scholar) were searched. The review included all case reports, letters and original articles reporting any treatment for palmoplantar lichen planus but not treatment used in the other type of lichen planus, generalized lichen planus or other type of palmoplantar dermatoses. We have gone over more than 50 articles. There are many drugs that have been used in the treatment of lichen planus and generalized lichen planus but the palmoplantar type is a rare variety of lichen planus. That is why we could not find any clinical trial on the subject and just case reports have been described in this manuscript. In spite of plentiful investigations carried out on lichen planus, there is no treatment modality that has proved to be utterly satisfactory in treatment of palmoplantar lichen planus.

  11. Lichen planus pigmetosus-like ashy dermatosis

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    Francesco Tripodi Cutrì

    2011-12-01

    Full Text Available Ashy dermatosis, also known as erythema dyschromicum perstans, is an idiopathic dermal melanosis of unknown etiology. We here describe an unusual case of 63-year-old Caucasian male with ashy dermatosis and skin lesion of lichen pigmentosus-like. No treatment was tried because the lesions were totally asymptomatic. After a control, three months later, all lesions had cleared up. This case is of interest because it proves the existence of ashy dermatosis with clinical aspect lichen planus pigmentosus-like. This is the first case in the literature of lichen planus pigmentosuslike ashy dermatosis confirming the view that ashy dermatosis is a variant of lichen planus without the typically band-like infiltrate and Max Joseph spaces.

  12. Plaque psoriasis vs. atopic dermatitis and lichen planus: a comparison for lesional T-cell subsets, epidermal proliferation and differentiation.

    NARCIS (Netherlands)

    Bovenschen, H.J.; Seijger, M.M.B.; Kerkhof, P.C.M. van de

    2005-01-01

    BACKGROUND: T-cell infiltration in plaque psoriasis has recently been an important subject of investigation. Interestingly, comparative analyses of the disease-specific composition of the lesional T-cell infiltrate in plaque psoriasis and other inflammatory dermatoses have only sparsely been

  13. VEGFR-3 Expression in Oral Lichen Planus

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    Zolfaghari Saravi, Zahra; Seyedmajidi, Maryam; Sharbatdaran, Majid; Bijani, Ali; Mozaffari, Fatemeh; Aminishakib, Pouyan

    2017-02-01

    Background and objective: Given the postulated the role of inflammation and possible contribution of lymphangiogenesis in oral lichen planus, this study aimed to assess any associated presence of VEGFR-3. Material and Methods: This cross-sectional study was performed on 52 formalin fixed and paraffin embedded blocks of oral lichen planus (pathological diagnosis based on Modified WHO criteria), comprising 25 of erosive and 27 of reticular type, along with 60 samples of normal mucosa (with minimal inflammation from clinical and histopathological aspects) obtained at crown lengthening surgery. Four micron sections were cut from paraffin blocks and stained with H and E for confirmation of diagnosis and by immunohistochemistry with primary antibodies against VEGFR-3. Negative controls were provided by omission of primary antibody and placenta was considered as a positive control. Data were analyzed by Chi-square, Mann-Whitney and Kruskal-wallis tests and P lichen planus specimens and 5% of those from normal mucosa (plichen planus than in normal mucosa (plichen planus (p=0.262) and the average number of stained vessels (p=0.092) demonstrated no significant difference according to the type. Conclusion: It appears that VEGFR-3 expression might be involved in the pathogenesis of the oral lichen planus through increasing lymphatic vessels and lymphangiogenesis. Creative Commons Attribution License

  14. Candidosis on oral lichen planus

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    Kus Harijanti

    2006-06-01

    Full Text Available Oral lichen planus (OLP is a chronic inflammatory disease of the oral mucous membrane which is characterized by unpredictable exacerbation and remission. The pathognomonic of oral features of OLP are hyperkeratotic striation surrounded white patches of mucosal erythema are called Wickham’s Striae. Chronic inflammation or epithelial damage of the mucous membrane often followed by candidosis as secondary infection. Candida species are commensal microorganism, its population in oral cavity reach 70% of the oral microorganism. It is harmless, but it could become opportunistic pathogen when the condition of oral environment support, i.e. decrease of oral immune response or the oral microorganism ecosystem change. This purpose of the paper was to report the case of a female patient (49 years old who came to the clinic of Oral Medicine Faculty of Dentistry Airlangga University Surabaya with clinical and mycological evidence of thrush (Oral acute pseudomembrane candidosis. The patient not only suffered thrush, but also chronic cervicitis vaginalis. So the patient also consumed the antibiotic which was given by gynecologist. The used of the antibiotic for chronic servicitis vaginalis was the contrary treatment of oral thrush, after treated with nystatin oral suspention, clinical examination showed clearly hyperkeratotic lesion (Wickham’s striae, and hystopathological test result showed that it was OLP. The chronic oral inflammation and epithelial damage (OLP or antibiotic consumption could inhibited the candidosis treatment. The case report suggested that the first treatment should be given antimicotic if the mycological test of candidosis showed positive result.

  15. A case with Lichen planus in the lines of Blaschko

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    Metehan Gençoğlu

    2011-12-01

    Full Text Available Lichen planus is an inflammatory disorder that may involveskin and mucous membranes. Linear lichen planusis a rare disorder occurring in approximately 0.2% of patientswith lichen planus. We report a case of linear lichenplanus on the upper extremity which lesions followed thelines of Blaschko. J Clin Exp Invest 2011; 2 (4: 430-432

  16. Upregulation of angiogenesis in oral lichen planus.

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    Al-Hassiny, A; Friedlander, L T; Parachuru, V Pb; Seo, B; M Hussaini, H; Rich, A M

    2017-11-24

    Since angiogenesis is fundamental to the pathogenesis of many chronic inflammatory disorders this study investigated the expression of various vascular markers in oral lichen planus and non-specific oral mucosal inflammatory tissues. Archival specimens of oral lichen planus (n=15) and inflamed tissues (n=13) were stained using immunohistochemistry with antibodies to CD34, vascular endothelial growth factor, vascular endothelial growth factor receptor and vasohibin. Nine representative sites at the epithelial-connective tissue junction and through the fibrous connective tissue were selected and automated analysis techniques were used to determine the extent of positivity expressed as the percentage of positive cells. Significance was denoted when plichen planus samples compared with inflamed controls. A higher level of CD34 was observed in the deeper parts of the connective tissue of OLP (p=0.04), whereas VEGF and VEGFR2 expression was higher all through the tissues (respectively plichen planus in all sites evaluated (plichen planus compared with inflamed controls, with increased expression of pro-angiogenic factors and decreased anti-angiogenic expression. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

  17. Oral erosive lichen planus regression after thymoma resection.

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    Bobbio, Antonio; Vescovi, Paolo; Ampollini, Luca; Rusca, Michele

    2007-03-01

    Thymomas are neoplasms known to be frequently associated with autoimmune disorders. Oral lichen planus is an immunologically based, chronic inflammatory oral mucosal disease of undetermined cause. We describe a 79-year-old patient with a 6-month history of generalized oral erosive lichen planus in whom a chest roentgenogram led to the discovery of an anterior mediastinal mass consistent with thymoma. Transsternal complete thymoma resection achieved erosive oral lichen planus regression. The clinical correlations between erosive oral lichen planus and thymoma are presented.

  18. Interleukin-6 and neopterin levels in the serum and saliva of patients with Lichen planus and oral Lichen planus.

    Science.gov (United States)

    Abdel-Haq, Ayman; Kusnierz-Cabala, Beata; Darczuk, Dagmara; Sobuta, Eliza; Dumnicka, Paulina; Wojas-Pelc, Anna; Chomyszyn-Gajewska, Maria

    2014-11-01

    Lichen planus together with its oral variant is a chronic, inflammatory disease of the skin and the mucosa of unclear aetiology and with an unpredictable course that still poses a major problem in terms of diagnosis and treatment. The objective of this study was to assess the concentrations of interleukin-6 (IL-6) and neopterin in saliva and serum of patients with lichen planus (including reticular and erosive form of oral lichen planus) and to compare them with the concentrations observed in healthy controls. The study material comprised serum and saliva samples from 56 patients diagnosed with lichen planus and 56 healthy volunteers. The ELISA test was used to measure concentrations of IL-6 and neopterin in the serum and saliva of the study participants. The concentrations of IL-6 in saliva and serum of patients with lichen planus were significantly higher than in controls (P = 0.0002; P lichen planus had significantly higher IL-6 concentrations in their saliva compared to patients with reticular form of disease (P = 0.01). The concentrations of neopterin were significantly higher in the serum but not in saliva of lichen planus patients vs. controls (P lichen planus as well as the salivary concentrations of IL-6. The differences observed in IL-6 levels in patients with erosive-atrophic forms of oral lichen planus may indicate a substantial role played by the cytokine in the disease. © 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  19. Aloe vera as cure for lichen planus.

    Science.gov (United States)

    Patil, Bharati A; Bhaskar, Hebbar Pragati; Pol, Jyoti S; Sodhi, Amandeep; Madhu, Asha V

    2013-01-01

    Oral lichen planus is a difficult condition to treat because of its chronic nature. Various treatment modalities have resulted in partial regression of symptoms but not a complete cure. Aloe vera, a product with minimal adverse effects, can be tried to treat this disorder. A 38-year-old male patient diagnosed with lichen planus of the skin and the oral mucosa was suffering from severe pain and a burning sensation intraorally and pruritus of the skin lesions. Considering the extensive involvement, an herbal alternative was considered. The patient was prescribed aloe vera juice and gel application for two months. At the nine-month follow-up, the patient was symptom-free and totally cured of the intraoral and skin lesions.

  20. Dapsone versus corticosteroids in lichen planus

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    Chopra Adarsh

    1999-01-01

    Full Text Available Seventy five patients with Lichen Planus (LP were enrolled from out-patient department for screening the therapeutic effect of dapsone. Patients were divided into two groups of 50 and 25. In regimen - 1 (RI 25 patients were given local corticosteroids and oral chlorpheniramine maleate. In regimen - 2 (R2 50 patients were given oral dapsone and chlorpheniramine maleate and topical coconut oil. It was found that total efficacy of R2 was 18% higher than R1.

  1. Acitretin for the management of generalized cutaneous lichen planus.

    Science.gov (United States)

    Vazirnia, Aria; Cohen, Philip R

    2014-09-16

    Lichen planus is an inflammatory disease that affects the skin, the oral mucosa, or both. Generalized cutaneous lichen planus may pose a therapeutic challenge for clinicians if the condition persists or flares after topical or systemic corticosteroid therapy. Acitretin, a systemic retinoid, can be considered a potential second-line treatment for patients with generalized cutaneous lichen planus. Herein, we describe a postmenopausal woman with generalized cutaneous lichen planus who was successfully treated with acitretin. A 58-year-old woman presented with generalized cutaneous lichen planus involving her upper and lower extremities as well as her lower back. After failing corticosteroid therapy, she was started on acitretin 20 mg/day, which was later increased to 30 mg/day. To review the literature on the use of acitretin in cutaneous lichen planus, we used the PubMed search engine and searched for the terms "acitretin" and "cutaneous lichen planus." Our patient had complete resolution of pruritus within one week of initiating acitretin 20 mg/day. After an increase in dose to 30 mg/day, the cutaneous lesions completely resolved over a 3-month period. There was no recurrence of disease as acitretin was tapered and discontinued. Generalized cutaneous lichen planus may pose a therapeutic challenge for the symptomatic relief of skin lesions. Topical and systemic corticosteroids are first-line treatments. In patients who fail corticosteroids, relapse after corticosteroid therapy, or have contraindications to corticosteroids, acitretin may be considered a potential second-line therapy.

  2. Hepatitis B virus in Nigerians with Lichen planus | Daramola | West ...

    African Journals Online (AJOL)

    Background: Lichen planus had been reported as one of the cutaneous manifestations of Hepatitis B virus (HBV) in the literature. The prevalence of HBV among Nigerians with lichen planus has not been documented in the literature despite the high prevalence of HBV in the community, and the reports of a possible ...

  3. Marjolin's ulcer arising from cutaneous lichen planus | Olawoye ...

    African Journals Online (AJOL)

    The association between cutaneous lichen planus and Squamous cell carcinoma has been controversial. The rarity of documented cases, has led some to suggest that it may represent a chance association. Whilst there have been many reports of Marjolin's ulcer arising from oral lichen planus, reports of Squamous cell ...

  4. Oral Lichen Planus: Relation with Transaminase Levels and Diabetes

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    Altaf Hussain Chalkoo

    2010-01-01

    We hence conclude that diabetes mellitus and elevated transaminase levels might be related to the development of oral lichen planus lesions. There is a strong association between elevated SCOT/SGPT levels and detection of erosive type of oral lichen planus

  5. Surgical management of vulvovaginal agglutination due to lichen planus.

    Science.gov (United States)

    Fairchild, Pamela S; Haefner, Hope K

    2016-02-01

    Lichen planus is a rare dermatological disorder that is often associated with painful and disfiguring vulvovaginal effects. At the University of Michigan Center for Vulvar Diseases, we see many women with vulvovaginal lichen planus each year, with marked scarring and vulvovaginal agglutination that precludes vaginal intercourse and causes difficulty with urination. Through our experience, we developed a protocol for the operative management and postoperative care for severe vulvovaginal agglutination. Our objective is to share this protocol with a wider audience so that providers who see patients with these devastating effects of lichen planus can benefit from our experience to better serve this patient population. The figure represents a case of erosive lichen planus with early vaginal agglutination. The video reviews the pathophysiology and presentation of lichen planus. We then present a case of scarring and agglutination in a young woman, including our surgical management and postoperative care recommendations. Copyright © 2016 Elsevier Inc. All rights reserved.

  6. Cutaneous lichen planus: A systematic review of treatments.

    Science.gov (United States)

    Fazel, Nasim

    2015-06-01

    Various treatment modalities are available for cutaneous lichen planus. Pubmed, EMBASE, Cochrane Database of Systematic Reviews, Cochrane Central Register of Controlled Trials, Database of Abstracts of Reviews of Effects, and Health Technology Assessment Database were searched for all the systematic reviews and randomized controlled trials related to cutaneous lichen planus. Two systematic reviews and nine relevant randomized controlled trials were identified. Acitretin, griseofulvin, hydroxychloroquine and narrow band ultraviolet B are demonstrated to be effective in the treatment of cutaneous lichen planus. Sulfasalazine is effective, but has an unfavorable safety profile. KH1060, a vitamin D analogue, is not beneficial in the management of cutaneous lichen planus. Evidence from large scale randomized trials demonstrating the safety and efficacy for many other treatment modalities used to treat cutaneous lichen planus is simply not available.

  7. ORAL MANIFESTATIONS OF THE LICHEN PLANUS

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    Ana Pejčić

    2002-07-01

    Full Text Available The Lichen planus is frequent dermatosis that only attack mucus with no skin manifestation. Its only location can be only upon oral mucus.The aim of the paper is to examine the oral localization incidence in all its key variants.From March, 1999, to December, 2002, 35 patients were examined, namely, 28 women and 7 men of 19 to 63 years of age. Of 6 variants of the Lichen planus oral manifestations 17 had an erosive-ulcerous form, 13 had a reticular one and 5 patients had an atrophic form.The erosive-ulcerous form that was dominant in the last few years in its clinic variants was diagnosed upon the byccal mucus, gingiva, tongue, hard palate, lips and mouth cavity floor.This form requires an adequate therapy regarding its chronic nature as well as frequent check-ups due to the possibility of the "lichen dysplasia". Similar treatment is required with the atrophic form while the reticular variant requires occasional controls with no specific therapy except for the one referring to everyday maintenance of good oral hygiene, caries elimination and periodontal diseases along with the hygienic-diet regime.

  8. Oral lichen planus and lichenoid mucositis.

    Science.gov (United States)

    De Rossi, Scott S; Ciarrocca, Katharine

    2014-04-01

    Oral lichen planus (OLP) is commonly found in middle-aged women. Although the cause is unknown, research points to several complex immunologic events and cells that are responsible for the inflammatory destruction and chronicity of these lesions. Biopsy for histologic diagnosis is recommended. The mainstay of treatment remains topical corticosteroids; however, newer therapies such as immunomodulating agents are available for recalcitrant lesions. In cases of lichenoid mucositis or reactions, treatment should be directed at identifying and removing the presumed cause. Given the apparent risk of squamous cell carcinoma in these patients, frequent follow-up and repeat biopsy are vital. Copyright © 2014 Elsevier Inc. All rights reserved.

  9. Lichen planus pigmentosus: two atypical presentation

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    Falguni Nag

    2013-01-01

    Full Text Available Lichen planus pigmentosus (LPP is a chronic pigmentary disorder with variable pattern of presentation. We here by present two cases of LPP one with parallel band like pigmentation over abdomen sparing the abdominal skin creases and other with parallel band like pattern following the Blaschko’s lines over left side of the abdomen. Our cases are unique not only for its presentation but also for the pattern of distribution and LPP should be the differential diagnosis in any pigmentary disorders.

  10. Photodynamic therapy in treatment of severe oral lichen planus.

    Science.gov (United States)

    Rabinovich, O F; Rabinovich, I M; Guseva, A V

    2016-01-01

    The aim of the study was to elaborate the rationale for the application of photodynamic therapy in complex treatment of patient with severe oral lichen planus. Complex clinical and laboratory examination and treatment was performed in 54 patients divided on 3 groups. Diagnosis of oral lichen planus was based on clinical, histological and immunohistochemical features. Group 1 received standard treatment, in the second group photodynamic therapy was conducted in addition to conventional treatment, patients in the third group received only photodynamic therapy. The study results proved photodynamic therapy to be useful tool in complex treatment of severe oral lichen planus.

  11. A potential peptide pathway from viruses to oral lichen planus.

    Science.gov (United States)

    Lucchese, Alberta

    2015-06-01

    Oral lichen planus is an idiopathic inflammatory disease of oral mucous membranes, characterized by an autoimmune epidermis attack by T cells. It remains unknown, however, how such aggressive T cells are activated in vivo to cause epidermal damage. This study analyzes the relationship at the peptide level between viruses and oral lichen planus disease. Four potentially immunogenic peptides (SSSSSSS, QEQLEKA, LLLLLLA, and MLSGNAG) are found to be shared between HCV, EBV, HHV-7, HSV-1, and CMV and three human proteins (namely pinin, desmoglein-3, and plectin). The described peptide sharing might be of help in deciphering the still unexplained immunopathogenic pathway that leads to oral lichen planus. © 2015 Wiley Periodicals, Inc.

  12. Eccrine syringofibroadenoma in a patient with erosive palmoplantar lichen planus.

    Science.gov (United States)

    French, L E; Masgrau, E; Chavaz, P; Saurat, J H

    1997-01-01

    We report the case of an 82-year-old woman with a 6-year history of erosive palmoplantar lichen planus associated with eccrine syringofibroadenoma (ESFA). Examination revealed a well-demarcated patche writish of reticulated whitish papular lesions in skin of otherwise normal appearance at the border of erosive lichen planus plaques. These lesions had the histological appearance of ESFA. We suggest that these lesions are induced by the inflammatory remodelling associated with erosive lichen planus and propose to consider ESFA in the context of skin tissue remodelling as a new subtype of ESFA.

  13. VCAM1 and ICAM1 expression in oral lichen planus.

    Science.gov (United States)

    Seyedmajidi, Maryam; Shafaee, Shahryar; Bijani, Ali; Bagheri, Soodabeh

    2013-01-01

    Oral lichen planus is a chronic inflammatory immune-mediated disease. ICAM-1 and VCAM-1 are vascular adhesion molecules that their receptors are located on endothelial cells and leukocytes. The aim of this study is the immunohistochemical evaluation of VCAM1 and ICAM1 in oral lichen planus and to compare these two markers with normal mucosa for evaluation of angiogenesis. This descriptive-analytical study was performed on 70 paraffined blocks of oral lichen planus and 30 normal mucosa samples taken from around the lesions. Samples were stained with H & E and then with Immunohistochemistry using monoclonal mouse anti human VCAM1 (CD106), & monoclonal mouse anti human ICAM1(CD54) for confirmation of diagnosis. Slides were evaluated under light microscope and VCAM1 and ICAM1 positive cells (endothelial cells and leukocytes) were counted. Data were analyzed with Mann-Whitney test, Wilcoxon and Chi-Square and plichen planus according to the percentage of stained cells (p=0.000& p=0.000, Mann-Whitney test). Thirty cases of oral normal mucosa associated with lichen planus showed that the VCAM1 has increased significantly in comparison to normal mucosa (plichen planus and normal mucosa, showed a significantly difference (plichen planus was not observed (p>0.05). Regarding the results, it seems that high expression of VCAM1 and ICAM1 is related to oral lichen planus.

  14. Pigmented Oral Lichen Planus: A Case Report

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    Firstine Kelsi Hartanto

    2017-09-01

    Full Text Available Background: Lichen planus is a chronic muccocutaneous inflammatory disorder. Oral lichen planus (OLP has certain specific characteristics in its clinical presentation, but can also be presented in forms resembling other diseases. This may introduce difficulty in the diagnostic process. It has been reported that OLP affects between 0.1 to 4% individuals, predominantly women and people over 40 years old. Case Report: A 46-year-old woman complained of a non-healing ulcer present for 1.5 months. Intraorally, multiple white striae with prominent central areas of brownish hyperpigmentation were apparent on the right and left buccal mucosa, right and left buccal sulcus, and lateral and dorsum of the tongue. A biopsy was completed and the histopathology features confirmed the diagnosis of OLP. For the initial treatment, a topical corticosteroid was prescribed, followed by steroid mouthwash. Response to this treatment was positive. OLP has been frequently reported to affect women over the age of 40, with psychological stress as a primary predisposing factor. The clinical presentation is characteristic of Wickham’s striae with erosive areas. However, a biopsy and histopathological examination is mandatory to confirm the diagnosis. The clinical feature of pigmented OLP has been reported and confirmed by microscopic finding of band-like lymphocytic appearance which is the pathognomonic features of OLP, along with basal cell liquefaction degeneration, and melanin in continence at the lamina propria. Conclusion: Pigmented OLP is a variant of erosive OLP. Anamnesis, clinical presentation, and histopathological examination confirm diagnosis.

  15. Lichen planus secondary to hepatitis B vaccination

    Directory of Open Access Journals (Sweden)

    Agrawal Akhilesh

    2004-07-01

    Full Text Available The association of lichen planus (LP with liver diseases is now well established. Recent reports suggest that the hepatitis viruses may play a central role in this association. Lichen planus following hepatitis B vaccination is much more unusual. A 19-year-old previously healthy male developed itchy violaceous papules and plaques over the upper extremities eight to ten days after the first injection of hepatitis B vaccine. He developed similar lesions over the upper trunk, neck and lower leg after the second and third injections. A skin biopsy showed a lichenoid tissue reaction. Direct immunofluorescence (DIF showed multiple colloid bodies and a strong continuous ragged basement membrane zone (BMZ band with fibrinogen. HbsAg by ELISA and anti-HCV antibodies were negative. The patient was treated with oral steroids and the lesions improved. LP is a pruritic inflammatory dermatosis of unknown origin. An increased prevalence of liver disease in patient with LP has been reported. Since the first case reported by Rebora in 1990, about 15 cases of LP occurring after hepatitis B vaccination have been reported in the literature irrespective of the type of vaccine used.

  16. Classical lichen planus and lichen planus pigmentosus inversus overlap with dermoscopic features

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    Şule Güngör

    2014-01-01

    Full Text Available A 35-year-old man was referred to our hospital with a 3 months history of itchy cutaneous eruption on the trunk and asymptomatic cutaneous eruption on both groins. Physical examination revealed several, purplish-brown, scaly papules on the trunk and well-circumscribed, brown patchs in a linear distribution, on the bilateral inguinal regions. Dermoscopic examination of papules on the trunk revealed white crossing lines surrounded by brown dots; dermoscopic examination of patchs on groins revealed gray-brown dots and globules. According to histological, dermoscopical and clinical changes, the diagnoses of classical lichen planus (LP for the lesions on the trunk; and lichen planus pigmentosus inversus (LPPI for the lesions on the inguinal regions were made. Inhere we have described a rare case of LPPI and classical LP with dermoscopic features; and we suggest that LPPI is a variant of classical LP.

  17. [Dynamic concept of oral lichen planus. The diagnosis easy at early stages may become difficult in ancient lichen planus].

    Science.gov (United States)

    Lombardi, Tommaso; Küffer, Roger

    2016-02-01

    Dynamic concept of oral lichen planus. The diagnosis easy at early stages may become difficult in ancient lichen planus. Lichen planus is a chronic inflammatory dermatosis of the skin, skin appendages and mucous membranes, which frequently affects the oral mucosa. Its aetiology still remains unknown, and currently accepted pathogenesis is that of an autoimmune cell-mediated disease. To the contrary of skin lichen planus, oral lichen planus is a long-term chronic disease with dynamic evolution, in which progressive and profound changes of the clinical and histopathological aspects occur over time and under the influence of various exogenous factors. By convention, in the history of the oral lichen planus four successive stages can be distinguished without well-defined boundaries between them. These stages can be defined as an initial phase; a long intermediate phase with alternating periods of activity and quiescence, which has a gradually increasing risk of malignant transformation; a late stage which activity is traditionally diminished; and a post-lichen cicatricial stage with an absent or negligible and undetectable activity, often undiagnosed because clinically unrecognized; in this stage, the lesion does not respond to usual treatments, but retains the same risk of malignant transformation. Copyright © 2015 Elsevier Masson SAS. All rights reserved.

  18. Esophageal Lichen Planus: Clinical and Radiographic Findings in Eight Patients.

    Science.gov (United States)

    Rauschecker, Andreas M; Levine, Marc S; Whitson, Matthew J; Tondon, Rashmi; Rubesin, Stephen E; Furth, Emma E; Metz, David C

    2017-01-01

    The purpose of this study is to present the clinical and radiographic findings of esophageal lichen planus. A search of computerized medical records identified 15 patients with pathologic findings of esophageal lichen planus on endoscopic biopsy specimens. Three other patients had presumed esophageal lichen planus, although no biopsy specimens were obtained. Twelve of these 18 patients (67%) had double-contrast esophagography performed at our institution; for eight of the 12 patients (67%), the studies revealed abnormalities in the esophagus. These eight patients constituted our study group. The barium esophagrams and medical records of these eight patients were reviewed to determine the clinical, radiographic, and endoscopic findings of esophageal lichen planus as well as the treatment and patient outcome. All eight patients were women (median age, 66.5 years), and all eight presented with dysphagia (mean duration, 3.2 years). Four patients had previous lichen planus that involved the skin (n = 1), the oral cavity (n = 2), or both (n = 1), and one patient later had lichen planus that involved the vagina. Five patients had a small-caliber esophagus with diffuse esophageal narrowing. The remaining three patients had segmental strictures in the cervical (n = 1), upper thoracic (n = 1), and distal thoracic (n = 1) esophagus. Esophageal lichen planus typically occurs in older women with longstanding dysphagia and often develops in the absence of extraesophageal disease. Barium esophagrams may reveal a small-caliber esophagus or, less commonly, segmental esophageal strictures. Greater awareness of the radiographic findings of esophageal lichen planus hopefully will lead to earlier diagnosis and better management of this condition.

  19. Lichen Planus Pigmentosus-like Reaction to Guasha.

    Science.gov (United States)

    Yang, Gang; Tan, Cheng

    2016-11-01

    Lichen planus pigmentosus (LPP) is an uncommon variant of lichen planus (LP) that manifests as macular hyperpigmentation involving chiefly the face and upper limbs. Although its etiology has not been fully elucidated, a relationship with hepatitis C infection, restrictive underwear, localized friction, and sun exposure have been proposed. Rarely, exposure to mustard oil, amla oil, henna, or hair dyes has been reported. We herein describe an LPP-like reaction to Guasha. © The Author(s) 2016.

  20. Evaluation of Relationship between Lichen Planus and HCV Antibody

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    Ali Taghavi Zenouz

    2010-03-01

    Full Text Available Background and aims. Lichen planus is a relatively common chronic mucocutaneaous disease with an unknown cause, and is considered a manifestation of cell-mediated immune response. Hepatitis C virus (HCV and its subgroups have been associated with lichen planus in different geographic locations. The present study was undertaken to evaluate the prevalence of HCV antibody in patients with lichen planus in northwest Iran. Materials and methods. This descriptive analytical study included 30 patients with cutaneous lichen planus, 30 patients with oral lichen planus, and 30 healthy individuals as controls. Anti-HCV test was run for all the subjects. Descriptive statistics as well as chi-square test, to compare means in the three study groups, were applied to the data using SPSS 14.0 computer software. Results. Age and sex differences between the groups were not significant. No statistically significant differences were observed in anti-HCV test results between the groups (P = 0.50. Conclusion. No statistically significant relationships were observed between lichen planus and HCV antibody in the studied samples.

  1. Oral lichen planus and stress: An appraisal

    Directory of Open Access Journals (Sweden)

    Simarpreet V Sandhu

    2014-01-01

    Full Text Available Introduction: Oral lichen planus (OLP is a chronic inflammatory disease characterized by bilateral white striations or plaques on the buccal mucosa, tongue or gingiva that has a multifactorial etiology, where the psychogenic factors seem to play an important role. Purpose: The aim of this study was to determine the existing relation between the OLP and psychological alterations of the patient, such as stress, anxiety, and depression. Materials and Methods: Hospital anxiety and depression scale was applied for psychometric analysis. Results: The study indicates a definitive relationship between a stressful life event and onset and progression of OLP. Conclusion: Stress management and bereavement counseling should be a part of management protocol of OLP.

  2. Vulvovaginal-gingival Lichen Planus: Association with Lichen Planopilaris and Stratified Epithelium-specific Antinuclear Antibodies.

    Science.gov (United States)

    Olszewska, Malgorzata; Banka-Wrona, Agnieszka; Skrok, Anna; Rakowska, Adriana; Górska, Renata; Solomon, Lynn W; Rudnicka, Lidia

    2016-01-01

    Vulvovaginal-gingival lichen planus (VVG-LP) consists of a triad of symptoms: vulval, vaginal and gingival lichen planus lesions. The aim of this study was to analyse the prevalence of lesions in various anatomical locations in patients with VVG-LP. The study included 126 consecutive patients with lichen planus. Sixteen (12.7%) patients fulfilled the criteria of VVG-LP. In 12/16 (75%) patients with VVG-LP scalp lesions were also observed. Stratified epithelium-specific antinuclear antibodies (SES-ANA) and anti-ΔNp.3α antibodies were detected in 10/16 (75%) patients with VVG-LP and in 15/110 (13.6%) patients with other forms of lichen planus (p lichen planopilaris. The new entity may be termed "vulvovaginal-gingival-pilar lichen planus" and our study indicates that SES-ANA is a marker of this type of lichen planus with extensive, severe and refractory-to-therapy involvement of the mucous membranes, skin and scalp.

  3. Association of classic lichen planus with human herpesvirus-7 infection.

    Science.gov (United States)

    Nahidi, Yalda; Tayyebi Meibodi, Naser; Ghazvini, Kiarash; Esmaily, Habibollah; Esmaeelzadeh, Maryam

    2017-01-01

    Lichen planus is a mucocutaneous papulosquamous itchy disease with unknown etiology. A number of factors such as immune mechanisms, viral agents, and drugs have been implicated in pathogenesis of lichen planus. In recent years, several studies have indicated the role of viral agents in this disease, including human herpesvirus-7 (HHV-7). Studies have given contradictory results, which is why we decided to study the possible association between lichen planus with HHV-7. In this case-control study, which was conducted on 60 cutaneous classic lichen planus samples as well as 60 healthy control skin samples after matching the two groups in terms of gender and age, tissue samples of patients and controls were studied by real time polymerase chain reaction to detect for HHV-7. According to this study, HHV-7 DNA was found in 18 samples of the case group (30.0%) and in six (10.0%) of the control group (P = 0.006). The results of this study support the likely role of HHV-7 in pathogenesis of lichen planus. As an exogenous antigen, this virus may be involved in cellular immune-mediated destruction of keratinocytes. © 2016 The International Society of Dermatology.

  4. Emotional assessment of patients with oral lichen planus.

    Science.gov (United States)

    Alves, Mônica Ghislaine Oliveira; do Carmo Carvalho, Bruna Fernandes; Balducci, Ivan; Cabral, Luiz Antonio Guimarães; Nicodemo, Denise; Almeida, Janete Dias

    2015-01-01

    Oral lichen planus is a chronic immune-mediated disease with an estimated prevalence of 0.5-2.5% in the general population. Patients with oral lichen planus are often emotionally unstable and anxious and may develop concomitant systemic disorders. The objective of this study was to evaluate emotional characteristics of patients with oral lichen planus. Two groups were studied: the first group consisted of 48 patients with a diagnosis of oral lichen planus, and the second group consisted of controls without the disease matched for age and gender at a proportion of 1:1. The emotional state of the patients was evaluated using the State-Trait Anxiety Inventory, SF-36 generic quality of life questionnaire, and the Self Reporting Questionnaire-20. The present investigation demonstrated the presence of anxiety and depression in patients with oral lichen planus and a negative impact of the disorder on the patient's quality of life as indicated by impairment of the physical aspect, vitality, mental health, and social aspect domains. This could indicate that associated psychological treatment may be important in the follow-up of these patients. © 2014 The International Society of Dermatology.

  5. The microbiology of oral lichen planus: Is microbial infection the cause of oral lichen planus?

    Science.gov (United States)

    Baek, K; Choi, Y

    2017-09-04

    Oral lichen planus (OLP) is a variant of lichen planus (LP), a common chronic mucocutaneous inflammatory disease. Cutaneous lesions of LP are self-limiting, but OLP lesions are non-remissive, alternating periods of exacerbation and quiescence, and only symptomatic treatments exist for OLP. The precise etiology and pathogenesis of OLP are hardly understood, which is a major obstacle to the development of new therapeutics for this disease. OLP is considered a T-cell-mediated inflammatory disease. Although various antigens have been considered, what actually triggers the inflammatory response of T cells is unknown. Suggested predisposing factors include genetic factors, stress, trauma, and infection. The aim of this review was to determine whether microbial infection can cause OLP. We first reviewed the association between OLP and microbial factors, including viral, fungal, and bacterial infections. In addition, each microbial factor associated with OLP was assessed by modified guidelines of Fredricks and Relman to determine whether it establishes a causal relationship. In conclusion, no microbial factor yet fulfills the guidelines to establish the causality of OLP. By focusing on the unclarified issues, however, the potential roles of microbial factors in the pathogenesis of OLP will be soon elucidated. © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  6. FIELD CANCERIZATION IN LICHEN PLANUS – AN UNUSUAL CASE REPORT

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    Tamgadge Avinash

    2012-12-01

    Full Text Available Lichen Planus is a muco-cutaneous disorder affecting females. The oral lesions precede the skin lesions, with malignant potential rate, ranging from 0.3 to 3%. Malignant changes are usually associated with stress and cocarcinogens. Usually, malignant transformation is presented as solitary lesion in the oral cavity, Oral Squamous Cell Carcinoma (OSCC, developing at multiple sites, as a very rare finding in patients of Oral Lichen Planus (OLP. A case of OLP without risk factors and strong history of stress, the Grinspan syndrome with field cancerization is presented in this article

  7. Update on lichen planus and its clinical variants.

    Science.gov (United States)

    Weston, Gillian; Payette, Michael

    2015-08-01

    Lichen planus (LP) is an inflammatory skin condition with characteristic clinical and histopathological findings. Classic LP typically presents as pruritic, polygonal, violaceous flat-topped papules and plaques; many variants in morphology and location also exist, including oral, nail, linear, annular, atrophic, hypertrophic, inverse, eruptive, bullous, ulcerative, lichen planus pigmentosus, lichen planopilaris, vulvovaginal, actinic, lichen planus-lupus erythematosus overlap syndrome, and lichen planus pemphigoides. Clinical presentation of the rarer variant lesions may be largely dissimilar to classic LP and therefore difficult to diagnose based solely on clinical examination. However, histopathological examination of LP and LP-variant lesions reveal similar features, aiding in the proper diagnosis of the disease. Management of LP and LP variants aims to control symptoms and to decrease time from onset to resolution; it often involves topical corticosteroids, but varies depending on the severity and location of the lesion. The literature contains an array of reports on the variations in presentation and successful management of LP and its variants. A familiarity with LP and its variants is important in achieving timely recognition and management of the disease.

  8. [The expression and clinical significance of IL-35 in periodontitis and oral lichen planus].

    Science.gov (United States)

    Wang, Yu; Jin, Ying; Wang, Yi-Yue; Xu, Dan-Ni; Lin, Xiao-Ping

    2016-08-01

    To investigate the influence of IL-35 in the pathogenesis of periodontitis and oral lichen planus, and the correlation between periodontitis and oral lichen planus patients. The gingival crevicular fluid(GCF) and serum were collected from patients with oral lichen planus (n=20), periodontitis (n=20), periodontitis and oral lichen planus (n=20) and healthy controls (n=12). The patients' basic information, probing depth, clinical attachment loss, gingival index, sulcus bleeding index were measured and collected. The expression of IL-35 in GCF and serum was detected by ELISA. SPSS19.0 software package was used for statistical analysis. The concentration of IL-35 in patients with periodontitis and oral lichen planus was significantly higher than that of other groups(Plichen planus may increase the concentration of IL-35 both in serum and GCF. The expression of IL-35 was positively correlated with periodontitis and oral lichen planus.

  9. Lichen Planus Pigmentosus: The Controversial Consensus

    Science.gov (United States)

    Ghosh, Aparajita; Coondoo, Arijit

    2016-01-01

    A pigmented variant of lichen planus (LP) was first reported from India in 1974 by Bhutani et al. who coined the term LP pigmentosus (LPP) to give a descriptive nomenclature to it. LP has a number of variants, one of which is LPP. This disease has also later been reported from the Middle East, Latin America, Korea, and Japan, especially in people with darker skin. It has an insidious onset. Initially, small, black or brown macules appear on sun-exposed areas. They later merge to form large hyperpigmented patches. The disease principally affects the sun-exposed areas of the body such as the face, trunk, and upper extremities. The oral mucosa may rarely be involved. However, the palms, soles, and nails are not affected. Histologically, the epidermis is atrophic along with vacuolar degeneration of basal cell layer. The dermis exhibits incontinence of pigment with scattered melanophages and a sparse follicular or perivascular infiltrate. There is a considerable similarity in histopathological findings between LPP and erythema dyschromicum perstans. However, there are immunologic and clinical differences between the two. These observations have led to a controversy regarding the identity of the two entities. While some dermatologists consider them to be the same, others have opined that the two should be considered as distinctly different diseases. A number of associations such as hepatitis C virus infection, frontal fibrosing alopecia, acrokeratosis of Bazex and nephrotic syndrome have been reported with LPP. A rare variant, LPP inversus, with similar clinical and histopathological findings was reported in 2001. As opposed to LPP, this variant occurs in covered intertriginous locations such as groins and axillae and mostly affects white-skinned persons. PMID:27688435

  10. Direct Immunofluorescence in Oral Lichen Planus

    Science.gov (United States)

    Okuma, Nis; Thanakun, Supanee; Laothumthut, Titikarn

    2015-01-01

    Introduction Oral lichen planus (OLP) is a common immune-mediated oral mucosal disease. Diagnosis of OLP depends mainly on both clinical and histopathological features. Direct immunofluorescence (DIF) is a useful investigation method to distinguish between similar lesions and to confirm diagnosis in cases of uncharacterized features. Aim The purpose of this study was to evaluate the prevalence and pattern of DIF in a group of Thai patients with OLP. Materials and Methods Records of clinically and histologically diagnosed OLP patients attending the Oral Medicine Clinic, Faculty of Dentistry, Mahidol University, Bangkok, Thailand were consecutively reviewed for DIF results. The DIF patterns in these patients were analysed. Results There were 82 atrophic and/or erosive OLP patients with a mean age of 51.6 years. Male to female ratio was 1:5. Of these, 82.9% showed positive DIF. Buccal mucosa was superior to the gingiva and palate in terms of sensitivity for DIF. All specimens except one (98.5%) demonstrated deposition of fibrinogen at the basement membrane zone (BMZ) in a shaggy pattern. The most common DIF pattern was shaggy fibrinogen at BMZ with IgM deposition on the colloid bodies (CB) (35.3%) followed by shaggy fibrinogen along BMZ (27.9%). Conclusion The prevalence of positive DIF in Thai OLP patients was 82.9%. The most common finding was shaggy fibrinogen at BMZ. The typical pattern was shaggy fibrinogen along BMZ with or without positive IgM at CB. DIF pattern could be evaluated for the diagnosis of OLP lacking clinical and/or histopathological characteristic features. PMID:26436043

  11. Lichen planus pigmentosus: The controversial consensus

    Directory of Open Access Journals (Sweden)

    Aparajita Ghosh

    2016-01-01

    Full Text Available A pigmented variant of lichen planus (LP was first reported from India in 1974 by Bhutani et al. who coined the term LP pigmentosus (LPP to give a descriptive nomenclature to it. LP has a number of variants, one of which is LPP. This disease has also later been reported from the Middle East, Latin America, Korea, and Japan, especially in people with darker skin. It has an insidious onset. Initially, small, black or brown macules appear on sun-exposed areas. They later merge to form large hyperpigmented patches. The disease principally affects the sun-exposed areas of the body such as the face, trunk, and upper extremities. The oral mucosa may rarely be involved. However, the palms, soles, and nails are not affected. Histologically, the epidermis is atrophic along with vacuolar degeneration of basal cell layer. The dermis exhibits incontinence of pigment with scattered melanophages and a sparse follicular or perivascular infiltrate. There is a considerable similarity in histopathological findings between LPP and erythema dyschromicum perstans. However, there are immunologic and clinical differences between the two. These observations have led to a controversy regarding the identity of the two entities. While some dermatologists consider them to be the same, others have opined that the two should be considered as distinctly different diseases. A number of associations such as hepatitis C virus infection, frontal fibrosing alopecia, acrokeratosis of Bazex and nephrotic syndrome have been reported with LPP. A rare variant, LPP inversus, with similar clinical and histopathological findings was reported in 2001. As opposed to LPP, this variant occurs in covered intertriginous locations such as groins and axillae and mostly affects white-skinned persons.

  12. ON THE PROBLEM OF THE TREATMENT OF GENITAL LICHEN PLANUS

    Directory of Open Access Journals (Sweden)

    Yu. A. Molochkova

    2016-01-01

    Full Text Available Lichen planus is a chronic inflammatory disease of the coated flat nonkeratinizing epithelium of the skin and mucous membranes. Still etiology of this disease is not completely clear. At the same time, many researchers have expressed their views in favor of the theory of occurrence of autoimmune planus. The emergence of this disease may also be associated with infectious diseases, trauma, hormonal disorders, and hereditary predisposition. Currently, standard treatment of lichen planus is topical application of corticosteroids. With the lack of effectiveness of the last clinicians suggest topical calcineurin inhibitors. That less, all treatments planus today are ineffective. Researchers continue to search for more effective treatments for this pathology. At this point in the treatment of various diseases is well proven photodynamic therapy. Given the high efficacy of photodynamic therapy in the treatment of basal cell carcinoma, actinic keratosis and various other skin diseases, clinicians began to fully explore the impact of the use of photodynamic therapy in the treatment of lichen planus.

  13. Update on oral lichen planus: etiopathogenesis and management

    DEFF Research Database (Denmark)

    Scully, C; Beyli, M; Ferreiro, M C

    1998-01-01

    Lichen planus (LP) is a relatively common disorder of the stratified squamous epithelia, which is, in many ways, an enigma. This paper is the consensus outcome of a workshop held in Switzerland in 1995, involving a selection of clinicians and scientists with an interest in the condition and its m...

  14. Hyperkeratotic oral lichen planus role of vitamin A

    Directory of Open Access Journals (Sweden)

    Chopra Adarsh

    1999-01-01

    Full Text Available Chronic tobacco chewing and smoking have been implicated as precipitating factors for the development of oral lichen planus (OLP. We here report a case of chronic cigarette smoker who developed OLP plaque, without any other clinical pattern of OLP and skin involvement, which did not respond to conventional corticosteroid treatment and dapsone, but responded when vitamin A was added.

  15. CO2 laser evaporation of oral lichen planus

    NARCIS (Netherlands)

    van der Hem, P. S.; Egges, M.; van der Wal, J. E.; Roodenburg, J. L. N.

    Oral lichen planus is a relatively common disease of the oral mucosa. The buccal mucosa and lateral border of the tongue are mostly involved, although the condition can occur anywhere in the oral cavity. The erosive type in particular can cause spontaneous pain during eating. In the period from 1975

  16. Comparison of topical tretinoin and betamethasone in oral lichen planus

    Directory of Open Access Journals (Sweden)

    Kar H

    1996-01-01

    Full Text Available Thirty-one patients of oral lichen planus were enrolled in this study and two groups were made. Group 1 consisting of 16 patients who applied topical tretinoin 0.05% and Group 2 comprising of 15 patients who were given topical betamethasone dipropionate 0.05%. The patients applying tretinoin showed statistically significant improvement as compared to patients applying betamethasone.

  17. Case of lichen planus pigmented — аtrophic

    Directory of Open Access Journals (Sweden)

    Yeremina M.G.

    2012-06-01

    Full Text Available

    This study presents a case of a combination of rarely encountered forms of lichen planus (pigmented and atrophic. The results of measurements of indexes of pigmentation and erythema in the lesions and healthy skin are given, and comparing them with different forms of LP. A comprehensive examination of the patient to identify the pathology of internal organs.

  18. Hepatitis C virus infection in patients with oral lichen planus ...

    African Journals Online (AJOL)

    Background: Lichen planus (LP) is a chronic mucocutaneous disease of uncertain etiology. Recent reports suggest that LP is an extrahepatic manifestation of Hepatitis C infection. Objective: To determine the association of Hepatitis C virus (HCV) infection with oral LP and to study the tests of liver function in patients with ...

  19. Liver enzymes in Nigerians with lichen planus | Daramola | Nigerian ...

    African Journals Online (AJOL)

    Lichen planus has been reported in association with liver diseases. Clinical signs such as jaundice may not be reliable indicator of ongoing inflammation or the presence of an ongoing liver disease. Liver function test in spite of its variability may serve as amore reliable indicator of liver disease. The objective of this study is ...

  20. Bullous Lichen Planus in an Indian female | Puri | Sudanese Journal ...

    African Journals Online (AJOL)

    We describe bullous lichen planus in an. Indian female who had itchy erythematous papular lesions with vesicles and bullae predominantly over the dorsa of both legs. The patient was subjected to histopathological examination after which the diagnosis was confirmed. The patient was put on oral steroids and dapsone.

  1. Disease scoring systems for oral lichen planus; a critical appraisal

    NARCIS (Netherlands)

    Wang, J.; van der Waal, I.

    2015-01-01

    The aim of the present study has been to critically review 22 disease scoring systems (DSSs) on oral lichen planus (OLP) that have been reported in the literature during the past decades. Although the presently available DSSs may all have some merit, particularly for research purposes, the diversity

  2. Squamous Cell Carcinoma Arising in Hypertrophic Lichen Planus: A Review and Analysis of 38 Cases.

    Science.gov (United States)

    Knackstedt, Thomas J; Collins, Lindsey K; Li, Zhongze; Yan, Shaofeng; Samie, Faramarz H

    2015-12-01

    Hypertrophic lichen planus is a chronic variant of lichen planus with controversial malignant association. To describe and analyze the relationship of squamous cell carcinoma (SCC) and hypertrophic lichen planus. A retrospective chart review of patients with hypertrophic lichen planus and SCC was performed at the authors' institution. Thereafter, scientific databases were searched for articles reporting cases of SCC arising in hypertrophic lichen planus. Patient demographics, immune status, lichen planus features, and SCC data points were extracted for each patient and evaluated. Thirty-eight cases of SCC in hypertrophic lichen planus occurred in 16 women, average age: 61.4, and 22 men, average age: 51.3, after a lag time of 88 days to 40 years. Squamous cell carcinoma was uniformly located on the lower extremity. Men had larger SCC than women (p = .027) and a significantly longer lag time to SCC development (p = .002). Long lag time was associated with a smaller SCC size (p = .032). In the past, hypertrophic lichen planus and SCC have been considered isolated diseases. Based on an increasing number of cases, the association between hypertrophic lichen planus and keratinocyte malignancies warrants surveillance.

  3. Squamous cell carcinoma developing in a cutaneous lichen planus lesion: a rare case.

    Science.gov (United States)

    Ghosh, Saptarshi; Kotne, Sivasankar; Ananda Rao, P B; Turlapati, S P V; Kumar Soren, Dillip

    2014-01-01

    Lichen planus is a benign disorder characterized by an itchy, noninfectious skin rash. Though lichen planus is a common papulosquamous disorder affecting about 1-2% of the population, neoplastic transformation of cutaneous lichen planus lesions occurs very rarely and should be borne in mind while treating nonhealing longstanding lesions of lichen planus. Studies suggest an estimated 0.3-3% risk of malignancy in patients with oral lichen planus, however, cutaneous lichen planus does not carry an increased risk of malignant degeneration. We present a case of a 36-year-old male with a 10-year-long history of hypertrophic lichen planus who presented with a nonhealing ulcer in the left popliteal fossa. The patient underwent wide local excision with superficial skin grafting. Postoperative histopathological examination revealed verrucous squamous cell carcinoma complicating lichen planus. In view of underlying structure involvement, adjuvant radiation therapy was given. This case is being reported to emphasize the infrequent possibility of development of malignancy in cutaneous lichen planus, especially if it presents as a longstanding, nonhealing, itchy lesion with patchy areas of depigmentation in the lower limbs.

  4. Treatment of recalcitrant erosive oral lichen planus and desquamative gingivitis with oral apremilast.

    Science.gov (United States)

    AbuHilal, Mohn'd; Walsh, Scott; Shear, Neil

    2016-11-30

    Erosive oral lichen planus and desquamative gingivitis are uncommon but severe debilitating variants of oral lichen planus. Treatment of these presentations is difficult and challenging. A 44-year-old woman was referred to the dermatology clinic with chronic painful lichen planus-related gingivitis and buccal erosions. She has failed multiple treatments including topical clobetasol and tacrolimus, intralesional corticosteroids and several systemic and immunosuppressive agents. Following completion of three months of treatment with oral apremilast at a dose of 30 mg twice daily, significant improvement was noted in her disease activity. Oral apremilast may be a safe and effective treatment for erosive oral lichen planus.

  5. Disease scoring systems for oral lichen planus; a critical appraisal

    Science.gov (United States)

    Wang, Jing

    2015-01-01

    The aim of the present study has been to critically review 22 disease scoring systems (DSSs) on oral lichen planus (OLP) that have been reported in the literature during the past decades. Although the presently available DSSs may all have some merit, particularly for research purposes, the diversity of both the objective and subjective parameters used in these systems and the lack of acceptance of one of these systems for uniform use, there is a need for an international, authorized consensus meeting on this subject. Because of the natural course of OLP characterized by remissions and exacerbations and also due to the varying distribution pattern and the varying clinical types, e.g. reticular and erosive, the relevance of a DSS based on morphologic parameters is somewhat questionable. Instead, one may consider to only look for a quality of life scoring system adapted for use in OLP patients. Key words:Oral lichen planus, disease scoring system, classification. PMID:25681372

  6. Increased salivary aldehyde dehydrogenase 1 in non-reticular oral lichen planus.

    Science.gov (United States)

    Mansourian, Arash; Shanbehzadeh, Najmeh; Kia, Seyed Javad; Moosavi, Mahdieh-Sadat

    2017-01-01

    Oral lichen planus is a potentially malignant disorder. One of the malignant transformation markers is cancer stem cells. One of the proposed marker for the detection of cancer stem cells's in head and neck cancer is aldehyde dehydrogenase. Recently it is shown that aldehyde dehydrogenase 1 expression in tissue samples is associated with oral lichen planus malignant transformation. This study evaluates salivary aldehyde dehydrogenase 1 in oral lichen planus. Thirty patients and 30 age and sex-matched healthy volunteers were recruited. Oral lichen planus was diagnosed based on the modified World Health Organization criteria. Subjects in the case group were divided into reticular and non-reticular forms. Unstimulated salivary samples were collected at 10-12 AM. Saliva concentrations of aldehyde dehydrogenase 1 were measured by ELISA. The differences between aldehyde dehydrogenase levels in the oral lichen planus group compared with the control group were not significant but aldehyde dehydrogenase in non-reticular oral lichen planus was significantly higher than that of the reticular form. This is a cross-sectional study, thus longitudinal studies in oral lichen planus may present similar or different results. The mechanism of malignant transformation in oral lichen planus is not defined. Previous analyses revealed that the aldehyde dehydrogenase 1 expression is significantly correlated with increased risk of transformation. This finding is consistent with our results because in the erosive and ulcerative forms of oral lichen planus, which have an increased risk of transformation, salivary aldehyde dehydrogenase 1 was overexpressed. A higher salivary aldehyde dehydrogenase level in non-reticular oral lichen planus can be a defensive mechanism against higher oxidative stress in these groups. Aldehyde dehydrogenase may be one of the malignant transformation markers in oral lichen planus. Further studies are needed for introducing aldehyde dehydrogenase as a prognostic

  7. Oral lichen planus: A look from diagnosis to treatment.

    OpenAIRE

    Pablo Córdova; Aida Rubio; Paula Echeverría

    2014-01-01

    ABSTRACT Oral lichen planus (OLP) is a chronic mucocutaneous disease of unknown etiology. Its pathogenesis is multifactorial and it may affect the oral mucosa, skin and other mucous membranes. Diagnosis is based on clinic and histopathology; direct immunofluorescence techniques can also be of use. It affects about one to two percent of the population, mainly women between the fifth and sixth decades of life. In the mouth, the most affected area is the buccal mucosa, followed by the gums, ton...

  8. Salivary oxidative status in patients with oral lichen planus.

    Science.gov (United States)

    Darczuk, D; Krzysciak, W; Vyhouskaya, P; Kesek, B; Galecka-Wanatowicz, D; Lipska, W; Kaczmarzyk, T; Gluch-Lutwin, M; Mordyl, B; Chomyszyn-Gajewska, M

    2016-12-01

    Reactive oxygen species (ROS) are involved in the pathogenesis of many inflammatory diseases, including oral lichen planus. Therefore, determining the salivary markers of oxidative stress is an excellent alternative approach to diagnosing oral cavity diseases. The objective of our study was to provide preliminary validation and determination of the salivary markers of oxidative stress in both patients with reticular and erosive forms of oral lichen planus as well as in healthy individuals without any oral lesions. In total, 62 patients with oral lichen planus (OLP) were enrolled in the study, including 31 with the reticular form of lichen planus (44.63 ± 11.05 years) and 31 with erosive forms (40.43 ± 10.05 years), who had never been treated for their disease. The control group comprised 30 individuals without any oral lesions (42.12 ± 12.22 years). We determined the saliva levels in glutathione (GSH), total antioxidant capacity (TAC), and thiobarbituric acid reactive substances (TBARS). The mean saliva levels of GSH and TAC were significantly lower (P < 0.01) in OLP patients compared to the control group. The mean levels of salivary TBARS were higher in both OLP groups (reticular and erosive) compared to the control group (P = 0.01). The lower saliva levels of GSH and TAC in patients with OLP indicate that free radicals and the resulting oxidative damage may play an important role in the pathogenesis of OLP lesions. In conclusion, monitoring the oxidant-antioxidant status of saliva may serve as an efficient and less intrusive marker for determining stages of disease development in patients with OLP.

  9. Mucosal lichen planus: an evidence-based treatment update.

    Science.gov (United States)

    Davari, Parastoo; Hsiao, Hui-Hua; Fazel, Nasim

    2014-07-01

    Mucosal lichen planus (MLP) is a chronic mucosal disorder that often poses a therapeutic challenge to dermatologists, dentists, and gynecologists. To relieve patients' pain and discomfort, improve their quality of life, and achieve clinical improvement, various therapeutic approaches can be considered for this disease. Based on the current literature it is difficult to define any particular treatment as the main therapeutic modality. We aimed to systematically review the current literature for the effectiveness of available treatment modalities for MLP. All of the randomized controlled trials and systematic reviews of MLP were collected by searching Pubmed, EMBASE, the Cochrane Database of Systematic Reviews, Database of Abstracts of Reviews of Effects, Cochrane Central Register of Controlled Trials, Health Technology Assessment Database, and China National Knowledge Infrastructure. Meta-analysis was performed, if possible. Topical betamethasone valerate, clobetasol-17-propionate, and fluocinonide are effective in the treatment of oral lichen planus (OLP) when compared with placebo. Calcineurin inhibitors and topical retinoids are also beneficial treatment options. The review does not include therapies with a lower level of evidence. Topical corticosteroids are the mainstay of therapy for OLP. High-quality evidence is lacking for the treatment of lichen planus.

  10. Successful treatment of bullous lichen planus with acitretin monotherapy. Review of treatment options for bullous lichen planus and case report.

    Science.gov (United States)

    Rallis, Efstathios; Liakopoulou, Angeliki; Christodoulopoulos, Constantinos; Katoulis, Alexandros

    2016-12-31

    Bullous lichen planus (BLP) is a rare variant of lichen planus, characterized by the development of vesicular and bullous lesions, of skin, nails, hair and/or mucosa. We present a case of 63-year-old woman with BLP, unresponsive to previous therapies with topical corticosteroids, topical calcipotriol, antihistamines and oral cyclosporine (4 mg/kg/day for 4 months). She was already receiving treatment for arterial hypertension, hyperlipidemia, atrial fibrillation and uncontrolled diabetes mellitus. Acitretin was administered for 5 months with complete remission of BLP lesions and no major side effects. This is probably the first reported case of BLP treated with acitretin monotherapy. In this case acitretin was an efficacious and well-tolerated therapeutic option for BLP.

  11. Current Treatment Options in Challenging Oral Diseases: Oral Lichen Planus, Oral Leukoplakia

    OpenAIRE

    Dilek Bayramgürler; Evren Odyakmaz Demirsoy

    2012-01-01

    Oral lichen planus and leukoplakia, two diseases affecting oral mucosa where diagnosis and treatment is challenging for most dermatologists, are much easily diagnosed than other diseases as white plaques accompany. Besides complaints of the patients they cause, their malignancy potential make treatment and follow up of both diseases more important. Here, current treatment options in oral lichen planus and leukoplakia were reviewed.

  12. Prevalence of oral lichen planus in Iranian children and adolescents: a 12-year retrospective study.

    Science.gov (United States)

    Bakhtiari, S; Taheri, J B; Toossi, P; Azimi, S; Kawosi Nezhad, Sh

    2017-11-14

    To investigate the prevalence of oral lichen planus in patients younger than 18 years, referred to a dermatology centre in Iran during 2002-2014. Lichen planus is a chronic inflammatory, immune-mediated disease that could affect the oral mucosa and is a pre-cancerous condition. The disease usually develops in middle age with female predominance and is rare in children. In this retrospective study, cases with definitive histopathologic diagnosis of lichen planus, over a 12-year period from 2002 to 2014 from a dermatologic hospital archive were evaluated. The prevalence of both cutaneous and oral lichen planus, the male:female ratio and site of involvement were calculated using SPSS version 21. Thirty-six of 564 patients younger than 18 years old diagnosed with lichen planus. Two females (0.4%) had oral lichen planus. One patient had erosive, and one had bullous, oral lichen planus. Oral lichen planus had a very low frequency in Iranian population younger than 18 years old, identifying these patients is recommended for long-term follow-up.

  13. Oral lichen planus and oral lichenoid lesions; a critical appraisal with emphasis on the diagnostic aspects

    NARCIS (Netherlands)

    van der Waal, I.

    2009-01-01

    Oral lichen planus (OLP) has a prevalence of approximately 1%. The etiopathogenesis is poorly understood. The annual malignant transformation is less than 0.5%. There are no effective means to either predict or to prevent such event. Oral lesions may occur that to some extent look like lichen planus

  14. Homocysteine and other cardiovascular risk factors in patients with lichen planus.

    Science.gov (United States)

    Saleh, N; Samir, N; Megahed, H; Farid, E

    2014-11-01

    Chronic inflammation was found to play an important role in the development of cardiovascular risk factors. Homocysteine (Hcy) and fibrinogen have been identified as a major independent risk factor for cardiovascular disease. Lichen planus is assumed to be closely related to dyslipidaemia. Several cytokines involved in lichen planus pathogenesis, could explain its association with dyslipidaemia. Also chronic inflammation with lichen planus has been suggested as a component of the metabolic syndrome. The aim of this study was to detect a panel of cardiovascular risk factors in patients of lichen planus. This study was done on 40 patients of lichen planus and 40 healthy controls. All patients and controls were subjected to clinical examination. Serum levels of homocysteine, fibrinogen and high-sensitive C-reactive protein (hs-CRP) were measured by enzyme-linked immunosorbent assay technique (ELISA). Metabolic syndrome parameters including anthropometric measures, lipid profiles, blood sugar and blood pressure were studied. Patients with lichen planus showed significant association with metabolic syndrome parameters than controls (P lichen planus patients than controls (P lichen planus were found to have higher makers of both metabolic and cardiovascular risk factors in relation to controls most probably due to long standing inflammation. © 2013 European Academy of Dermatology and Venereology.

  15. Successful treatment of hypertrophic lichen planus with betamethasone under occlusion and TCA-peelings.

    Science.gov (United States)

    Theodosiou, Grigorios; Papageorgiou, Marina; Vakirlis, Efstratios; Mandekou-Lefaki, Ioanna

    2016-09-01

    Hypertrophic lichen planus (HLP) is a variant of lichen planus characterized by marked epidermal hyperplasia and severe pruritus. We present a case of a female patient with HLP and concomitant primary biliary cirrhosis, which responded to topical therapy with betamethasone under occlusion and TCA-peelings. © 2016 Wiley Periodicals, Inc.

  16. Lichen planus and Hepatitis C: A case-control study | Elagraa ...

    African Journals Online (AJOL)

    Background The exact cause of LP is not known. However, the association of lichen planus with hepatitis C virus (HCV) infection has been reported in literature. A wide variation in the reported prevalence of HCV infection in patients with lichen planus in different geographical areas was observed. This case – control study ...

  17. Type 2 Diabetes Mellitus in a Patient with Lichen Planus-A Case ...

    African Journals Online (AJOL)

    We present the case of a 42 year-old teacher with generalized lichen planus, in whom a diagnosis of type 2 diabetes mellitus was made at the same time. This case is reported because of the rare association between the two conditions, the challenge of managing lichen planus with steroids in a patient with diabetes ...

  18. Lichen planus and other lichenoid dermatoses: Kids are not just little people.

    Science.gov (United States)

    Payette, Michael J; Weston, Gillian; Humphrey, Stephen; Yu, JiaDe; Holland, Kristen E

    2015-01-01

    Lichenoid dermatoses, a group of inflammatory skin conditions with characteristic clinical and histopathologic findings, range from common to rare. Classic lichen planus typically presents as pruritic, polygonal, violaceous flat-topped papules and plaques; many variants in morphology and location also exist. Other lichenoid dermatoses share similar clinical presentations and histopathologic findings. These include lichenoid drug eruption, lichen planus-like keratosis, lichen striatus, lichen nitidus, and keratosis lichenoides chronica. Epidemiologic characteristics vary among each lichenoid disorder. While classic lichen planus is considered a disease of adults, other lichenoid dermatoses may be more common in younger populations. The literature contains an array of reports on the variations in presentation and successful management of lichen planus and lichenoid dermatoses among diverse populations. Familiarity with the characteristics of each lichenoid dermatosis, rare or common within each patient population, is key to accomplishing timely recognition and effective management. Copyright © 2015 Elsevier Inc. All rights reserved.

  19. Facial follicular cysts: a case of lichen planus follicularis tumidus?

    Science.gov (United States)

    Jiménez-Gallo, David; Albarrán-Planelles, Cristina; Linares-Barrios, Mario; Martínez-Rodríguez, Alberto; Báez-Perea, José María; González-Fernández, Julio Abraham

    2013-09-01

    Lichen planus follicularis tumidus (LPFT) represents an uncommon variety of lichen planus (LP). Clinically, it presents with prominent purplish lesions or white-pigmented yellowish cysts and comedones. Histopathologically, it is similar to lichen planopilaris, and it is additionally characterized by follicles and cysts surrounded by a lichenoid lymphocytic infiltrate. The most common location is the retroauricular region, and it may be associated with other variants of LP. Herein, we describe the case of a 50-year-old woman with a history of lower limb hypertrophic LP who subsequently presented with multiple pink, tumid, pruritic plaques with white-yellow cysts and comedones extensively affecting the bilateral face. Histopathologic examination revealed a lichenoid infiltrate surrounding the follicles and cysts. We diagnosed LPFT and began treatment with topical corticosteroids, antihistamines, systemic corticosteroids and oral acitretin without improvement. Subsequently, the patient had an acceptable response to cyclosporine at doses of 5 mg/kg/day with remission of itching and tumidity but with residual cysts and comedones remaining. To date, the literature contains only 16 cases of LPFT. To our knowledge, this is the most severe case and is the only one with cessation of disease activity in response to cyclosporine. © 2013 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  20. Photodynamic Therapy in Treatment of Oral Lichen Planus

    Science.gov (United States)

    Mostafa, Diana; Tarakji, Bassel

    2015-01-01

    Oral lichen planus (OLP) is a relatively common chronic immunologic mucocutaneous disorder. Although there are many presenting treatments, some of them proved its failure. Recently, the use of photodynamic therapy (PDT) has been expanding due to its numerous advantages, as it is safe, convenient, and non-invasive and has toxic effect towards selective tissues. This article provides comprehensive review on OLP, its etiology, clinical features and recent non-pharmacological treatments. We also describe the topical PDT and its mechanisms. Our purpose was to evaluate the efficacy of PDT in treatment of OLP through collecting the data of the related clinical studies. We searched in PubMed website for the clinical studies that were reported from 2000 to 2014 using specific keywords: “photodynamic therapy” and “treatment of oral lichen planus”. Inclusion criteria were English publications only were concerned. In the selected studies of photodynamic treatment, adult patients (more than 20 years) were conducted and the OLP lesions were clinically and histologically confirmed. Exclusion criteria were classical and pharmacological treatments of OLP were excluded and also the using of PDT on skin lesions of lichen planus. We established five clinical studies in this review where all of them reported improvement and effectiveness of PDT in treatment of OLP lesions. The main outcome of comparing the related clinical studies is that the photodynamic is considered as a safe, effective and promising treatment modality for OLP. PMID:25883701

  1. Frequency of Genital Involvement in Women with Oral Lichen Planus in Southern Iran

    Directory of Open Access Journals (Sweden)

    M. Davarmanesh

    2012-01-01

    Full Text Available Background. Lichen Planus is a chronic mucocutaneous disease of immunological basis and unknown etiology. women with oral lichen planus may have concomitant manifestations in vulvovaginal areas. Objective. To determine the frequency and risk factors of genital involvement in a group of Iranian women affected by oral lichen planus. Methods. Thirty-six women with clinical and histopathological diagnosis of oral lichen planus were evaluated for demographic, historical, and clinical parameters of the oral disease. All the patients were referred for careful vulvovaginal examination, as well as histopathological assessment upon clinical indication. Results. Nineteen patients complained from genital symptoms but the number of women with the final diagnosis of genital lichen planus (=2 was too small to show any correlation with the parameters evaluated. Conclusion. In spite of low genital involvement possibly due to inadequate patient population, lack of follow-up visits, and contribution of genetic or ethnic factors, for conservative patient care, women with the oral lichen planus in particular those having some relevant genital symptoms, should preferably be referred for careful vulvovaginal examination. Multicenter cohort studies on women of different geographical regions or ethnicities who have genital lichen planus alone or in combination with other common sites are encouraged.

  2. Oral lichen planus: An update on pathogenesis and treatment

    Science.gov (United States)

    Lavanya, N; Jayanthi, P; Rao, Umadevi K; Ranganathan, K

    2011-01-01

    Oral lichen planus (OLP) is a chronic inflammatory disease that affects the mucus membrane of the oral cavity. It is a T-cell mediated autoimmune disease in which the cytotoxic CD8+ T cells trigger apoptosis of the basal cells of the oral epithelium. Several antigen-specific and nonspecific inflammatory mechanisms have been put forward to explain the accumulation and homing of CD8+ T cells subepithelially and the subsequent keratinocyte apoptosis. A wide spectrum of treatment modalities is available, from topical corticosteroids to laser ablation of the lesion. In this review, we discuss the various concepts in the pathogenesis and current treatment modalities of OLP. PMID:22529568

  3. Oral lichen planus: a literature review and update.

    Science.gov (United States)

    Alrashdan, Mohammad S; Cirillo, Nicola; McCullough, Michael

    2016-10-01

    Lichen planus (LP) is a common chronic inflammatory condition that can affect skin and mucous membranes, including the oral mucosa. Because of the anatomic, physiologic and functional peculiarities of the oral cavity, the oral variant of LP (OLP) requires specific evaluations in terms of diagnosis and management. In this comprehensive review, we discuss the current developments in the understanding of the etiopathogenesis, clinical-pathologic presentation, and treatment of OLP, and provide follow-up recommendations informed by recent data on the malignant potential of the disease as well as health economics evaluations.

  4. Childhood Oral Lichen Planus: Report of Two Cases

    Directory of Open Access Journals (Sweden)

    Sageena George

    2015-10-01

    Full Text Available Lichen planus (LP is a chronic mucocutaneous disease widely recognized in adults, but uncommon in children. The purpose of this paper is to report two cases of LP in children. The diagnosis was made based on clinical and histopathological findings. The treatment consisted of antifungal and multivitamin therapy. Regression of lesions was observed. The patients are still under follow up.Although LP is uncommon in children, it is necessary to have adequate knowledge about this condition for proper diagnosis and treatment.

  5. Smoking Habits Among Patients Diagnosed with Oral Lichen Planus

    Directory of Open Access Journals (Sweden)

    Gorsky Meir

    2004-06-01

    Full Text Available Abstract Introduction Oral lichen planus (OLP is one of the most common dermatologic diseases that manifests in the oral cavity. The purpose of this study was to evaluate the association between smoking habits and the clinical subtypes of OLP. Methods Oral findings and smoking data from 187 charts of OLP patients from an oral medicine clinic was reviewed and compared to data from 76 matched control patients. Results and Discussion Ninety-three patients were diagnosed with reticular OLP, 55 with atrophic and 39 with erosive forms of the disease. Symptomatic OLP occurred in 63.6% of patients. Fewer cases of reticular OLP were symptomatic than erosive OLP (p

  6. Association of Oral Lichen Planus with Chronic C Hepatitis. Review of the Data in Literature

    Science.gov (United States)

    GHEORGHE, Carmen; MIHAI, Lelia; PARLATESCU, Ioanina; TOVARU, Serban

    2014-01-01

    The relationship between chronic hepatitis C virus infection (HCV) and oral lichen planus (OLP) is a current topic in the field of oral medicine. Many studies of this association have been made over time. The geographic variation of the hepatitis C prevalence proved to be an important factor influencing the statistical results of the studies analyzing the association of the oral plan lichen with the hepatitis C virus. Approaching this issue is not to be neglected. Treatment outcomes in patients with oral lichen planus associated with chronic hepatitis C virus are often unsatisfactory compared to patients suffering from idiopathic oral lichen planus. Also, the evolution of oral lesions is often fluctuating, with repeated periods of relapse according to the degree of liver function decompensation. Background therapy for liver disease itself may influence lichen planus lesions. Thus, during therapy with interferon and ribavirin oral lesions may appear or become acute. PMID:25553136

  7. The Relationship between Anger Expression and Its Indices and Oral Lichen Planus.

    Science.gov (United States)

    Mehdipour, Masoumeh; Taghavi Zenouz, Ali; Farnam, Alireza; Attaran, Rana; Farhang, Sara; Safarnavadeh, Maryam; Gholizadeh, Narges; Azari-Marhabi, Saranaz

    2016-05-01

    Oral lichen planus (OLP) is a common inflammatory disease with unknown etiology. Depression, stress and anxiety are psychological factors that their influence on the expression of lichen planus by affecting the immune system's function has been confirmed. There is a probable relationship between anger and OLP expression. Therefore, the present study aimed to evaluate the association of "anger" and OLP. In this descriptive study 95 subjects were included in 3 groups. A: patients with oral lichen planus, B: positive control, C: negative control. Anger and its indices were assessed by the State-Trait Anger Expression Inventory-2 (STAXI-2) questionnaire, and pain was measured via the Visual Analogue Scale (VAS). The collected data were analyzed statistically using SPSS 18 software. The lichen planus and positive control groups bore higher total anger index (AX index) values compared with the negative control. Comparing anger expression-in (AXI) among the lichen planus and negative control groups revealed higher grades in lichen planus group. Evaluating the pain severity index (VAS) data and anger indices in lichen planus group, Spearman's Rank Correlation Test revealed a significant correlation between TAngR (reactional anger traits) and pain severity. The findings of this study indicated that there was a significant correlation between anger control and suppression of lichen planus development. On the other hand, the patients with more severe pain mostly expressed their anger physically. Based on the findings, we can make the claim that anger suppression and its control-in (gathering tension) may play a role in the development of lichen planus as a known psychosomatic disorders.

  8. Lichen planus following tetanus-diphtheria-acellular pertussis vaccination: A case report and review of the literature.

    Science.gov (United States)

    Rosengard, Heather C; Wheat, Chikoti M; Tilson, Matthew P; Cuda, Jonathan D

    2018-01-01

    Lichen planus is an inflammatory dermatosis with a prevalence of approximately 1%. Recent meta-analyses show that patients with hepatitis C virus have a 2.5- to 4.5-fold increased risk of developing lichen planus. Lichen planus has also followed vaccinations and has specifically been attributed to the hepatitis B vaccine, the influenza vaccine, and the tetanus-diphtheria-acellular pertussis vaccine. We describe a case of lichen planus in a hepatitis C virus-infected African American male occurring in temporal association with the administration of the tetanus-diphtheria-acellular pertussis vaccine. The patient's presentation was clinically consistent with lichen planus and confirmed by biopsy. It is likely that many cases of vaccine-induced lichen planus have gone unpublished or unrecognized. In areas with high prevalence of hepatitis C virus infection, we may expect to see more cases of vaccine-induced lichen planus especially in light of the updated Centers for Disease Control and Prevention tetanus-diphtheria-acellular pertussis vaccination recommendations. This case serves to educate healthcare providers about vaccine-induced lichen planus and, in particular, the need to counsel hepatitis C virus-infected patients about a potential risk of developing lichen planus following vaccination. We also reflect on current theories suggesting the T-cell-mediated pathogenesis of lichen planus and the role that hepatitis C virus and toxoid or protein vaccines may play in initiating the disease.

  9. Lichen planus following tetanus–diphtheria–acellular pertussis vaccination: A case report and review of the literature

    Science.gov (United States)

    Rosengard, Heather C; Wheat, Chikoti M; Tilson, Matthew P; Cuda, Jonathan D

    2018-01-01

    Lichen planus is an inflammatory dermatosis with a prevalence of approximately 1%. Recent meta-analyses show that patients with hepatitis C virus have a 2.5- to 4.5-fold increased risk of developing lichen planus. Lichen planus has also followed vaccinations and has specifically been attributed to the hepatitis B vaccine, the influenza vaccine, and the tetanus–diphtheria–acellular pertussis vaccine. We describe a case of lichen planus in a hepatitis C virus–infected African American male occurring in temporal association with the administration of the tetanus–diphtheria–acellular pertussis vaccine. The patient’s presentation was clinically consistent with lichen planus and confirmed by biopsy. It is likely that many cases of vaccine-induced lichen planus have gone unpublished or unrecognized. In areas with high prevalence of hepatitis C virus infection, we may expect to see more cases of vaccine-induced lichen planus especially in light of the updated Centers for Disease Control and Prevention tetanus–diphtheria–acellular pertussis vaccination recommendations. This case serves to educate healthcare providers about vaccine-induced lichen planus and, in particular, the need to counsel hepatitis C virus–infected patients about a potential risk of developing lichen planus following vaccination. We also reflect on current theories suggesting the T-cell–mediated pathogenesis of lichen planus and the role that hepatitis C virus and toxoid or protein vaccines may play in initiating the disease. PMID:29326823

  10. Psychiatric morbidity in oral lichen planus: A preliminary study

    Directory of Open Access Journals (Sweden)

    Abhishek Ranjan Pati

    2014-01-01

    Full Text Available Objective: To study the clinical types and association of psychological factors in patients with Oral Lichen Planus (OLP. Materials and Methods: An analytical age- and sex-matched study involved 30 patients with oral lichen planus (group 1 and 30 control subjects (group 2. We applied the following psychometric tests to both groups: General Health Questionnaire (GHQ and Hospital Anxiety and Depression Scale (HADS. Results: The patients with OLP were found to exhibit statistically significant higher anxiety, insomnia, and social dysfunction with the tests that were used (GHQ 24 and HADS than the control group (P > 0.05. The study group likewise exhibited greater depression and somatic symptoms. The mean total of the GHQ and HAD scores were found to be higher in the study group than in the controls (P > 0.05. Among the various types of OLP, patients with the erosive type had higher mean scores for anxiety and insomnia, social dysfunction and depression. Conclusion: In most patients psychiatric morbidity was strongly associated with OLP, which could support its role in the etiopathogenesis of the disease. The higher scores of the General Health Questionnaire and Hospital Anxiety and Depression Scale gave an insight into the hypothesis that psychological factors are associated with the causation of OLP.

  11. Líquen plano oral Oral lichen planus

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    Marcello Menta Simonsen Nico

    2011-08-01

    Full Text Available O líquen plano da mucosa oral (LPO é afecção relativamente comum, que pode aparecer isolado ou associado ao líquen plano cutâneo, havendo, no entanto, significantes diferenças clínicoevolutivas: o LPO tende a ser crônico, recidivante e de difícil tratamento, levando a importante morbidade, principalmente em sua forma erosiva. Novas formas clínicas agressivas têm sido salientadas na literatura, como a forma gingivo-vulvar. Este artigo revisa a etiopatogenia, as formas clínicas, a diagnose diferencial e laboratorial, a prognose e o tratamento do LPO, além de mencionar, brevemente, a experiência dos autores com esta enfermidade, vivida no Ambulatório de Estomatologia da Divisão de Dermatologia do Hospital das Clínicas da Faculdade de Medicina da Universidade de São PauloOral lichen planus (OLP is a relatively common mucosal disease that can present isolated or associated with cutaneous lichen planus. Contrarily to its cutaneous counterpart, though, OLP tends to be chronic, relapsing, and difficult to treat. Severe morbidity is related to erosive forms, and more aggressive presentations have been described, such as the "gingivo-vulvar syndrome". This article reviews the current knowledge about the pathogenesis, clinical picture, differential and laboratorial diagnosis, prognosis, and treatment of OLP

  12. Oral lichen planus: A look from diagnosis to treatment.

    Directory of Open Access Journals (Sweden)

    Pablo Córdova

    2014-03-01

    Full Text Available Oral lichen planus (OLP is a chronic mucocutaneous disease of unknown etiology. Its pathogenesis is multifactorial and it may affect the oral mucosa, skin and other mucous membranes. Diagnosis is based on clinic and histopathology; direct immunofluorescence techniques can also be of use. It affects about one to two percent of the population, mainly women between the fifth and sixth decades of life. In the mouth, the most affected area is the buccal mucosa, followed by the gums, tongue and/or palate. Its three most representative clinical forms are reticular, erythematous and erosive; evolution depends on the type it is. Lesion treatment is determined by the clinical form and, since no fully effective treatment has been found yet, it is directed towards controlling the disease. The treatment of choice involves topical or systemic corticosteroids, but other drugs may also be used.The aim of this paper is to gather current and relevant information about oral lichen planus: its pathogenesis, diagnosis, treatment and management.

  13. Serum cytokine profile and clinicopathological findings in oral lichen planus, oral lichenoid lesions and stomatitis

    DEFF Research Database (Denmark)

    Larsen, Kristine Røn; Johansen, Jeanne Duus; Reibel, Jesper

    2017-01-01

    The objective of this study was to examine if clinical and histopathological variables in patients with oral lichen planus (OLP), oral lichenoid lesions (OLL), and generalized stomatitis display different cytokine profiles and if concomitant contact allergy influences this profile. Forty...

  14. Mycophenolate mofetil in erosive genital lichen planus: a case and review of the literature.

    Science.gov (United States)

    Deen, Kristyn; McMeniman, Erin

    2015-03-01

    Erosive genital lichen planus is a disabling, inflammatory mucocutaneous condition that can cause significant patient morbidity and loss of function. Treatment initially involves topical corticosteroids but some patients can have severe treatment-resistant courses requiring systemic immunosuppression. With potentially unfavorable adverse effect profiles and subsequent intolerance of these agents by patients, erosive lichen planus can ultimately be a challenging condition to treat effectively. We present a case of a 66-year-old woman with treatment-resistant erosive genital lichen planus who was successfully managed with mycophenolate mofetil. Although there is only weak evidence for this agent in this condition, its role in dermatology is growing due to its efficacy and advantageous adverse effect profile and should therefore be considered in patients with treatment-resistant erosive genital lichen planus. © 2015 Japanese Dermatological Association.

  15. An Unusual Occurrence of OSMF with Oral Lichen Planus - A Case Report And Review of Literature

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    L Ashok

    2003-01-01

    Full Text Available An unusual case of Oral submucous fibrosis and concomitant occurrence of oral lichen planus in a 18 year old male patient is presented. These conditions are defined and the clinical features on histopathology are discussed.

  16. Early Onset Squamous Cell Carcinoma In A Case Of Lichen Planus

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    Singh Shri Nath

    1998-01-01

    Full Text Available Lichen planus, which is a very common condition, is being presented. However, the uncommon feature in this cases is its early onset and equally early development of squamous cell carcinoma on a lesion on the right thigh.

  17. Oral Lichen Planus in a Pediatric Patient: A Novel Therapeutic Approach.

    Science.gov (United States)

    Sharma, Gaurav; Sardana, Divesh; Vohra, Puneeta; Rehani, Shweta; Nagpal, Archna

    2017-03-01

    Lichen planus is a mucocutaneous disease, predominantly affecting the middle-aged individuals and may be associated with a plethora of signs and symptoms related to the skin, scalp, nails and mucous membranes. The definitive etiology of lichen planus is not yet known and no therapeutic modality has yet been universally accepted. Lichen planus in pediatric patients is a rare phenomenon and its presence in the oral mucosa is even rarer. The aim of this article is to present a rare case of a symptomatic oral lichen planus (OLP) occurring in a 12-year old child that was managed successfully with a novel sequential modality of topical retinoids followed by aloe vera gel application.

  18. Topical tacrolimus in the management of oral lichen planus: literature review

    National Research Council Canada - National Science Library

    Shilpa, P S; Kaul, Rachna; Bhat, Suraksha; Sanjay, C J; Sultana, Nishat

    2014-01-01

    .... The objective of this article is to review the pharmacology of tacrolimus, its usage in oral lichen planus, adverse effects and advantages of tacrolimus over other conventional drugs, thus making...

  19. Evaluation of oxidative stress in oral lichen planus using malonaldehyde: A systematic review

    OpenAIRE

    Mishra, Shovna Shivani; T N Uma Maheswari

    2014-01-01

    Background: Oral lichen planus is a chronic, mucocutaneous, inflammatory disease, with an unknown aetiology. Reactive Oxygen Species and oxidative damage to the tissues might be the cause. Malonaldehyde, a low molecular weight end product of lipid peroxidation reaction is a suitable biomarker of endogenous DNA damage. Aims: To analyse the existing literature on the “evaluation of oxidative stress in oral lichen planus using malonaldehyde as a biomarker”. Methods: Electronic search of sc...

  20. Current Treatment Options in Challenging Oral Diseases: Oral Lichen Planus, Oral Leukoplakia

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    Dilek Bayramgürler

    2012-12-01

    Full Text Available Oral lichen planus and leukoplakia, two diseases affecting oral mucosa where diagnosis and treatment is challenging for most dermatologists, are much easily diagnosed than other diseases as white plaques accompany. Besides complaints of the patients they cause, their malignancy potential make treatment and follow up of both diseases more important. Here, current treatment options in oral lichen planus and leukoplakia were reviewed.

  1. Dermoscopic findings in different clinical variants of lichen planus. Is dermoscopy useful?

    Science.gov (United States)

    Friedman, Paula; Sabban, Emilia Cohen; Marcucci, Carolina; Peralta, Rosario; Cabo, Horacio

    2015-01-01

    Lichen planus (LP) is a papulosquamous dermatosis that involves the skin, scalp, nails and mucous membranes. Although its pathogenesis is still unknown, there is evidence that an imbalance of immunologic cellular reactivity plays an important role. Histopathologic examination reveals characteristic interface dermatitis. Dermoscopy is a non-invasive tool, useful in the assessment of inflammatory dermatoses, such as lichen planus. In this paper we describe the dermoscopic findings of different variants of LP (ungual, cutaneous, planopilaris, pigmentosus). PMID:26693092

  2. Salivary total antioxidant capacity and lipid peroxidation in patients with erosive oral lichen planus.

    Science.gov (United States)

    Shirzad, Atena; Pouramir, Mahdi; Seyedmajidi, Maryam; Jenabian, Niloofar; Bijani, Ali; Motallebnejad, Mina

    2014-01-01

    Background and aims. Oral lichen planus is a common chronic inflammatory disease of the oral mucosa with malignant potential, pathogenesis of which is not still well known. Free radicals and reactive oxygen species can play an important role in the pathogenesis of oral lichen planus. The aim of this study was to investigate salivary oxidative stress and antioxidant systems in patients with oral lichen planus. Materials and methods. In this case-control study, 30 patients with oral lichen planus (case group) and 30 age-and gender-matched healthy subjects (control group), referring to Dental School of Babol University of Medical Sciences, were selected using simple sampling method. Unstimulated saliva of the two groups was collected. Salivary total antioxidant capacity (TAC) and lipid peroxidation products were investigated and compared, using ferric reducing antioxidant power (FRAP) and thiobarbituric acid reactive substance (TBARS) methods, respectively. Data were analyzed using Student' t-test. Results. The mean and standard deviation of salivary TAC in patients with oral lichen planus (297.23 ± 149.72 μM) was significantly lower than that in the controls (791.43 ± 183.95 μM; P & 0.0001), and mean and standard deviation of salivary malondialdehyde (MDA) (0.49 ± 0.30 μM) was remarkably higher in oral lichen planus patients compared to the control group (0.15 ± 0.11 μM) (P & 0.0001). TAC was also reduced in both groups in line with an increase in the level of MDA (P & 0.0001, r = -0.48). Conclusion. The results of this study suggested that an increase in oxidative stress and an imbalance in antioxidant defense system in the saliva of oral lichen planus patients may be involved in the pathogenesis of oral lichen planus.

  3. Salivary Total Antioxidant Capacity and Lipid Peroxidation in Patients with Erosive Oral Lichen Planus

    Directory of Open Access Journals (Sweden)

    Atena Shirzad

    2014-03-01

    Full Text Available Background and aims. Oral lichen planus is a common chronic inflammatory disease of the oral mucosa with malignant potential, pathogenesis of which is not still well known. Free radicals and reactive oxygen species can play an important role in the pathogenesis of oral lichen planus. The aim of this study was to investigate salivary oxidative stress and antioxidant systems in patients with oral lichen planus. Materials and methods. In this case-control study, 30 patients with oral lichen planus (case group and 30 age- and gender-matched healthy subjects (control group, referring to Dental School of Babol University of Medical Sciences, were selected using simple sampling method. Unstimulated saliva of the two groups was collected. Salivary total antioxidant capacity (TAC and lipid peroxidation products were investigated and compared, using ferric reducing antioxidant power (FRAP and thiobarbituric acid reactive substance (TBARS methods, respectively. Data were analyzed using Student’s ttest. Results. The mean and standard deviation of salivary TAC in patients with oral lichen planus (297.23 ± 149.72 μM was significantly lower than that in the controls (791.43±183.95 μM; P < 0.0001, and mean and standard deviation of salivary malondialdehyde (MDA (0.49 ± 0.30 μM was remarkably higher in oral lichen planus patients compared to the control group (0.15 ± 0.11 μM (P < 0.0001. TAC was also reduced in both groups in line with an increase in the level of MDA (P < 0.0001, r = −0.48. Conclusion. The results of this study suggested that an increase in oxidative stress and an imbalance in antioxidant defense system in the saliva of oral lichen planus patients may be involved in the pathogenesis of oral lichen planus.

  4. Expression of cdk4 and p16 in Oral Lichen Planus.

    Science.gov (United States)

    Goel, Sinny; Khurana, Nita; Marwah, Akanksha; Gupta, Sunita

    2015-01-01

    The purpose of this study was to evaluate the expression of cdk4 and p16, the proteins implicated in hyperproliferation and arrest in oral lichen planus and to compare their expression in erosive and non-erosive oral lichen planus and with normal mucosa and oral squamous cell carcinoma. Analysis of cdk4 and p16 expression was done in 43 erosive oral lichen planus (EOLP) and 17 non-erosive oral lichen planus (NOLP) cases, 10 normal mucosa and 10 oral squamous cell carcinoma (OSCC) cases with immunohistochemistry. This study demonstrated a significantly increased expression of cytoplasmic cdk4 (80% cases, cells stained - 19.6%), and cytoplasmic p16 (68.3% cases, cells stained - 16.4%) in oral lichen planus (OLP) compared to normal mucosa. cdk4 was much higher in OSCC in both cytoplasm and nuclei compared to normal mucosa. Also, while comparing OLP with positive control, significant difference was noted for cdk4 and p16, with expression being more in OSCC. While comparing EOLP with NOLP; significant differences were seen for cdk4 cytoplasmic staining only, for number of cases with positive staining as well as number of cells stained. Overexpression of cytoplasmic cdk4 and p16 was registered in oral lichen planus, however considerably lower than in squamous cell carcinoma. Erosive oral lichen planus demonstrated overexpression of cytoplasmic cdk4 and premalignant nature compared to non-erosive lesion. Therefore there is an obvious possibility for cytoplasmic expression of cdk4 and p16 to predict malignant potential of oral lichen planus lesions.

  5. Concurrent presentation of erythrodermic lichen planus and squamous cell carcinoma: Coincidence or malignant transformation?

    Directory of Open Access Journals (Sweden)

    Neema M Ali

    2015-01-01

    Full Text Available Lichen planus is a common papulosquamous disorder affecting about 1-2% of the population, neoplastic transformation of cutaneous lichen planus lesions occurs very rarely. A 40 year old female patient presented with a 1 year history of developing multiple, itchy, pigmented lesions over both lower legs which gradually spread to involve the whole body. A few tense bullae were seen on the extremities. An erythematous fleshy lesion was seen on the upper aspect of the left buttock. Skin biopsy from a plaque on the right forearm showed features suggestive of lichen planus. Skin biopsy of a bullae showed a sub epidermal bulla filled with a mixed inflammatory infiltrate. Direct immunofluorescence revealed no immunoreactants along the basement membrane zone. A diagnosis of erythrodermic lichen planus with bullous lichen planus was made. Biopsy of fleshy lesion of left buttock revealed a moderately differentiated squamous cell carcinoma. Erythrodermic lichen planus with bullous lesions and secondary squamous cell carcinoma; these occurences in a single patient is extremely rare and has not been previously reported to the best of our knowledge.

  6. Concurrent Presentation of Erythrodermic Lichen Planus and Squamous Cell Carcinoma: Coincidence or Malignant Transformation?

    Science.gov (United States)

    Ali, Neema M; Bhat, Ramesh; Rao, Shwetha B

    2015-01-01

    Lichen planus is a common papulosquamous disorder affecting about 1-2% of the population, neoplastic transformation of cutaneous lichen planus lesions occurs very rarely. A 40 year old female patient presented with a 1 year history of developing multiple, itchy, pigmented lesions over both lower legs which gradually spread to involve the whole body. A few tense bullae were seen on the extremities. An erythematous fleshy lesion was seen on the upper aspect of the left buttock. Skin biopsy from a plaque on the right forearm showed features suggestive of lichen planus. Skin biopsy of a bullae showed a sub epidermal bulla filled with a mixed inflammatory infiltrate. Direct immunofluorescence revealed no immunoreactants along the basement membrane zone. A diagnosis of erythrodermic lichen planus with bullous lichen planus was made. Biopsy of fleshy lesion of left buttock revealed a moderately differentiated squamous cell carcinoma. Erythrodermic lichen planus with bullous lesions and secondary squamous cell carcinoma; these occurences in a single patient is extremely rare and has not been previously reported to the best of our knowledge.

  7. Diagnostic profiling of salivary exosomal microRNAs in oral lichen planus patients.

    Science.gov (United States)

    Byun, J-S; Hong, S-H; Choi, J-K; Jung, J-K; Lee, H-J

    2015-11-01

    Oral lichen planus is a chronic inflammatory oral mucosal disease whose exact cause is unclear and which requires efficient diagnostic and therapeutic strategies. Identification of disease-specific biomarkers in saliva is an easy, quick, and non-invasive approach for molecular diagnosis. This study was designed to examine salivary exosomal microRNAs (miRNAs) that could be candidates for diagnosing and elucidating the pathogenesis of oral lichen planus. We compared miRNA profiles of salivary exosomes of patients with oral lichen planus with those of healthy controls. Saliva samples from 16 patients with oral lichen planus and eight healthy controls were divided into two sets and examined using miRNA microarray analysis and TaqMan quantitative PCR. The three miRNAs identified (miR-4484, miR-1246, and miR-1290) were further validated. Of these, miR-4484 was significantly upregulated in the salivary exosomes of patients with oral lichen planus. This study thus identifies a potential miRNA biomarker for oral lichen planus and provides insight into the functions of miRNAs in the pathogenesis of oral inflammatory diseases. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  8. Hepatitis C virus infections in oral lichen planus: a systematic review and meta-analysis.

    Science.gov (United States)

    Alaizari, N A; Al-Maweri, S A; Al-Shamiri, H M; Tarakji, B; Shugaa-Addin, B

    2016-09-01

    A role for hepatitis C virus in oral lichen planus has been postulated. This systematic review and meta-analysis of the existing epidemiological studies was conducted to determine if there is a correlation between oral lichen planus and hepatitis C virus infection. We examined the association between hepatitis C virus and oral lichen planus by conducting a systematic review and meta-analysis of case-control studies that examined the prevalence of anti-HCV antibodies in the serum of cases and controls. We searched PubMed, Embase and The Cochrane Library databases from 2005 to January 2015. Associations were measured using random-effect odds ratios (ORs) combined with 95% confidence intervals. Nineteen eligible studies, encompassing 1807 cases of OLP and 2519 controls, were retrieved and included in this review. The summary estimate OR for all studies was 6.07 (95% CI: 2.73-13.48), showing a statistically significant difference in the proportion of HCV seropositivity among oral lichen planus patients, compared with controls and substantial heterogeneity between studies (I(2) = 65%) as a result of a variety of geographical distributions. The association of hepatitis C virus infection with oral lichen planus emphasizes the importance of hepatitis C virus screening in oral lichen planus patients. © 2015 Australian Dental Association.

  9. The development of proliferative verrucous leukoplakia in oral lichen planus. A preliminary study

    Science.gov (United States)

    Llorente-Pendás, Santiago; González-Garcia, Manuel; García-Martín, José-Manuel

    2016-01-01

    Background Was to describe 14 cases of a proliferative verrucous leukoplakia as a clinical evolution of oral lichen planus. Material and Methods The clinical and histopathological characteristics of 14 cases of OLP that progress towards a plaque-like and verrucous form were indicated, with monitoring over a period of six to 24.3 years. Results The female/male ratio was 11/3, (78.6 and 21.4%). The mean age when the first biopsy was undertaken was 56.4 years old. None of the patients smoked during the study. As bilateral reticular was clinically diagnostic criterion, the second most frequent clinical form was the plaque form (n=10; 71.4%), followed by the atrophic (n=6; 42.8%), and erosive forms (n=4; 28.5%). Clinically it spread towards attached gingival mucosa and the hard palate. In the histopathologic study, there were a predominance of hyperkeratosis and verrucous epithelial hyperplasia. Three of the cases progressed to a squamous cell carcinoma, and one patient developed two verrucous carcinoma. Conclusions Further research is needed to demonstrate if proliferative multifocal oral lichen planus and proliferative multifocal oral leukoplakia are the same disorder but have different behaviour of malignancy for reasons of origin. Key words:Oral lichen planus, proliferative verrucous oral leukoplakia, malignant oral lichen planus, multifocal verrucous oral lichen planus, proliferative verrucous oral lichen planus. PMID:27031060

  10. Comparative analysis of cell proliferation ratio in plaque and erosive oral lichen planus: An immunohistochemical study.

    Science.gov (United States)

    Redder, C Pramod; Pandit, Siddharth; Desai, Dinkar; Kandagal, V Suresh; Ingaleshwar, Pramod S; Shetty, Sharan J; Vibhute, Nupura

    2014-05-01

    Proliferating cell nuclear antigen (PCNA) is a nuclear protein synthesized in the late G1 and S-phase of the cell cycle. Detection of this protein represents a useful marker of the proliferation status of lesions. This study has been carried out to evaluate the cell proliferation rate in oral lichen planus (OLP) and comparison between plaque and erosive lichen planus, which indicates the potential for malignant transformation. This study was comprised of 64 cases of histologically proven lichen planus, out of which 32 cases of plaque and erosive each was taken. Two sections were taken from each, one for H and E staining to verify histological diagnosis according to Eisenberg criteria, other sections were stained according to super sensitive polymer horse radish peroxidise method for identifying immunohistochemical expression of PCNA. Data were statistically analyzed by Tukey high-range statistical domain test. Statistically significant P value was considered lichen planus, erosive type (66.86%) showed higher expression of PCNA followed by plaque (17.07%). Overall, P value was lichen planus followed by plaque type, which ultimately results in increased rate of malignant transformation. PCNA is a good nuclear protein marker to evaluate the proliferation status of OLP. Out of the two types of lichen planus, erosive type possesses more proliferative ratio and chances of malignant change is more in this type. It emphasizes the importance of long-term follow-up with erosive type when compared with plaque type.

  11. Sleep disturbances, anxiety and depression in patients with oral lichen planus: a case-control study.

    Science.gov (United States)

    Adamo, D; Ruoppo, E; Leuci, S; Aria, M; Amato, M; Mignogna, M D

    2015-02-01

    The psychological factors and their association with chronic inflammatory disease, aren't well recognized, yet their importance in oral lichen planus is still debated. The aim of this study was to investigate the prevalence of sleep disturbances, anxiety, depression and their association in patient with oral lichen planus. 50 patients with oral lichen planus vs. equal number of age and sex-matched healthy controls were enrolled. Questionnaires examining insomnia symptoms, excessive daytime sleepiness (Pittsburgh sleep quality index and Epworth aleepiness scale) depression and anxiety (The Hamilton rating scale for Depression and Anxiety) were used. The patients with oral lichen planus had statistically higher scores in all items of the Pittsburgh sleep quality index, the Hamilton rating scale for depression and anxiety and Epworth sleepiness scale than the healthy controls. The median and inter-quartile range of the Pittsburgh sleep quality index was 5-2 and for the oral lichen planus patients and 4-2 for the healthy controls (P depressed mood and anxiety correlated positively with sleep disturbances. The Pearson correlations were 0.76 for Pittsburgh sleep quality Index vs. Hamilton rating scale for depression (P sleep quality Index vs. Hamilton rating scale for anxiety (P sleep problems, depressed mood and anxiety as compared with controls. We suggest to screen sleep disturbances in patients with oral lichen planus because they could be considered a prodromal symptoms of mood disorders. © 2014 European Academy of Dermatology and Venereology.

  12. [Oral lichen planus and chronic hepatopathy. Clinico-statistical study].

    Science.gov (United States)

    Matarasso, S; Dante, G; Fusco, A; Martuscelli, R

    1989-07-01

    Recent researches on the aetiopathogenesis of lichen planus have revealed a significant physiopathological and clinical association of this disease with the chronic hepatopathies. A clinico-statistical investigation has been carried out for the purpose of ascertaining the real importance of oral LP in the economy of this association. The results substantially demonstrated that oral LP, particularly the erosive variety, rather than cutaneous or cutaneous-mucosa clinical forms, occupies a central role in relation to association with the chronic hepatopathies (an important factor for diagnosis and predictive purposes). It has also been found that the erosive variety presents a significantly higher frequency in forms of LP with an exclusively oral involvement. Hence the need to propose an interdisciplinary type clinico-diagnostic approach to LP patients, particularly those with erosive type oral LP.

  13. Oral Lichen Planus as a Preneoplastic Inflammatory Model

    Science.gov (United States)

    Georgakopoulou, Eleni A.; Achtari, Marina D.; Achtaris, Michael; Foukas, Periklis G.; Kotsinas, Athanassios

    2012-01-01

    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. PMID:22675259

  14. Oral lichen planus to oral lichenoid lesions: Evolution or revolution

    Science.gov (United States)

    Dudhia, Bhavin B; Dudhia, Sonal B; Patel, Purv S; Jani, Yesha V

    2015-01-01

    The diagnosis between different diseases may be impaired by clinical and histopathologic similarities, as observed in the oral lichen planus (OLP) and oral lichenoid lesion (OLL). Inspite of similar clinicopathological features; etiology, diagnosis and prognosis differ which mandates separation of OLL from OLP. Hence, it is essential for the oral physician and oral pathologist to be familiarized with the individual variations among clinicopathological features of OLP and OLL as well as to obtain a thorough history and perform a complete mucocutaneous examination in addition to specific diagnostic testing. The difficulties faced to establish the diagnosis between these two pathologies are widely investigated in the literature with a lack of definite conclusion. This review is an attempt to throw some light on these clinicopathologic entities with the aim to resolve the diagnostic dilemma. PMID:26980966

  15. Clinico-pathological study to evaluate oral lichen planus for the establishment of clinical and histopathological diagnostic criteria.

    Science.gov (United States)

    Hiremath, Santhosh; Kale, Alka D; Hallikerimath, Seema

    2015-01-01

    Lichen planus and lichenoid lesions affecting the oral cavity show similar clinico-pathological features creating a diagnostic dilemma. Hence, the aim of the present study was to establish a clinical and histopathological correlation in the diagnosis of oral lichen planus, based on the modified WHO diagnostic criteria of oral lichen planus and oral lichenoid lesions proposed by Van der Meij and Van der Waal in 2003. In the present study, 100 cases of oral lichen planus were clinically and histopathologically analyzed. Out of the 100 cases, 50 were prospective and 50 were retrospective cases. Prospective cases were collected based on the clinical diagnosis of oral lichen planus and oral lichenoid lesion. Retrospective cases were collected based on the histopathological diagnosis of oral lichen planus. Both the clinical and histopathological analyses were performed based on a proposal for a set of modified diagnostic criteria of oral lichen planus and oral lichenoid lesion. A final diagnosis of oral lichen planus was made only after the correlation of the clinical diagnosis with the histopathological diagnosis. The interobserver agreement among three observers for both prospective and retrospective cases in the final diagnosis of oral lichen planus was found to be "good" to "very good" indicating high reproducibility. However, the final diagnoses of true oral lichen planus after clinico-pathological correlation in prospective and retrospective study groups appeared to be 38.0% and 54.0% respectively. The results of the present study revealed mild to moderate clinico-pathological correlation in the final diagnosis of oral lichen planus for the prospective and retrospective study groups respectively.

  16. Extra genital lichen sclerosus et atrophicus with cutaneous distribution and morphology simulating lichen planus

    Directory of Open Access Journals (Sweden)

    Bhumi Patel

    2015-01-01

    Full Text Available Lichen sclerosus et atrophicus (LSA also known as Csillag′s disease, characterized by small, porcelain white, sclerotic areas occur at any site on the skin including mucosa. There is strong association of autoimmune disorders with LSA. Lichen planus (LP is an inflammatory, papulosquamous disorder characterized by erythematous to violaceous, flat topped, polygonal, pruritic papules distributed mainly on flexural aspects like wrist, around ankles, lumbar region, trunk and neck and also involves mucous membranes, hair, and nail. LP and LSA share similar clinical and pathological features. There have been a few reported cases in the literature of the coexistence of LP and LSA. We reported a case of 39-years-old female having LSA with cutaneous distribution and morphologically simulating LP.

  17. Evaluation of the serum zinc level in erosive and non-erosive oral lichen planus.

    Science.gov (United States)

    Gholizadeh, N; Mehdipour, M; Najafi, Sh; Bahramian, A; Garjani, Sh; Khoeini Poorfar, H

    2014-06-01

    Lichen planus is a chronic inflammatory immunologic-based disease involving skin and mucosa. This disease is generally divided into two categories: erosive and non-erosive. Many etiologic factors are deliberated regarding the disease; however, the disorders of immune system and the role of cytotoxic T-lymphocytes and monocytes are more highlighted. Zinc is an imperative element for the growth of epithelium and its deficiency induces the cytotoxic activity of T-helper2 cells, which seems to be associated with lichen planus. This study was aimed to evaluate the levels of serum zinc in erosive and non-erosive oral lichen planus (OLP) and to compare it with the healthy control group to find out any feasible inference. A total of 22 patients with erosive oral lichen planus, 22 patients with non erosive OLP and 44 healthy individuals as the control group were recruited in this descriptive-comparative study. All the participants were selected from the referees to the department of oral medicine, school of dentistry, Tabriz University of Medical Sciences. Serum zinc level was examined for all the individuals with liquid-stat kit (Beckman Instruments Inc.; Carlsbad, CA). Data were analyzed by adopting the ANOVA and Tukey tests, using SPSS 16 statistical software. The mean age of patients with erosive and non-erosive LP was 41.7 and 41.3 years, respectively. The mean age of the healthy control group was 34.4 years .The mean serum zinc levels in the erosive and non erosive lichen planus groups and control groups were 8.3 (1.15), 11.15 (0.92) and 15.74 (1.75) μg/dl respectively. The difference was statistically significant (plichen planus. This finding may probably indicate the promising role of zinc in development of oral lichen planus.

  18. [Oral squamous cell carcinoma and lichen planus vs. lichenoid lesions. Case report].

    Science.gov (United States)

    Esquivel-Pedraza, Lilly; Fernández-Cuevas, Laura; Ruelas-Villavicencio, Ana Lilia; Guerrero-Ramos, Brenda; Hernández-Salazar, Amparo; Milke-García, María Pilar; Méndez-Flores, Silvia

    2016-01-01

    The development of squamous cell carcinoma from oral lichen planus is controversial. We report a case of intraoral squamous cell carcinoma, which presents together with lesions of oral lichen planus. The aim of this report was to analyze the problem to distinguish between the incipient changes of squamous cell carcinoma from the features described in oral lichen planus, in order to establish an accurate diagnosis of both entities. A 57-year old man with a history of smoking and chronic alcohol intake, who had an ulcerated tumor mass located in the tongue, and bilateral white reticular patches on buccal mucosa and borders of the tongue. The histopathological report was moderately differentiated invasive squamous cell carcinoma and lichen planus respectively. The premalignant nature of OLP is still indeterminate and controversial, this is primarily due to inconsistency in the clinical and histological diagnostic criteria used to differentiate cases of oral lichen planus from lichenoid reactions or other lesions causing intraepithelial dysplasia with high potentially malignant transformation. Oral lichenoid reactions are possibly most likely to develop malignant transformation as compared to the classic OLP lesions.

  19. Reduced immune responses to purified protein derivative and Candida albicans in oral lichen planus.

    Science.gov (United States)

    Simark-Mattsson, Charlotte; Eklund, Christina

    2013-10-01

    Impairment of cellular immunity is reported in lichen planus, an autoimmune disease affecting mucosae and skin. Our aim was to investigate immune responses directed against a set of microbial antigens in patients with oral lichen planus and in matched controls. Venous blood was obtained, and the mononuclear cells were enriched by density gradient centrifugation. The proliferation of peripheral blood mononuclear cells was assessed, following stimulation with purified protein derivative (PPD), Candida albicans, phytohemagglutinin or when cells were left unstimulated, after three or six days of cell culture. The production of interleukin-1ß (IL-1ß), IL-2, IL-4, IL-5, IL-6, IL-10, IL-12, IL-13, IL-17, interferon-γ (IFN-γ), tumour necrosis factor-α (TNF-α), G-CSF, GM-CSF, MCP-1, MIP-ß was assessed in supernatants using the Bio-plex(®) assay and was complemented with ELISA for selected cytokines. Patients with oral lichen planus demonstrated reduced proliferative responses against PPD (P lichen planus. Collectively, the findings suggested that memory lymphocytes from patients with oral lichen planus (OLP) may have an impaired functional ability to react against certain recall antigens, as part of a generalized response, which may reflect immune regulatory processes. Further studies are needed to clarify the mechanisms of down-regulation in OLP pathogenesis and progression. © 2013 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  20. A 10-year review of otic lichen planus: the Mayo Clinic experience.

    Science.gov (United States)

    Sartori-Valinotti, Julio C; Bruce, Alison J; Krotova Khan, Yulia; Beatty, Charles W

    2013-09-01

    Lichen planus is an autoimmune inflammatory dermatosis that typically affects the skin but can also involve the stratified squamous epithelium of the external auditory canals and tympanic membranes. Here we report our experience with the clinical presentation, diagnosis, and management of otic lichen planus. We retrospectively reviewed medical records from January 1, 2001, through May 31, 2011, of patients with a diagnosis of otic lichen planus. Nineteen cases were identified (mean age at diagnosis, 57 years; 15 women). The most common concerns were persistent otorrhea and hearing loss. Other symptoms included plugging, pruritus, tinnitus, pain, and bleeding. The mean symptom duration was 4.0 years (n = 13). Most patients responded well to topical tacrolimus within several months. One patient had a dramatic positive response to rituximab. Otic lichen planus can lead to persistent hearing loss and should be considered in the differential diagnosis of relentless otorrhea and external auditory canal stenosis. In our experience, topical tacrolimus is the best primary treatment, but alternative therapies could be instituted in severe cases. Early recognition of the nonspecific symptoms of otic lichen planus may lead to prompt treatment and avoidance of irreparable late sequelae.

  1. Oesophageal lichen planus: the efficacy of topical steroid-based therapies.

    Science.gov (United States)

    Podboy, A; Sunjaya, D; Smyrk, T C; Murray, J A; Binder, M; Katzka, D A; Alexander, J A; Halland, M

    2017-01-01

    Oesophageal lichen planus is an idiopathic inflammatory disorder characterized by significant oesophageal stricturing. Oesophageal lichen planus is a rare, difficult to diagnose, and likely an under recognized disease. As a result, there is no standardized approach to therapy and treatment strategies vary. To examine the utility of topical steroid therapy (fluticasone or budesonide) in the management of oesophageal lichen planus. A retrospective chart review was conducted of patients diagnosed with oesophageal lichen planus who underwent baseline and follow up endoscopy pre and post topical steroid therapy between 1995 and 2016 at Mayo Clinic, Rochester MN. Average time between upper GI endoscopy was 3.2 months (0.7-11.7). Swallowed steroid preparations included fluticasone 880 μg twice daily or budesonide 3 mg twice daily. Patients were reviewed for symptomatic response to therapy using the Dakkak-Bennett dysphagia score (0-4, no dysphagia to total aphagia). Pre- and post-endoscopic findings were assessed. Additional baseline demographic, endoscopic, and histologic data were also obtained. We identified 40 patients who met the inclusion criteria. A significant reduction in median dysphagia score from 1 (0-4) to 0 (0-3) after steroid therapy (P lichen planus. © 2016 John Wiley & Sons Ltd.

  2. A clitoral verrucous carcinoma in an area of lichen planus has aggressive features.

    Science.gov (United States)

    Tjalma, Wiebren A A; Siozopoulou, Vasiliki; Huizing, Manon T

    2017-01-06

    Verrucous carcinoma of the vulva is extremely rare. It is a slow growing, low malignant variant of a squamous cell carcinoma with a cauliflower appearance. Women with lichen planus have an increased risk of developing vulval cancer. A 79-year-old woman consulted for vulval itching. On clinical examination, a 3-cm large verrucous clitoral cancer in an area of lichen planus was seen. Based on her last clinical examination, the growth was estimated to be 1 cm2 per month with an invasion depth after 6 months of 5 mm. A tumor developing in an area of lichen planus appears to have more aggressive features. This is the first time that the growth of a verrucous carcinoma has been documented in an area of lichen planus. Clinicians and patients should be aware of the aggressive behavior of cancers developing in areas of lichen planus and adjust their surgical management together with the follow-up strategy.

  3. Role of depression, anxiety and stress in patients with oral lichen planus: A pilot study

    Directory of Open Access Journals (Sweden)

    Chaithra Kalkur

    2015-01-01

    Full Text Available Context: Lichen planus is a psychosomatic disease. Higher frequency of psychiatric symptoms, poor quality of life, higher level of anxiety and neuroendocrine and immune dysregulations, all these factors, will enhance the exacerbation of the disease. Aims: The present study was to assess depression, anxiety and stress levels in patients with oral lichen planus. Methods: The psychometric evaluation using the Depression Anxiety Stress Scale (DASS-42 questionnaire was carried out, by the same investigator on all members of group 1 (Oral Lichen Planus and group 2 (Control. DASS-42 questionnaire consists of 42 symptoms divided into three subscales of 14 items: Depression scale, anxiety scale, and stress scale. Statistical Analysis Used: The Student t test was used to determine statistical difference for both the groups and to evaluate for significant relationships among variables. Results: Psychological assessment using DASS-42 reveals lichen planus patients showed higher frequency of psychiatric co morbidities like depression, anxiety and stress compared to control group. Conclusions: This study has provided evidence that the DASS-42 questionnaire is internally consistent and valid measures of depression, anxiety, and stress. Psychiatric evaluation can be considered for patients with oral lichen planus with routine treatment protocols are recommended. DASS-42 Questionnaire can also be used to determine the level of anxiety, stress and depression in diseases of the oral mucosa like recurrent apthous stomatitis, burning mouth syndrome and TMD disorders.

  4. Alterations in Factors Involved in Differentiation and Barrier Function in the Epithelium in Oral and Genital Lichen Planus.

    Science.gov (United States)

    Danielsson, Karin; Ebrahimi, Majid; Nylander, Elisabet; Wahlin, Ylva Britt; Nylander, Karin

    2017-02-08

    Lichen planus is a chronic recurrent inflammatory disease affecting both skin and mucosa, mainly in oral and/or genital regions. Keratinocytes go through a well-regulated process of proliferation and differentiation, alterations in which may result in defects in the protective epithelial barrier. Long-term barrier impairment might lead to chronic inflammation. In order to broaden our understanding of the differentiation process in mucosal lichen planus, we mapped the expression of 4 factors known to be involved in differentiation. Biopsies were collected from oral and genital lichen planus lesions and normal controls. Altered expression of all 4 factors in epithelium from lichen planus lesions was found, clearly indicating disturbed epithelial differentiation in lichen planus lesions.

  5. Oral symptoms and salivary findings in oral lichen planus, oral lichenoid lesions and stomatitis

    DEFF Research Database (Denmark)

    Larsen, Kristine Roen; Johansen, Jeanne Duus; Reibel, Jesper

    2017-01-01

    BACKGROUND: To examine if patients with oral lichen planus, oral lichenoid lesions and generalised stomatitis and concomitant contact allergy have more frequent and severe xerostomia, lower unstimulated and chewing-stimulated saliva and citric-acid-stimulated parotid saliva flow rates, and higher...... of xerostomia, clinical examination, sialometry, mucosal biopsy and contact allergy testing. RESULTS: Nineteen patients had oral lichen planus, 19 patients had oral lichenoid lesions and 11 patients had generalised stomatitis. 38.8% had contact allergy. Xerostomia was significantly more common and severe...... in the chewing stimulated saliva samples from patients when compared to healthy controls. The differences were not significant and they were irrespective of the presence of contact allergy. CONCLUSION: Xerostomia is prevalent in patients with oral lichen planus, lichenoid lesions and generalised stomatitis...

  6. Oral symptoms and salivary findings in oral lichen planus, oral lichenoid lesions and stomatitis

    DEFF Research Database (Denmark)

    Larsen, Kristine Røn; Johansen, Jeanne Duus; Reibel, Jesper

    2017-01-01

    Background: To examine if patients with oral lichen planus, oral lichenoid lesions and generalised stomatitis and concomitant contact allergy have more frequent and severe xerostomia, lower unstimulated and chewing-stimulated saliva and citric-acid-stimulated parotid saliva flow rates, and higher......, clinical examination, sialometry, mucosal biopsy and contact allergy testing. Results: 19 patients had oral lichen planus, 19 patients had oral lichenoid lesions and 11 patients had generalised stomatitis. 38.8% had contact allergy. Xerostomia was significantly more common and severe in patients (46...... in the chewing stimulated saliva samples from patients when compared to healthy controls. The differences were not significant and they were irrespective of the presence of contact allergy. Conclusion: Xerostomia is prevalent in patients with oral lichen planus, lichenoid lesions and generalised stomatitis...

  7. Lupus erythematosus/lichen planus overlap syndrome: successful treatment with acitretin.

    Science.gov (United States)

    Lospinoso, D J; Fernelius, C; Edhegard, K D; Finger, D R; Arora, N S

    2013-07-01

    Lupus erythematosus/lichen planus overlap syndrome is a rare disorder combining the clinical, histological and immunopathological features of both lupus erythematosus (LE) and lichen planus (LP). Cutaneous lesions mostly affect the distal arms, legs, face and trunk. Palmoplantar involvement is felt to be characteristic of this condition. Plaques are often painful, centrally atrophic, bluish-red to hypopigmented in color, large, and scaly. On biopsy of clinically ambiguous lesions, histopathological features of one or both processes can be found, obscuring the diagnosis and complicating prognosis and treatment. Thus, direct immunofluorescence has become an essential tool in helping to diagnose this condition. In this report we describe the unique clinical and immunohistopathological manifestations of lupus erythematosus/lichen planus overlap syndrome along with a successful response to treatment with acitretin.

  8. Cyclosporine in the Management of Esophageal Lichen Planus

    Directory of Open Access Journals (Sweden)

    M Chaklader

    2009-01-01

    Full Text Available Lichen planus (LP is an uncommon disorder of unknown etiology, mostly affecting patients in their fifth and sixth decade of life. It is believed to be an autoimmune process involving T cells directed against basal keratinocytes. It affects the skin, nails, oral pharynx and genitals. Esophageal involvement is quite rare and can cause strictures, ulcerations and squamous cell cancer. The present article describes the case of a 54-year-old woman who was referred for assessment of dysphagia that initially occurred with solids, which then progressed to soft foods but spared liquids. The patient reported a weight loss of 9.1 kg. An esophagogastroduodenoscopy was performed and she was subsequently diagnosed with pill esophagitis. At the same time, she was also diagnosed with oral LP, with no involvement of the esophagus. She was treated with a proton pump inhibitor that resolved her gastrointestinal symptoms. The symptoms returned one year later and a repeat esophagogastroduodenoscopy revealed white plaques due to LP. She was treated with intermittent glucocorticoids. Diagnosis of esophageal LP is crucial for the proper treatment. Some patients may require systemic immunosuppression and mechanical dilation to prevent weight loss. Surveillance endoscopies should be performed to monitor for squamous cell cancer. Cyclosporine has been used for genital and oral LP, but the present case is the first in which it has been used successfully to treat esophageal LP.

  9. Cytomorphometric analysis of exfoliated cells in oral lichen planus.

    Science.gov (United States)

    Teja, Chitturi Suryaprakash Ravi; Devy, A Santha; Nirmal, R Madhavan; Sunil, P M; Deepasree, M

    2014-01-01

    Tumors are distinguished from normal tissues partly by their pronounced variability of cellular and nuclear dimensions. Therefore, such factors may be an indicator to assess whether the cells are malignant or not. Exfoliative cytology is a reliable tool in assessing such changes in the uterine cervix and has been used in the oral cavity also with success. The aims and objectives of the following study were to evaluate the malignant changes by assessing the quantitative parameters such as cytoplasmic diameter, cytoplasmic perimeter and cytoplasmic area (CD, CP, CA) and nuclear diameter, nuclear perimeter and nuclear area (ND, NP, NA) and cytoplasmic to nuclear ratio in the exfoliated cells of various subtypes of oral lichen planus (OLP) using cytomorphometry. Oral exfoliated cells from nineteen cases of histologically proven OLP (1 atrophic, 13 reticular, 4 erosive and 1 plaque) and ten controls with healthy mucosa were taken and stained by Feulgen-Rossenback reaction and cytomorphometric analysis was performed using an image analysis software. The parameters taken into account were CD, CP, CA and ND, NP, NA. Furthermore CA/NA was calculated. The parameters were statistically analyzed using the t-test. Cytomorphometric analysis of all the parameters showed no significant difference between the control group and the reticular/plaque subtypes, whereas statistically significant (P exfoliative cytology and cytomorphometry can be used as a tool to assess the malignant changes.

  10. Ascorbic acid deficiency in patients with lichen planus.

    Science.gov (United States)

    Nicolae, Ilinca; Mitran, Cristina Iulia; Mitran, Madalina Irina; Ene, Corina Daniela; Tampa, Mircea; Georgescu, Simona Roxana

    2017-01-01

    Recent studies have highlighted the role of oxidative stress in the pathogenesis of lichen planus (LP). In the present study, the interest of the authors is focused on the investigation of ascorbic acid status in patients with LP and identification of parameters that might influence the level of this vitamin. We analyzed the level of urinary ascorbic acid (reflectometric method) in 77 patients with LP (cutaneous LP (CLP)-49 cases; oral LP (OLP)-28 cases) and 50 control subjects. The evaluation of all participants included clinical examination and laboratory and imaging tests. Compared to the control group (19.82 mg/dl) the level of ascorbic acid was significantly lower both in patients with CLP (8.47 mg/dl, p = 0.001) and in those with OLP (8.04 mg/dl, p = 0.001). In patients with LP it was found that the deficiency of ascorbic acid increases with age (r = -0.318, p = 0.032). The urinary concentrations of ascorbic acid were significantly lower in patients with LP associated with infections compared to patients with LP without infections. The urinary ascorbic acid level may be a useful parameter in identifying patients with LP who are at risk of developing viral or bacterial infections.

  11. Oral candidiasis following steroid therapy for oral lichen planus.

    Science.gov (United States)

    Marable, D R; Bowers, L M; Stout, T L; Stewart, C M; Berg, K M; Sankar, V; DeRossi, S S; Thoppay, J R; Brennan, M T

    2016-03-01

    The purpose of this multicentre study was to determine the incidence of oral candidiasis in patients treated with topical steroids for oral lichen planus (OLP) and to determine whether the application of a concurrent antifungal therapy prevented the development of an oral candidiasis in these patients. Records of 315 patients with OLP seen at four Oral Medicine practices treated for at least 2 weeks with steroids with and without the use of an antifungal regimen were retrospectively reviewed. The overall incidence of oral fungal infection in those treated with steroid therapy for OLP was 13.6%. There was no statistically significant difference in the rate of oral candidiasis development in those treated with an antifungal regimen vs those not treated prophylactically (14.3% vs 12.6%) (P = 0.68). Despite the use of various regimens, none of the preventive antifungal strategies used in this study resulted in a significant difference in the rate of development of an oral candidiasis in patients with OLP treated with steroids. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  12. Comparative analysis of cell proliferation ratio in plaque and erosive oral lichen planus: An immunohistochemical study

    Directory of Open Access Journals (Sweden)

    C Pramod Redder

    2014-01-01

    Full Text Available Background: Proliferating cell nuclear antigen (PCNA is a nuclear protein synthesized in the late G1 and S-phase of the cell cycle. Detection of this protein represents a useful marker of the proliferation status of lesions. This study has been carried out to evaluate the cell proliferation rate in oral lichen planus (OLP and comparison between plaque and erosive lichen planus, which indicates the potential for malignant transformation. Materials and Methods: This study was comprised of 64 cases of histologically proven lichen planus, out of which 32 cases of plaque and erosive each was taken. Two sections were taken from each, one for H and E staining to verify histological diagnosis according to Eisenberg criteria, other sections were stained according to super sensitive polymer horse radish peroxidise method for identifying immunohistochemical expression of PCNA. Data were statistically analyzed by Tukey high-range statistical domain test. Statistically significant P value was considered <0.05. Results: In two types of lichen planus, erosive type (66.86% showed higher expression of PCNA followed by plaque (17.07%. Overall, P value was <0.001, which was statistically significant. It indicates that proliferation activity is more in erosive lichen planus followed by plaque type, which ultimately results in increased rate of malignant transformation. Conclusion: PCNA is a good nuclear protein marker to evaluate the proliferation status of OLP. Out of the two types of lichen planus, erosive type possesses more proliferative ratio and chances of malignant change is more in this type. It emphasizes the importance of long-term follow-up with erosive type when compared with plaque type.

  13. Oral lichen planus and oral lichenoid lesions; a critical appraisal with emphasis on the diagnostic aspects.

    Science.gov (United States)

    van der Waal, Isaac

    2009-07-01

    Oral lichen planus (OLP) has a prevalence of approximately 1%. The etiopathogenesis is poorly understood. The annual malignant transformation is less than 0.5%. There are no effective means to either predict or to prevent such event. Oral lesions may occur that to some extent look like lichen planus but lacking the characteristic features of OLP, or that are indistinguishable from OLP clinically but having a distinct cause, e.g. amalgam restoration associated. Such lesions are referred to as oral lichenoid lesions (OLLs). The management of OLP and the various OLLs may be different. Therefore, accurate diagnosis should be aimed at.

  14. Oral leukoplakia development in patients with pre-existing oral lichen planus.

    Science.gov (United States)

    Chainani-Wu, Nita; Purnell, Daniel M; Silverman, Sol

    2015-01-01

    Oral leukoplakia and oral lichen planus are conditions that have the potential to transform into squamous cell carcinoma. This article describes a series of nine patients with an initial clinical-microscopic diagnosis of lichen planus. During close follow-up, these patients developed localized areas of leukoplakia at intervals ranging from one and a half to six and a half years. While both conditions may present with white and red oral mucosal changes, their management differs with leukoplakia requiring surgical intervention, therefore accurate diagnosis is imperative.

  15. Lichen planus pigmentosus-inversus: report of three Chinese cases and review of the published work.

    Science.gov (United States)

    Chen, Shumin; Sun, Wenqi; Zhou, Guizhi; Chen, Shengli; Lu, Xuanmei

    2015-01-01

    Lichen planus pigmentosus-inversus is a rare variant of lichen planus. So far, only 24 cases from 12 reports have been documented in the published work. The prominent characteristics of the disease are dark-brown macules and patches confined to the non-sun exposed, flexural areas and skin folds with lichenoid pathological changes and prominent melanin incontinence. We report three female Chinese patients with typical clinical and pathological manifestations and a miniature review of the published work. © 2014 Japanese Dermatological Association.

  16. Image cytometric evaluation of nuclear texture features and DNA content of the reticular form of oral lichen planus.

    Science.gov (United States)

    Rode, Matjaz; Flezar, Margareta Strojan; Kogoj-Rode, Mirela; Us-Krasovec, Marija

    2006-10-01

    To analyze image cytometric chromatin changes reflected in nuclear texture features and DNA ploidy of oral lichen planus in relation to the normal buccal mucosa and buccal mucosa expressing malignancy-associated changes in cancer patients. Twenty-eight patients with the reticular form of oral lichen planus, with a follow-up period of 25 years, 50 healthy controls and 50 lung cancer patients were included in the study. Scrapings of buccal mucosa were suspended in transport medium. Monolayer filter preparations were Feulgen-thionin stained. Image cytometric analysis was performed by Cyto-Savant. All oral lichen planus specimens in our study were diploid. In univariate analysis, differences between the normal buccal mucosa and oral lichen planus were found in several nuclear texture features, which gave an 80% correct classification rate in multivariate analysis. In the second part of the study, the classifier that recognizes malignancy-associated changes on the buccal mucosa of patients with lung cancer correctly recognized > 80% of oral lichen planus samples as normal buccal mucosa. Our results indicate that chromatin changes in oral lichen planus exist compared to normal cells; however, the chromatin structure of the reticular form of oral lichen planus does not express malignancy-associated changes and is more similar to normal squamous cells.

  17. Genome-Wide Association Study Identifies Risk Variants for Lichen Planus in Patients With Hepatitis C Virus Infection.

    Science.gov (United States)

    Nagao, Yumiko; Nishida, Nao; Toyo-Oka, Licht; Kawaguchi, Atsushi; Amoroso, Antonio; Carrozzo, Marco; Sata, Michio; Mizokami, Masashi; Tokunaga, Katsushi; Tanaka, Yasuhito

    2017-06-01

    There is a close relationship between hepatitis C virus (HCV) infection and lichen planus, a chronic inflammatory mucocutaneous disease. We performed a genome-wide association study (GWAS) to identify genetic variants associated with HCV-related lichen planus. We conducted a GWAS of 261 patients with HCV infection treated at a tertiary medical center in Japan from October 2007 through January 2013; a total of 71 had lichen planus and 190 had normal oral mucosa. We validated our findings in a GWAS of 38 patients with HCV-associated lichen planus and 7 HCV-infected patients with normal oral mucosa treated at a medical center in Italy. Single-nucleotide polymorphisms in NRP2 (rs884000) and IGFBP4 (rs538399) were associated with risk of HCV-associated lichen planus (P lichen planus. The odds ratios for the minor alleles of rs884000, rs538399, and rs9461799 were 3.25 (95% confidence interval, 1.95-5.41), 0.40 (95% confidence interval, 0.25-0.63), and 2.15 (95% confidence interval, 1.41-3.28), respectively. In a GWAS of Japanese patients with HCV infection, we replicated associations between previously reported polymorphisms in HLA class II genes and risk for lichen planus. We also identified single-nucleotide polymorphisms in NRP2 and IGFBP4 loci that increase and reduce risk of lichen planus, respectively. These genetic variants might be used to identify patients with HCV infection who are at risk for lichen planus. Copyright © 2017 AGA Institute. Published by Elsevier Inc. All rights reserved.

  18. TRPA1 receptor is upregulated in human oral lichen planus.

    Science.gov (United States)

    Kun, J; Perkecz, A; Knie, L; Sétáló, G; Tornóczki, T; Pintér, E; Bán, Á

    2017-03-01

    Oral lichen planus (OLP) is a chronic inflammatory disease of unknown etiology with antigen-specific and non-specific mechanisms. Transient receptor potential ankyrin 1 (TRPA1) is a non-selective cation channel activated by noxious stimuli such as oxidative stress products evoking pain and release of proinflammatory mediators from sensory nerve endings culminating in neurogenic inflammation. Extraneuronal TRPA1s, for example, on immune cells possess yet unknown functions. We studied the buccal mRNA expression (qPCR) and protein localization (immunohistochemistry) of TRPA1 receptors and key OLP mediator transcripts in oral mucosa samples of healthy volunteers (n = 9), OLP patients (n = 43), and OLP-like hyperkeratotic patients (n = 12). We measured 27.7- and 25.5-fold TRPA1 mRNA increase in OLP and OLP-like hyperkeratotic patients compared to healthy controls. TRPA1 transcripts elevated 2.4-fold in hypertensive OLP but not in hyperkeratotic patients compared to counterparts, reduced by 1.6-fold by angiotensin-convertase inhibitor intake. TRPA1 messenger RNA was more coexpressed with transcripts of tumor necrosis factor α than with interferon γ. Keratinocytes, macrophages but not T cells expressed TRPA1. We provided evidence for the extraneuronal presence and upregulation of the proinflammatory TRPA1 receptor in buccal samples of patients with OLP. This may implicate the ion channel in the pathomechanism of OLP. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  19. Cathepsin K expression is increased in oral lichen planus.

    Science.gov (United States)

    Siponen, Maria; Bitu, Carolina Cavalcante; Al-Samadi, Ahmed; Nieminen, Pentti; Salo, Tuula

    2016-11-01

    Oral lichen planus (OLP) is an idiopathic T-cell-mediated mucosal inflammatory disease. Cathepsin K (Cat K) is one of the lysosomal cysteine proteases. It is involved in many pathological conditions, including osteoporosis and cancer. The expression and role of Cat K in OLP are unknown. Twenty-five oral mucosal specimens diagnosed histopathologically as OLP and fourteen healthy controls (HC) were used to study the immunohistochemical (IHC) expression of Cat K. Colocalization of Cat K with CD1a, Melan-A, CD68, CD45, mast cell tryptase (MCT), and Toll-like receptors (TLRs) 4 and 9 were studied using double IHC and/or immunofluorescence (IF) staining. Expression of Cat K was also evaluated in OLP tissue samples before and after topical tacrolimus treatment. Cat K was expressed in a higher percentage of cells in the epithelial zone, and the staining intensity was stronger in the stroma in OLP compared to controls (P < 0.001). In OLP, Cat K was present mostly in melanocytes and macrophages and sporadically in basal keratinocytes, endothelial cells, and extracellularly. Cat K was found also in some fibroblasts in HC and OLP samples. Coexpression of Cat K and TLRs 4 and 9 was seen in some dendritic cells (presumably melanocytes) and macrophages. In OLP, tacrolimus treatment reduced the expression of Cat K in the epithelium but increased it in the stroma. These results suggest that Cat K is involved in the pathogenesis of OLP. Cat K possibly takes part in the modulation of matrix molecules and cellular receptors. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  20. Cytomorphometric analysis of exfoliated cells in oral lichen planus

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    Chitturi Suryaprakash Ravi Teja

    2014-01-01

    Full Text Available Background: Tumors are distinguished from normal tissues partly by their pronounced variability of cellular and nuclear dimensions. Therefore, such factors may be an indicator to assess whether the cells are malignant or not. Exfoliative cytology is a reliable tool in assessing such changes in the uterine cervix and has been used in the oral cavity also with success. The aims and objectives of the following study were to evaluate the malignant changes by assessing the quantitative parameters such as cytoplasmic diameter, cytoplasmic perimeter and cytoplasmic area (CD, CP, CA and nuclear diameter, nuclear perimeter and nuclear area (ND, NP, NA and cytoplasmic to nuclear ratio in the exfoliated cells of various subtypes of oral lichen planus (OLP using cytomorphometry. Materials and Methods: Oral exfoliated cells from nineteen cases of histologically proven OLP (1 atrophic, 13 reticular, 4 erosive and 1 plaque and ten controls with healthy mucosa were taken and stained by Feulgen-Rossenback reaction and cytomorphometric analysis was performed using an image analysis software. The parameters taken into account were CD, CP, CA and ND, NP, NA. Furthermore CA/NA was calculated. The parameters were statistically analyzed using the t-test. Results: Cytomorphometric analysis of all the parameters showed no significant difference between the control group and the reticular/plaque subtypes, whereas statistically significant (P < 0.05 differences was obtained between the control group and the atrophic/erosive subtypes group when compared using t-test. Conclusions: The cytomorphometric analysis of OLP shows that erosive/atrophic subtypes of OLP are at more risk and exfoliative cytology and cytomorphometry can be used as a tool to assess the malignant changes.

  1. Mast cell - Melanocyte axis mediates pathogenesis in Oral Lichen Planus

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    Komali Rajkumar

    2014-01-01

    Full Text Available Background: Oral Lichen Planus (OLP is a cell-mediated inflammatory condition of the oral cavity with propensity for malignant transformation. Often classified as an autoimmune disorder, the pathogenesis of the lesion is still under debate. The presence of mast cells (MCs and melanocytes (MNs has been identified as an integral part of the cellular reaction in all stages of the disorder. Aims: The present study aims to qualify, localize and quantify MCs and MNs in OLP and normal oral mucosa (NOM using special stains and image analysis software. Computations and correlations between the numbers and localization of the cells in different layers of the tissue were done.Materials and Methods: Thirty cases of OLP and 10 cases of NOM were included. MCs were identified by their metachromasia using Toluidine blue and the MNs by Masson′s Fontana stain. A localization and quantification of the numbers of the two cell groups was done by image analysis and statistically correlated by two sample t-test. Results: The total count of mast cells and melanocytes was more in OLP in comparison to that of NOM. The MCs were present in the deeper tissues in contrast to MNs which were localized only to the basal and sub-basal areas. MNs appeared to proliferate and migrate to the subepithelial areas in OLPs in contrast to their strong localization to the basal layer in NOM. The ratio of MCs/MNs was higher in OLP compared with NOM. Interestingly the toluidine blue stain showed cross-sensitivity in expression of both MCs and MNs in OLP. Conclusion: MCs and MNs are expressed in increased numbers in OLP and probably have a synergistic mode of action in the pathogenesis of the disorder. The spilling out of MNs in OLP to the sub-basal areas is consistent with the clinical observation of pigmentation in healed/under remission OLP cases.

  2. Alterations in lipid metabolism and antioxidant status in lichen planus

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    Falguni H Panchal

    2015-01-01

    Full Text Available Background: Lichen planus (LP, a T-cell-mediated inflammatory disorder, wherein inflammation produces lipid metabolism disturbances, is linked to increase in cardiovascular (CV risk with dyslipidemia. Increased reactive oxygen species and lipid peroxides have also been implicated in its pathogenesis. Aim and Objective: The aim of the study was to evaluate the status on lipid disturbances, oxidative stress, and inflammation in LP patients. Materials and Methods: The study was initiated after obtaining Institutional Ethics Committee permission and written informed consent from participants. The study included 125 patients (74 LP patients and 51 age and sex-matched controls visiting the outpatient clinic in the dermatology department of our hospital. Variables analyzed included lipid profile, C-reactive protein (CRP, malondialdehyde (MDA, and catalase (CAT activity. Results: Analysis of lipid parameters revealed significantly higher levels of total cholesterol (TC, triglycerides, and low-density lipoprotein cholesterol (LDL-C along with decreased levels of high-density lipoprotein cholesterol (HDL-C in LP patients as compared to their respective controls. LP patients also presented with a significantly higher atherogenic index that is, (TC/HDL-C and LDL-C/HDL-C ratios than the controls. A significant increase in CRP levels was observed among the LP patients. There was a statistically significant increase in the serum levels of the lipid peroxidation product, MDA and a statistically significant decrease in CAT activity in LP patients as compared to their respective controls. A statistically significant positive correlation (r = 0.96 was observed between serum MDA levels and duration of LP whereas a significantly negative correlation (r = −0.76 was seen between CAT activity and LP duration. Conclusion: Chronic inflammation in patients with LP may explain the association with dyslipidemia and CV risk. Our findings also suggest that an increase in

  3. A Study of Depression and Quality of Life in Patients of Lichen Planus

    Science.gov (United States)

    Sawant, Neena S.; Vanjari, Nakul A.; Khopkar, Uday; Adulkar, Satish

    2015-01-01

    The precise cause of lichen planus is unknown, but the disease seems to be immunologically mediated. It is a psychocutaneous disorder. Due to scarcity of Indian studies in this field, we decided to study in patients of lichen planus the prevalence of depression and quality of life with comparison of the same in both the genders. Patients diagnosed as having lichen planus by consultant dermatologist were enrolled after informed consent and ethics approval. 45 patients were screened, of which 35 who satisfied the criteria were taken up for the study. A semistructured proforma was designed to collect the necessary information with administration of dermatology life quality index and Beck's depression inventory. While 25% were depressed with females being more affected than males, quality of life was impaired in more than 90% patients. Impairment was maximum due to symptoms and illness feelings, disturbed daily activities, or work and time consumption in treatment. There was a strong association between depression and impairment in quality of life in both the genders. This study helps in early identification of psychological problems in lichen planus patients and in planning their future course of management, hence reducing the lack of productivity and improving the prognosis and quality of life. PMID:25802892

  4. Oral lichen planus and the p53 family: what do we know?

    NARCIS (Netherlands)

    Ebrahimi, M.; Nylander, K.; van der Waal, I.

    2011-01-01

    Oral lichen planus (OLP) is a relatively common chronic disease of the oral mucosa for which the aetiopathogenesis is not fully understood. It mainly affects middle aged and elderly. The finding of autoantibodies against p63, a member of the p53 family, is a strong indication of autoimmunity as a

  5. Buccal Micronuclei Assay as a Tool For Biomonitoring DNA Damage in Oral Lichen Planus.

    Science.gov (United States)

    Vidyalakshmi, S; Nirmal, R Madhavan; Veeravarmal, V; Santhadevy, A; Aravindhan, R; Sumathy

    2016-07-01

    The malignant transformation rate of Oral Lichen Planus (OLP) is between 0% and 5.8%. Oral lesions of lichen planus clinically presents itself multifocally, simulating the process of field cancerization in high risk malignancies. The Buccal MicroNucleus Cytome Assay (BMN Assay) provides a platform to identify the high risk individuals by evaluating the markers of nuclear damage at an earliest micro invasive phase. To evaluate DNA damage in exfoliated buccal mucosal cells in individuals with oral lichen planus lesions and thereby to delineate the high risk group. Buccal smears from 22 OLP and 10 control samples were stained in modified Feulgen-Rossenback reaction for micronuclei assay. Cytological evaluation of number of MicroNucleated cells (CMN), Total Number of Micronuclei (TMN) in micronucleated cells was done in both groups. Frequency of micronucleated cells (CMN) when compared among the study and control group, a mean value of 4.27 ± 1.80 and 0.90 ± 0.88 were obtained respectively. On comparing the total number of micronuclei in the micronucleated cells (TMN) between the study and control groups, a mean value of 5.38 ± 2.42 and 1.5 ± 0.88 were obtained respectively. There was a significant increase in the frequency of micronuclei and the micronucleated cells in the oral lichen planus as compared to normal individuals.

  6. MicroRNA-137 promoter methylation in oral lichen planus and oral squamous cell carcinoma

    DEFF Research Database (Denmark)

    Dang, Jun; Bian, Yong-qian; Sun, Jian-yong

    2013-01-01

    Oral lichen planus (OLP) is a common oral mucosal disease, which is generally considered a potentially malignant lesion. To identify efficiently prognostic biomarker, we investigated the microRNA-137 (miR-137) promoter methylation in OLP and compared with the samples from healthy volunteers and p...

  7. Oesophageal stricture caused by lichen planus and intramural pseudo-diverticulosis

    DEFF Research Database (Denmark)

    Jensen, Jonas Sanberg; Lindebjerg, Jan; Jørgensen, Lars Stig

    2017-01-01

    We present the rare case of a proximal oesophageal stricture caused by a combination of oesophageal lichen planus without any other manifestations and intramural pseudo-diverticulosis, resulting in significant dysphagia. The diagnosis was not reached until a second set of biopsies were performed...

  8. The presence of Helicobacter pylori in oral cavities of patients with leukoplakia and oral lichen planus

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    Magdalena Kazanowska-Dygdała

    2016-02-01

    Full Text Available ABSTRACT Objective Helicobacter pylori infection is one of the most common bacterial infections in men. This gastrointestinal pathogen is closely related to gastritis, peptic ulcers, and the increased risk of gastric cancer. Numerous studies have indicated oral cavities as possible Helicobacter pylori reservoirs. Helicobacter pylori has been detected both in supragingival and subgingival plaques, and also in saliva. In addition, the relationship between lesions of oral mucosa and the presence of H. pylori has been evaluated and described in some studies. The aim of this study was to assess the presence of Helicobacter pylori DNA in the oral cavity of patients with oral leukoplakia and oral lichen planus. Material and Methods The study included 54 patients with oral leukoplakia, 72 with oral lichen planus lesions, and 40 healthy controls. The presence of Helicobacter pylori in oral cavity samples was analyzed using a single-step Polymerase Chain Reaction (PCR method. All patients underwent a periodontal examination and the following clinical parameters were collected: pocket depth, bleeding, and plaque indexes. The periodontal status was assessed using the Offenbacher classification. Results In most patients, pathological lesions were in typical sites on the buccal mucosa (leukoplakia in 88%, and oral lichen planus in 93% of patients. The DNA of the Helicobacter pylori was present in 20% of patients with leukoplakia and 23% of patients with lichen planus. We did not find the DNA of H. pylori in healthy controls. The periodontal status described by periodontal indices was worse in the investigated group than in the control group. Conclusion These findings suggest that the H. pylori presence in oral cavities may be related with leukoplakia and lichen planus oral lesions.

  9. The presence of Helicobacter pylori in oral cavities of patients with leukoplakia and oral lichen planus.

    Science.gov (United States)

    Kazanowska-Dygdała, Magdalena; Duś, Irena; Radwan-Oczko, Małgorzata

    2016-01-01

    Helicobacter pylori infection is one of the most common bacterial infections in men. This gastrointestinal pathogen is closely related to gastritis, peptic ulcers, and the increased risk of gastric cancer. Numerous studies have indicated oral cavities as possible Helicobacter pylori reservoirs. Helicobacter pylori has been detected both in supragingival and subgingival plaques, and also in saliva. In addition, the relationship between lesions of oral mucosa and the presence of H. pylori has been evaluated and described in some studies. The aim of this study was to assess the presence of Helicobacter pylori DNA in the oral cavity of patients with oral leukoplakia and oral lichen planus. The study included 54 patients with oral leukoplakia, 72 with oral lichen planus lesions, and 40 healthy controls. The presence of Helicobacter pylori in oral cavity samples was analyzed using a single-step Polymerase Chain Reaction (PCR) method. All patients underwent a periodontal examination and the following clinical parameters were collected: pocket depth, bleeding, and plaque indexes. The periodontal status was assessed using the Offenbacher classification. In most patients, pathological lesions were in typical sites on the buccal mucosa (leukoplakia in 88%, and oral lichen planus in 93% of patients). The DNA of the Helicobacter pylori was present in 20% of patients with leukoplakia and 23% of patients with lichen planus. We did not find the DNA of H. pylori in healthy controls. The periodontal status described by periodontal indices was worse in the investigated group than in the control group. These findings suggest that the H. pylori presence in oral cavities may be related with leukoplakia and lichen planus oral lesions.

  10. Analysis of the changes in the basal cell region of oral lichen planus: An ultrastructural study

    Science.gov (United States)

    Paul, Mayura; Shetty, Devi Charan

    2013-01-01

    Context: Oral lichen planus (OLP) affects 0.5-1% of the total world's population. The histological features of oral lichen planus were first described by Dubreuill in 1906. Despite the advent of various techniques, the etiology of lichen planus remains obscure, although many theories for the etiology have been proposed. Aims: By studying OLP electron microscopically, we shall be emphasizing on the cells and its interactions in specific/altered surroundings which would help us in hypothesizing the effects of its specific cell-to-cell interactions. Materials and Methods: A total of 20 cases of oral lichen planus were selected and categorized into erosive and nonerosive forms based upon clinical pattern and confirmed as lichen planus by histopathological analysis. Tissue specimens thus obtained were cut into two halves and fixed in appropriate fixatives, i.e., neutral buffered formalin for paraffin-embedded hematoxylin and eosin stained sections and 2.5% glutaraldehyde and 2% paraformaldehyde for electron microscopic purpose respectively. Results: Ultrastructural comparison among the two forms showed significant differences between them. The basal layer showed cytoplasmic processes, intercellular spaces, desmosomes, nuclei, and signs of degeneration. The erosive form showed elongated, narrow or irregular cytoplasmic projections whereas the nonerosive showed short and broad based projections. Conclusions: The present study confirms the ultrastructural findings of basal cells in OLP with previous authors findings. Besides this, the categorization of the ultrastructural differences between erosive and nonerosive has raised the question of difference in the probable cellular and molecular mechanism between erosive and nonerosive forms. PMID:23798823

  11. Efficacy of Elaeagnus angustifolia Topical Gel in the Treatment of Symptomatic Oral Lichen Planus

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    Jamileh Beigom Taheri

    2010-03-01

    Full Text Available Background and aims. The purpose of this study was to determine efficacy of 19% Elaeagnus angustifolia (EA topical gel in the treatment of symptomatic oral lichen planus. Materials and methods. Patients with symptomatic oral lichen planus referring to the Department of Oral Medicine, Faculty of Dentistry at Shahid Beheshti University of Medical Sciences were asked to participate in the study. Twenty-eight patients who were histopathologically diagnosed with lichen planus were divided into two groups (15 in the case and 13 in the control groups. The subjects were randomly assigned to either topical gel of EA or placebo in a double-blind manner. They were then instructed to apply the medication on dried lesions three times daily. Pain and size of the lesions were evaluated after 2 weeks. Data were analyzed by SPSS 12.0 software, using t-test, paired t-test, Fisher’s exact test and chi-square test. Results. Twenty-eight patients (m/f: 7/21 with symptomatic oral lichen planus participated in the study. Fifteen patients (m/f: 4/11 received E A gel and 13 patients (m/f: 3/10 received placebo. There was a 75% decrease in pain (33.3% in the case and 7.7% in the control groups, and a decrease of 50% in size (33.3% in the case group and 75% only in 7.6% of the case group. Conclusion. The results suggest that 19% EA gel is efficient in the treatment of symptomatic oral lichen planus, with antiinflammatory and analgesic effects, as well.

  12. Malignant transformation of oral lichen planus by a chronic inflammatory process. Use of topical corticosteroids to prevent this progression?

    Science.gov (United States)

    Otero-Rey, Eva Maria; Suarez-Alen, Fatima; Peñamaria-Mallon, Manuel; Lopez-Lopez, Jose; Blanco-Carrion, Andres

    2014-11-01

    Oral lichen planus is a potentially malignant disorder with a capacity, although low, for malignant transformation. Of all the factors related to the process of malignant transformation, it is believed that the chronic inflammatory process plays a key role in the development of oral cancer. This inflammatory process is capable of providing a microenvironment based on different inflammatory cells and molecules that affect cellular growth, proliferation and differentiation. The objectives of our study are: to review the available evidence about the possible relationship between the chronic inflammatory process present in oral lichen planus and its malignant transformation, to discuss the potential therapeutic implications derived from this relationship and to study the role that topical corticosteroids play in the control of oral lichen planus inflammation and its possible progression to malignant transformation. The maintenance of a minimum dose of topical corticosteroids could prevent the inflammatory progression of oral lichen planus to oral cancer.

  13. Lack of evidence of hepatitis in patients with oral lichen planus in China: A case control study

    OpenAIRE

    Song, Jiangyuan; Zhang, Zhihui; JI, XIAOLI; Su, Sha; Liu, Xiaodan; Xu, Si; Han, Ying; Mu, Dongdong; Liu, Hongwei

    2016-01-01

    Background China has been one of the countries with high prevalence of chronic hepatitis B virus (HBV) and hepatitis C virus (HCV) liver disease. And lichen planus is an extrahepatic manifestation of patients with chronic HCV infection. This case-control study was conducted to investigate the relationship between oral lichen planus (OLP) and HBV/HCV infection in China. Material and Methods A total of 776 patients, including 150 patients with OLP (Group OLP), 429 inpatients from the Trauma War...

  14. A case of facial lentiginous lichen planus pigmentosus associated with Hashimoto’s thyroiditis and diabetes mellitus

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    Fadime Kilinc

    2015-10-01

    Full Text Available Lichen planus pigmentosus (LPP is an autoimmune, chronic and rare variant of lichen planus of unknown etiology that progresses with pigmentation. The condition is rarely observed concurrently with autoimmune diseases. In this case report, a diabetic male patient with speckled lentiginous lesions on the face, also diagnosed with concurrent autoimmune thyroiditis is presented due to the rarity of the condition and the morphological character of the lesions.

  15. Association between polymorphisms in interleukins and oral lichen planus

    Science.gov (United States)

    Shi, Quan; Zhang, Tong; Huo, Na; Huang, Yang; Xu, Juan; Liu, Hongchen

    2017-01-01

    Abstract Background: More and more studies have suggested that single-nucleotide polymorphisms (SNPs) in interleukin (IL) genes are correlated with an increased risk of developing oral lichen planus (OLP). However, these results were inconsistent. Therefore, the aim of this meta-analysis is to retrieve and comprehensively analyze all related clinical studies to investigate the association of ILs gene polymorphisms with the OLP risk. Methods: PubMed, Embase, and the Cochrane Library were searched for eligible studies to evaluate the association between IL polymorphisms and the OLP. The odds ratios (ORs) and 95% confidence intervals (CIs) from each study were pooled to estimate the strength of the association. Statistical analyses were performed by using STATA software. Results: In all 6 studies, including 4 SNPs (IL6-174G/C, IL10-592C/A, IL10-819C/T, and IL10-1082G/A), 362 OLP patients and 622 non-OLP control subjects from five different countries were investigated. As for the IL6-174G/C, IL10-819C/T, and IL10-1082G/A, no evidence was found to support the association between SNP and OLP susceptibility in any genetic models. However, as for IL10-592C/A, a significant relationship between them was identified in all of comparison models (C vs A: OR = 0.724, 95% CI = 0.585–0.897, P = 0.003; CC vs AA: OR = 0.447, 95% CI = 0.276–0.722, P = 0.001; AC vs AA: OR = 0.585, 95% CI = 0.387–0.883, P = 0.011; CC+AC vs AA: OR = 0.544, 95% CI = 0.365–0.809, P = 0.003; CC vs AA+AC: OR = 0.715, 95% CI = 0.515–0.994, P = 0.046). Conclusion: With the presently available evidence, this meta-analysis fails to show the statistical associations between IL6-174G/C, IL10-819C/T, and IL10-1082G/A and OLP susceptibility in any genetic models. However, the A allele and AA genotype in IL10-592C/A polymorphism may increase the risk of OLP. In the future, more well-designed studies with larger sample sizes are needed. PMID

  16. Histomorphometric analysis of nuclear and cellular volumetric alterations in oral lichen planus, lichenoid lesions and normal oral mucosa using image analysis software

    OpenAIRE

    Sowmya S Venkatesiah; Kale, Alka D.; Seema R Hallikeremath; Kotrashetti, Vijayalakshmi S.

    2013-01-01

    Introduction: Lichen planus is a chronic inflammatory mucocutaneous disease that clinically and histologically resembles lichenoid lesions, although the latter has a different etiology. Though criteria have been suggested for differentiating oral lichen planus from lichenoid lesions, confusion still prevails. Aims: To study the cellular and nuclear volumetric features in the epithelium of normal mucosa, lichen planus, and lichenoid lesions to determine variations if any. Materials and...

  17. Oral findings in patients with primary Sjögren's syndrome and oral lichen planus - a preliminary study on the effects of bovine colostrum-containing oral hygiene products

    DEFF Research Database (Denmark)

    Pedersen, A.M.; Torpet, L.A.; Reibel, J.

    2002-01-01

    Primary Sjögren's syndrome, oral lichen planus, bovine colostrum, saliva, xerostomia, oral mucosa......Primary Sjögren's syndrome, oral lichen planus, bovine colostrum, saliva, xerostomia, oral mucosa...

  18. Prevalence of herpes simplex, Epstein Barr and human papilloma viruses in oral lichen planus

    OpenAIRE

    Yildirim, Benay; Sengüven, Burcu; Demir, Cem

    2011-01-01

    Objectives: The aim of the present study was to assess the prevalence of Herpes Simplex virus, Epstein Barr virus and Human Papilloma virus -16 in oral lichen planus cases and to evaluate whether any clinical variant, histopathological or demographic feature correlates with these viruses. Study Design: The study was conducted on 65 cases. Viruses were detected immunohistochemically. We evaluated the histopathological and demographic features and statistically analysed correlation of these...

  19. Mucocutaneous Diseases: Oral Lichen Planus, Mucous Membrane Pemphigoid and Pemphigus Vulgaris.

    Science.gov (United States)

    Patel, Seena; Kumar, Satish; Laudenbach, Joel M; Teruel, Antonia

    2016-09-01

    Mucocutaneous diseases affect the oral cavity and can present a diagnostic challenge. They can have systemic involvement, necessitating multidisciplinary management. Frequently, patients will see their general dentists initially for evaluation. A better understanding of mucocutaneous diseases can prevent delay in appropriate diagnosis and treatment. Oral lichen planus, mucous membrane pemphigoid and pemphigus vulgaris are three mucocutaneous diseases that affect the oral mucosa. This review describes the clinical features, epidemiology, etiology, pathogenesis and management for each condition.

  20. Comparative Study of Expression of Smad3 in Oral Lichen Planus and Normal Oral Mucosa

    OpenAIRE

    Nafarzadeh, Shima; Ejtehadi, Samad; Amini Shakib, Pouyan; Fereidooni, Majid; Bijani, Ali

    2013-01-01

    Oral lichen planus (OLP) is a chronic inflammatory disease of the oral mucosa which is considered by the World Health Organization (WHO) as a premalignant condition. One step in malignant development is so called epithelial mesenchymal transition (EMT), a process whereby epithelial cells acquire mesenchymal characteristics. A factor known to induce EMT is the transforming growth factor-β (TGF-β), which uses the Smad proteins as mediators for its signaling. The aim of this study was to compare...

  1. Lupus erythematosus-lichen planus overlap syndrome in an HIV-infected individual.

    Science.gov (United States)

    Patil, Priyanka; Nayak, Chitra; Tambe, Swagata; Das, Dipti

    2016-10-01

    Lupus erythematosus-lichen planus (LE-LP) overlap syndrome is an uncommon disorder with clinical, histological and/or immunopathological features of both diseases. We report a case of LE-LP overlap syndrome in a patient with HIV infection. To the best of our knowledge, LE-LP overlap syndrome with HIV infection has never been reported in literature. © The Author(s) 2016.

  2. Clinical diagnosis of oral erosive lichen planus by direct oral microscopy

    OpenAIRE

    Drogoszewska, Barbara; Chomik, Piotr; Polcyn, Adam; Michcik, Adam

    2014-01-01

    Introduction Direct oral microscopy is a novel, non-invasive diagnostic technique that aids clinical examination of the oral cavity. The basic principles of this method derive from colposcopy and dermoscopy. The principle is to reveal precancerous lesions of oral mucosae in their subclinical phase in order to begin their treatment as early as possible and prevent malignant transformation. Oral lichen planus (OLP) is an autoimmune, inflammatory, chronic disease affecting oral mucous membranes....

  3. Prevalence of herpes simplex, Epstein Barr and human papilloma viruses in oral lichen planus.

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    Yildirim, Benay; Sengüven, Burcu; Demir, Cem

    2011-03-01

    The aim of the present study was to assess the prevalence of Herpes Simplex virus, Epstein Barr virus and Human Papilloma virus -16 in oral lichen planus cases and to evaluate whether any clinical variant, histopathological or demographic feature correlates with these viruses. The study was conducted on 65 cases. Viruses were detected immunohistochemically. We evaluated the histopathological and demographic features and statistically analysed correlation of these features with Herpes Simplex virus, Epstein Barr virus and Human Papilloma virus-16 positivity. Herpes Simplex virus was positive in six (9%) cases and this was not statistically significant. The number of Epstein Barr virus positive cases was 23 (35%) and it was statistically significant. Human Papilloma virus positivity in 14 cases (21%) was statistically significant. Except basal cell degeneration in Herpes Simplex virus positive cases, we did not observe any significant correlation between virus positivity and demographic or histopathological features. However an increased risk of Epstein Barr virus and Human Papilloma virus infection was noted in oral lichen planus cases. Taking into account the oncogenic potential of both viruses, oral lichen planus cases should be detected for the presence of these viruses.

  4. Severe Gingival Enlargement with Coexisting Erosive Lichen Planus in Severe Chronic Periodontitis Patient

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    Ambika Sharma

    2015-01-01

    Full Text Available Plaque induced gingival enlargement is most commonly seen and when encountered simultaneously with erosive lichen planus poses a challenge to the treating dentist. Prognosis of one condition may influence the prognosis of another condition. The presented case highlights the significance of proper diagnosis and the management of simultaneously occurring gingival lesions. A 49-year-old hypertensive female presented with painful enlarged bleeding and suppurating gums with burning sensation on eating food along with long-term usage of antihypertensive drug amlodipine known for its gingival enlargement effect. All these multiple factors led to diagnostic dilemma. Effective management of the gingival enlargement was done by using electrocautery to rehabilitate the functions and esthetics of the patient. Gingival condition was also complicated by the presence of coexisting lichen planus which was predominantly erosive for which topical corticosteroid, antifungal, and antimicrobial agents were prescribed. Eight-month follow-up did not show recurrence of gingival enlargement. Electrocautery is an effective tool for the gingivectomy in severe inflammatory type of gingival enlargement because of rapid postoperative hemostasis. For the management of erosive lichen planus, long-term use of topical corticosteroids is an effective approach. Maintenance of oral hygiene and regular follow-ups are essential for these conditions.

  5. Epidemiology of Oral Lichen Planus in a Cohort of South Indian Population: A Retrospective Study

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    Varghese, Soma Susan; George, Giju Baby; Sarojini, Sreenivasan Bargavan; Vinod, Sankar; Mathew, Philips; Mathew, Deepu George; Sebastian, Joseph; George, Arun

    2016-01-01

    Background: Oral lichen planus (OLP) is an immune-mediated potentially malignant disorder of the oral cavity. Dysplastic OLP has an altered cytogenic profile and can progress into oral squamous cell carcinoma. The epidemiology of OLP is well-described in several relatively large series from various geographic locations, whereas such series from southern India is rare. The aim of the present study was to determine the epidemiology of OLP in a cohort of South Indian population. Methods: All the case data records of 29,606 patients who visited Mar Baselios Dental College and Hospital, Kerala, India from 2014 to 2015 were retrospectively reviewed. For data review, 122 patients of OLP were selected Estimated were type, number, and location of lesions, clinical manifestation, age of the patient, gender, onset and duration of lesion, stressful life style, habits, skin involvement and associated systemic illness, and presence/absence of dysplasia. Results: When the distribution of OLP among the gender was considered, we found more prevalence in females than males. Fifty-seven percent of patients were associated with stressful lifestyle. Reticular lichen planus was the most common clinical subtype found. Bilateral buccal mucosal was the common site, when the distribution of sites of OLP were compared (P lichen planus lesions. Conclusions: OLP patients had high incidence of hypersensitivity reactions and 5% of OLP lesions showed anaplasia. Long term follow-up is necessary to monitor the recurrence, prognosis, and malignant transformation of OLP. PMID:27051650

  6. Relation Between Periodontal Status and Pre-Cancerous Condition (Oral Lichen Planus): A Pilot Study.

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    Rai, Narendra Parkash; Kumar, Prafful; Mustafa, Shabil M; Divakar, Darshan D; Kheraif, Abdulaziz Al; Ramakrishnaiah, Ravikumar; Vellapally, Sajith; Dalati, M H N; Parine, Narashimha Reddy; Anil, Sukumaran

    2016-01-01

    Oral lichen planus (OLP) is a common chronic mucocutaneous disease mostly seen in middle aged and elderly females. Oral lichen planus can occur in different oral sites such as gingiva, labial, buccal mucosa and on the tongue. And can have an indirect effect on initiating periodontitis. The purpose of the study was to evaluate the periodontal status of OLP patients and compare it with that of healthy controls. The presence of erosive lesions among gingival tissues makes oral hygiene procedures difficult to perform for obvious reasons. Plaque control and rigorous oral hygiene are primary requisites for the treatment of any oro-mucosal disease. Thirty patients with the erosive and reticular form of OLP as a study group and 30 healthy subjects as a control group were selected. The periodontal status of all subjects including gingival index (GI), Russell's periodontal index (PI) and bleeding on probing (BOP) were evaluated in both groups. Finally, the data was analyzed by a paired t-test using SPSS software v. 22. The mean values of GI, PI and BOP were observed to be higher in the study group compared to the control group, and this was statistically significant (p lichen planus patients with larger sample size, and careful follow-up of these will assure an increase in the quality of life of these patients. The patient should be informed regarding the risk of periodontal problems in OLP and should be advised to have regular dental checkups to avoid a worsening of the conditio.

  7. Vulvovaginal gingival lichen planus: report of two cases and review of literature.

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    Lucchese, A; Dolci, A; Minervini, G; Salerno, C; DI Stasio, D; Minervini, G; Laino, L; Silvestre, F; Serpico, R

    2016-01-01

    Oral Lichen Planus (OLP) is a chronic inflammatory disease of skin and mucous membranes. Approximately 20% of women with oral lichen planus develops lesions in the genital mucosa. In 1982, Pelisse described a special form of lichen planus (LP), which consists of a triad of symptoms: vulval, vaginal and gingival (VVG)-LP lesions. Aim of the present report is to report two new cases and review the international literature. Two cases of VVG-LP are reported and a review of recent literature is performed. The onset of erosive or ulcerative mouth lesions may precede or follow by months or even years the onset of vulvovaginal lesions. Vaginal agglutination is associated with the postmenopausal state in conjunction with a dermatologic condition. Intra-lesional corticosteroids have a role in localized chronic ulceration, while systemic therapies such as corticosteroids, azathioprine, mycophenolate mofetil, hydroxychloroquine, ciclosporin, methotrexate, retinoids, thalidomide and photo chemotherapy have been used in more severe cases with varying success. VVG-LP is rather a rare condition and has been documented in the literature mainly in the form of case reports. Lack of a precise diagnostic criteria of VVG-LP depends on the specialists.

  8. Comparative study of expression of smad3 in oral lichen planus and normal oral mucosa.

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    Nafarzadeh, Shima; Ejtehadi, Samad; Amini Shakib, Pouyan; Fereidooni, Majid; Bijani, Ali

    2013-01-01

    Oral lichen planus (OLP) is a chronic inflammatory disease of the oral mucosa which is considered by the World Health Organization (WHO) as a premalignant condition. One step in malignant development is so called epithelial mesenchymal transition (EMT), a process whereby epithelial cells acquire mesenchymal characteristics. A factor known to induce EMT is the transforming growth factor-β (TGF-β), which uses the Smad proteins as mediators for its signaling. The aim of this study was to compare the expression of Smad 3 in Oral Lichen Planus and normal oral mucosa. This descriptive analytic study was performed on 30 patients with OLP (21 women and 9 men with mean age of 45.23± 2.44 years) and 20 normal oral mucosa (14 women and 6 men with mean age of 46.95± 2.21 years). The samples were studied by immunohistochemical staining. Data were analyzed with paired T-test and Wilcoxon test by SPSS software. Expression of Smad3 in OLP samples and normal oral mucosa was different. This difference was statistically significant (Poral lichen planus compared to normal oral mucosa might help to discuss its higher potential for malignant transition.

  9. Lichen planus-like eruption resulting from a jellyfish sting: a case report

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    Ghosh Sudip Kumar

    2009-07-01

    Full Text Available Abstract Introduction Contact with a jellyfish can cause a wide variety of conditions, ranging from cutaneous eruption to fatal cardiovascular and respiratory collapse. Cutaneous features can be both acute and chronic. We report a case of persistent lichen planus-like eruption in a young boy after a jellyfish sting, a hitherto unreported occurrence. Case presentation A 15-year-old boy presented with multiple lichen planus-like violaceous papules over the lower part of his left thigh on the anterior aspect and also over the patellar region. He had a history of a jellyfish sting over his lower limbs incurred while bathing in the sea four weeks prior to presentation. Histopathology revealed a predominantly perivascular mononuclear cell infiltrate immediately beneath the dermoepidermal junction underneath the hyperplastic epidermis. The lesions significantly subsided with topical corticosteroid application. Conclusion This case report demonstrates a new variant of chronic cutaneous change following a jellyfish sting. We report it because of its uniqueness and we believe that physicians should be aware of the possibility of an aquatic animal-induced disease when dealing with lesions with lichen planus-like morphology.

  10. [Detection of human papillomavirus (HVP)-DNA in oral manifestation of lichen planus].

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    Vesper, M; Riethdorf, S; Christoph, E; Ruthke, A; Schmelzle, R; Löning, T

    1997-05-01

    Human papilloma viruses (HPV) can be detected in different epithelia with the help of the polymerase chain reaction (PCR). The role of HPV in the development of anogenital cancers has been intensively studied, and current evidence shows that most cervical cancers are associated with so-called high risk HPV types (e.g. HPV 16 and 18). HPV-infections can also be demonstrated in oral premalignant lesions and squamous cell carcinomas. Depending on the sensitivity of the detection method, 40-67% of leukoplakias, 2.5-76% of squamous cell carcinomas and 0-87% of cases of lichen planus were described to be infected with HPV 16 or 18. Whether lichen planus can be considered as a premalignant lesion is still controversial. By the use of PCR and hybridization we found infections with the high risk HPV types 16, 18 and 31 in 42% (3/7) of the patients with lichen planus. Further investigations with a higher numbers of cases in combination with the analysis of the viral gene expression as well as the clinical and histological control of the corresponding regions are necessary. The aim of these studies is to find out the prognostic value of the HPV infection for this facultative premalignant disease.

  11. Comparison of seropositivity of HCV between oral lichen planus and healthy control group in Hamedan province (west of Iran

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    Ahmad Reza Mobaien

    2011-10-01

    Full Text Available Background: Lichen planus is an idiopathic inflammatory disease of the skin, nail, hair and mucous membranes. Oral lichen planus (LP is a chronic inflammatory condition that affects the oral mucous membranes with a variety of clinical presentations. Various etiologies include HCV suggested for LP, and the aim of this study was comparison of seropositivity of HCV in LP patients and control group. Methods: All oral LP patients that were referred to dermatology clinic of farshchian hospitalwere entered in the study. Five cc of clot blood was taken from each patient and tested for anti-HCVand when anti-HCV tested positive another 2cc clot bloodwas taken for HCV-Rt-PCR test. The results were analyzed with SPSS 16. Results: This prospective cross-sectional study was conducted on 30 oral lichen planus patients [males 13(43.3% females 17(56.7%] with mean ages of 46±13.7years and 60 healthy individual [males 26(43.3% females 34(56.7%]. There was no oral lichen planus patients who had anti-HCV positive whiles 2 males(3.3% of healthy group had anti-HCV positive which was confirmed by HCV-Rt-PCR. Conclusions: This study showed that there is no correlation between seropositivity of HCV and oral lichen planus in our patients in the west of Iran.

  12. Comparison of Serum Autoantibodies to Desmogleins I, III in Patients with Oral Lichen Planus and Healthy Controls.

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    Gholizadeh, Narges; Khoini Poorfar, Hossein; TaghaviZenouz, Ali; Vatandoost, Masoumeh; Mehdipour, Masoumeh

    2015-01-01

    Lichen planus is a mucocutaneous disease which is relatively common and in 30-70% of patients, mucosal lesions can be seen and known as a precancerous lesion but its etiology is not completely understood. Desmogleins I and III are the main desmosomal transmembrane proteins. These proteins have been identified as the autoantigen of the autoimmune disease. The aim of this study was evaluation of serum autoantibodies against desmogleins Ι, ΙΙΙ in oral lichen planus . We attempted to determine the etiology of this disease with evaluation of these serum factors. Thirty-five patients with oral lichen planus and 35 healthy controls were recruited and tested for serum autoantibodies against desmogleins Ι, ΙΙΙ and indirect immunofluorescence also performed. Data were analyzed by statistical-analytical methods (Independent sample t -test) with using the SPSS.15 software. Serum autoantibody against desmoglein Ι had no significant difference in the two groups ( P =0.31 ) but significant increase in serum autoantibody to desmoglein ΙΙΙ was found in patients with oral lichen planus ( P =0.00) . It seems that autoantibody against desmoglein III has a significant role in the pathogenesis of oral lichen planus.

  13. Xerostomia and Salivary Gland Hypofunction in Patients with Oral Lichen Planus Before and After Treatment with Topical Corticosteroids.

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    Al-Janaby, Hala; El-Sakka, Haytham; Masood, Manal; Ashani W Mendis, Walimuni; M Slack-Smith, Linda; Parsons, Richard; M Frydrych, Agnieszka

    2017-01-01

    Oral lichen planus and mouth dryness are common pathoses, yet not entirely understood. These two conditions may be associated, with a few studies investigating the relationship between mouth dryness and oral lichen planus providing conflicting results. None of the studies have explored the specific impact of disease treatment on mouth dryness. The purpose of this observational before and after comparison study was to examine the effect of treatment of oral lichen planus with topical corticosteroids on mouth dryness. Nineteen subjects with oral lichen planus were evaluated for the severity of xerostomia using a xerostomia inventory and a visual analogue scale. Stimulated and unstimulated whole salivary flow rates, unstimulated salivary pH and buffering capacity were also measured. All subjects were evaluated before and after treatment with topical corticosteroids. All subjects reported xerostomia before treatment with topical corticosteroids, with 79% reporting a significant improvement (P = 0.03) after treatment. Topical corticosteroid treatment was not associated with statistically significant differences in stimulated or unstimulated salivary flow rates, unstimulated salivary pH or buffering capacity. The results of this study suggest that treatment of oral lichen planus with topical corticosteroids may decrease the severity of dry mouth symptoms.

  14. Serum Level of Vascular Endothelial Growth Factor in Patients with Different Clinical SubtypeS of Oral Lichen Planus

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    Maryam Mardani

    2012-12-01

    Full Text Available Background: Oral lichen planus is a chronic inflammatory disease with a poorly understood etiology. The role of angiogenesis in the development of different chronic inflammatory diseases is of great concern. Vascular endothelial growth factor (VEGF is an important regulator of angiogenesis. We aimed to evaluate the serum level of VEGF in patients with oral lichen planus compared with normal individuals and consider its clinical significance.Methods: In this case-control study, 36 serum samples from patients diagnosed with oral lichen planus admitted to the Oral Medicine Department of the School of Dentistry at Shiraz University of Medical Sciences (14 men, 22 women, mean [±SD] age: 38.8 [±6.07] years and 23 serum samples from healthy individuals (9 men, 14 women, mean [±SD] age: 38.7 [±4.9] years were collected. VEGF concentration was measured using the ELISA method. The Mann-Whitney test was used for statistical analysis.Results: The serum VEGF level was significantly higher in patients with oral lichen planus compared with the healthy controls (112.97 [±63.2] vs. 66.21 [±56.2] ngr/ml, P<0.001. A similar difference was also observed between the two types of oral lichen planus, being more pronounced in the erosive form (P<0.001.Conclusion: Serum VEGF can be used as a useful and suitable marker to scrutinize the disease activity.

  15. Relevance of psychosocial factors to quality of life in oral cancer and oral lichen planus: a prospective comparative study.

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    Rana, Madiha; Kanatas, Anastasios; Herzberg, Philipp Y; Gellrich, Nils-Claudius; Rana, Majeed

    2015-09-01

    We can improve our understanding of how patients cope with oral squamous cell carcinoma (SCC) by making a comparison with their processes of coping and those used in other conditions. We have therefore compared quality of life (QoL), severity of symptoms, coping strategies, and factors that influence coping between patients with oral SCC and those with oral lichen planus. We asked 104 patients with oral SCC and 51 with oral lichen planus to complete questionnaires about their coping strategies, social support, locus of control, spirituality, QoL, and severity of symptoms. The outcome was that patients with oral SCC were far more likely to resort to coping strategies such as depressive coping, distraction, and self-motivation. The groups also differed regarding QoL and severity of symptoms. Patients with oral SCC had a poorer QoL and higher depression scores, whereas patients with oral lichen planus had better scores in the social support and spirituality categories. Patients with oral SCC generally had more distress than those with oral lichen planus. Not only did the former resort to depressive coping strategies, but they also had poorer QoL and higher values for depression. For the patients with oral lichen planus, social support and spirituality were protective, whereas they were associated with distress by patients with oral SCC. Copyright © 2015 The British Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.

  16. Association of oral lichen planus with hepatitis C virus, surface antigen of hepatitis B virus, and diabetes: A clinical and biochemical study

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    Pavani Donempudi

    2016-01-01

    Full Text Available Background: Oral lichen planus is an inflammatory mucocutaneous disease commonly encountered in the dental clinic. The etiology of oral lichen planus is still unknown. The probable factors associated with oral lichen planus include anxiety, trauma, malnutrition, infection, and autoimmunity. Objectives: The aim of the study was to evaluate the serum levels of fasting and postprandial blood sugar levels, surface antigen of hepatitis B virus (HBsAg, and hepatitis C virus (HCV autoantibodies in oral lichen planus patients and controls, and to assess the association of oral lichen planus with diabetes, HCV, and HBsAg. Study Design: The study included a total of 25 oral lichen planus patients. Twenty-five individuals who did not have the above clinical conditions were also included in the study and comprised the control group. Both the study and control groups consisted of both sexes in the age group of 20–70 years. Patients were clinically diagnosed as oral lichen planus after obtaining a detailed history and was later confirmed by histopathologic examination. Materials and Methods: Blood samples were collected from both the oral lichen planus patients and controls. Biochemical analysis of blood glucose levels, i.e., fasting and postprandial blood glucose levels, HBsAg, hepatitis C autoantibodies were done by enzyme-linked immunosorbent assay. Results: Blood glucose levels, i.e., fasting and postprandial blood glucose levels, were found to be statistically increased in oral lichen planus patients when compared with controls. There was no significant change in HCV autoantibodies and HBsAg. The results of the present study also showed a significant association of oral lichen planus with diabetes. However, there was no significant association of oral lichen planus with HCV and HBsAg in patients when compared with controls. Conclusion: There was a direct relation of oral lichen planus with diabetes whereas there was no significant association with HCV

  17. Efficacy of steroidal vs non-steroidal agents in oral lichen planus: a randomised, open-label study.

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    Singh, A R; Rai, A; Aftab, M; Jain, S; Singh, M

    2017-01-01

    This study compared the therapeutic efficacy of steroidal and non-steroidal agents for treating oral lichen planus. Forty patients with clinical and/or histologically proven oral lichen planus were randomly placed into four groups and treated with topical triamcinolone, oral dapsone, topical tacrolimus or topical retinoid for three months. Pre- and post-treatment symptoms and signs were scored for each patient. Patients in all treatment groups showed significant clinical improvement after three months (p 0.05) and for topical retinoid vs topical tacrolimus (p > 0.05). Non-steroidal drugs such as dapsone, tacrolimus and retinoid are as efficacious as steroidal drugs for treating oral lichen planus, and avoid the side effects associated with steroids.

  18. Lichen planus and liver diseases: a multicentre case-control study. Gruppo Italiano Studi Epidemiologici in Dermatologia (GISED).

    Science.gov (United States)

    1990-01-27

    To assess the association of lichen planus with liver complaints and with known aetiological factors of liver diseases. Multicentre case-control study. Interviews were conducted by trained medical investigators on the basis of a structured questionnaire. At the interview patients and controls were asked for consent to blood samples being taken to determine transaminase activities and the presence of hepatitis B virus surface antigen. Outpatient departments of 27 Italian general and teaching hospitals that were collaborating in the Gruppo Italiano Studi Epidemiologici in Dermatologia (GISED). Incident cases and controls were eligible. A total of 577 patients with lichen planus and 1031 controls with dermatological diseases other than lichen planus were interviewed. Less than 1% of the people contacted refused to participate. Patients and controls were matched for sex and age in five year intervals. The risk of lichen planus was higher in patients with a history of liver diseases requiring hospital admission or specialist consultation (relative risk = 1.6; 95% confidence interval = 1.2 to 2.2), those who had had liver biopsy (5.5; 1.9 to 15.6), and those with a history of viral hepatitis (1.9; 1.1 to 3.1). High activities of liver enzymes and positive results of tests for hepatitis B virus surface antigen were also associated with lichen planus. The association with alcohol consumption was not clearly confirmed by a dose-risk relation. This study adds quantitative epidemiological evidence to the clinical observation that liver disease is a risk factor for lichen planus although not a specific marker of it.

  19. Evaluation of Potential Risk Factors that contribute to Malignant Transformation of Oral Lichen Planus: A Literature Review.

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    Agha-Hosseini, Farzaneh; Sheykhbahaei, Nafiseh; SadrZadeh-Afshar, Maryam-Sadat

    2016-08-01

    Many studies have suggested that a lesion originally diagnosed as oral lichen planus (OLP) has different possibilities of undergoing malignant transformation in time, although these findings remain a controversial issue; for example, some studies reported different values of potential malignancy of OLP. World Health Organization (WHO) classifies OLP as a "potentially malignant disorder" with unspecified malignant transformation risk, and suggests that OLP patients should be closely monitored. Numerous studies have attempted to confirm the malignant transformation potential of OLP. The Cochrane Controlled Trials Register, Medline and EMBASE databases, PubMed, Google Scholar, Ovid, Up To Date, BMJ Clinical Evidence, MD Consult, and Science Direct were searched for papers published between 1997 and 2015. The medical subject heading search terms were "lichen planus," "oral lichen planus," "erosive oral lichen planus," "dysplasia," "oral precancerous condition," "oral premalignant condition," oral cancer, oral squamous cell carcinoma (OSCC), and atrophic lichen planus. A total of 120 English language abstracts were reviewed, and 50 relevant articles identified. Because of the extensive literature on the association between OLP and SCC, we have divided the data into genetic and non-genetic factors for more accurate assessment. In this evidence base, malignant transformation ranges from 0 to 37% with a mean of 4.59%. The highest rate of malignancy was noted in erythematosus and erosive lesions. In this way, follow-up of OLP patients could be carried out more efficiently and appropriately. Oral lichen planus is a premalignant lesion. All types of OLP in any site of oral mucosa must be monitored regularly.

  20. A retrospective study of oral lichen planus in oral pathology department, Tehran University of Medical Sciences (1968-2002

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    Khalili M.

    2006-08-01

    Full Text Available Background and Aim: Oral lichen planus is a chronic mucocutaneous disease with various clinical expressions. The histopathologic features are not characteristic and may be seen in other diseases. The aim of this study was to determine the clinical and pathologic features of oral lichen planus in oral pathology department of dental school, Tehran university of medical sciences. Materials and Methods: In this case series study, archive of oral pathology department from 1968 to 2002 was reviewed and cases diagnosed as lichen planus and related lesions selected. The diagnosis of oral lichen planus was confirmed by evaluation of microscopic slides. Clinical informations such as age, sex, site and duration of lesions and differential diagnosis as well as microscopic findings were recorded. Data were analyzed with SPSS software using t student, ANOVA, Chi-square and Post Hoc Tukey tests with p<0.05 as the limit of significance. Results: From a total of 402 cases recorded as lichen planus and related lesions, 251 cases were confirmed for final analysis. The mean age of patients was 42 years (5 to 83 years. 50.4% of cases were men and 49.6% women. The most prevalent clinical type was the ulcerative form and the mean duration of disease was 18.4 months. Buccal mucosa was most frequently involved followed by the tongue and gingiva. A white patch, Wickham’s striae and mucosal erythema were the most prevalent clinical appearance and parakeratosis , orthokeratosis and eosinophilic band the most frequent microscopic features. Conclusion: Based on the results of this study, the correlation of clinical and pathological findings in the proper diagnosis of oral lichen planus is emphasized.

  1. The Comparison of Efficacy of Adcortyl Ointment and Topical Tacrolimus in Treatment of Erosive Oral Lichen Planus

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    Arash Azizi

    2007-12-01

    Full Text Available

    Background and aims. Oral lichen planus (OLP is a common chronic mucocutaneous disease. Patients with atrophic and erosive lichen planus often have symptoms of soreness and need proper treatment. The main therapy of OLP has been the administration of topical or systemic corticosteroids. Potent topical corticosteroids have been increasingly prescribed in the treatment of erosive lichen planus. The purpose of this study was to compare the efficacy of adcortyl ointment (triamcinolone in orabase with topical tacrolimus for the treatment of erosive oral lichen planus.

    Materials and methods. Sixty Patients with histopathologically confirmed oral lichen planus were enrolled in the study. The severity of lesions was scored from 0 to 5 according to the criteria described in a previous study. Patients were randomly given adcortyl (group A and topical tacrolimus ointment (group B and asked to apply the medication on dried lesions 4 times a day. The lesions were evaluated after 4 weeks of treatment. Visual analogue scale was used to assess the severity of pain before and after treatment. The severity scores were analyzed using the Kruskal-Wallis k-sample test.

    Results. The average score of lesions improved from 3.4 to 1.5 in patients who received adcortyl ointment and from 3.2 to 1.2 in patients who received topical tacrolimus ointment. The differences between the improvements in scores were not statistically significant in the two groups. The average pain severity in A and B groups was 8.2 and 7.8 at the beginning of treatment, and 3.5 and 3.2 at the end of treatment, respectively. There was a statistically significant reduction in pain severity in both groups.

    Conclusion. Topical tacrolimus is a safe and effective alternative therapy in the treatment of oral lichen planus.

  2. Study of P21 Expression in Oral Lichen Planus and Oral Squamous Cell Carcinoma by Immunohistochemical Technique.

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    Baghaei, Fahimeh; Shojaei, Setareh; Afshar-Moghaddam, Noushin; Zargaran, Massoumeh; Rastin, Verisheh; Nasr, Mohsen; Moghimbeigi, Abbas

    2015-09-01

    Lichen planus is a mucocutaneous disease that is relatively common in middle aged individuals. Some studies have shown that oral lichen planus has a potential to progress to squamous cell carcinoma.p21 is a cyclin-dependent kinase inhibitor that regulates the cell cycle, thus it acts as an inhibitor in cell proliferation. This study was aimed to evaluate and compare the immunostaining of p21 (as a proliferation inhibitory factor) in oral lichen planus (OLP) and oral squamous cell carcinoma (OSCC). In this descriptive cross-sectional study, p21expression was investigated in 24 samples of oral lichen planus (OLP), 24 samples of oral squamous cell carcinoma (OSCC) and 24 samples of oral epithelial hyperplasia (OEH) by employing immunohistochemical staining. The mean percentage of p21-positive cells in OSCC (54.5±6.6) was significantly higher than that in OLP (32.8±6.08) and OEH (9.4±3.8). Moreover, OLP samples expressed p21 significantly higher than the OEH. Kruskal Wallis test revealed a statistically significant difference between the groups regarding the intensity of staining (plichen planus to SCC. Therefore, continuous follow-up periods for OLP are recommended for diagnosis of the malignant transformations in early stages.

  3. Evaluation of efficacy of a bioresorbable membrane in the treatment of oral lichen planus

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    Kapoor, Anoop; Sikri, Poonam; Grover, Vishakha; Malhotra, Ranjan; Sachdeva, Sonia

    2014-01-01

    Background: Gingival involvement is commonly seen in lichen planus, a chronic mucocutaneous inflammatory condition of the stratified squamous epithelia. It is often painful and may undergo malignant transformation and thus warrants early diagnosis and prompt treatment. The aim of this study is to evaluate the use of a bioresorbable membrane (Polyglactin 910) in the management of erosive lichen planus of gingiva. Materials and Methods: A split-mouth randomized controlled trial was carried out. Fifteen patients with identical bilateral lesions of lichen planus on gingiva were included in the study. Three parameters were selected for the clinical assessment of gingival lesions: Surface texture, color, and burning sensation. After complete oral prophylaxis, an excisional biopsy procedure was carried out for lesions on both sides, but on the experimental side, the biopsy procedure was combined with placement of the bioresorbable membrane. The statistical significance of intergroup differences in measurements was tested by using an independent sample t-test. A two-tailed P-value less than 0.05 was considered as statistically significant. Results: Intragroup comparisons revealed a statistically significant difference between mean value of grades at 6, 12, and 24 weeks in both groups for the surface texture, color, and burning sensation of gingiva, respectively. For intergroup comparison of change in surface texture, color, and burning sensation of gingiva between group A and group B, differences were statistically nonsignificant. Conclusion: Surgical management of the lesion accomplished significant improvement of lesion with no significant additional clinical benefits with the application of bioresorbable membrane. Worsening of baseline scores was not observed in any case at the end of the study. PMID:25097651

  4. Lichen planus pigmentosus-inversus following Langer's lines of cleavage: a rare clinical presentation

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    Wan-Su Peng

    2015-12-01

    Full Text Available We present an interesting case of a patient who had a 5-month history of insidiously developing pigmented macules along skin cleavage lines over the skin of submammary and inguinal folds. There was no history of previous medication. Skin examination revealed multiple discrete and slate-grey macules distributed over the skin cleavage lines of the submammary and inguinal folds. These lesions did not coalesce, forming several, intermittent and brownish lines. Pathologically, it showed atrophic epidermis with foci of colloid bodies. A dense lymphocytic infiltration along with prominent melanophages was noticeable in the superficial dermis. The patient was diagnosed with lichen planus pigmentosus-inversus following skin cleavage lines.

  5. Oral Lichen Planus: Clinical Features, Etiology, Treatment and Management; A Review of Literature

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    Marzieh Boorghani

    2010-03-01

    Full Text Available Lichen planus is a chronic inflammatory mucocutaneous disease. Mucosal lesions are classified into six clinical forms and there is malignant potential for two forms of OLP; therefore, follow-up should be considered. There are many unestablished etiological factors for OLP and some different treatment modalities are based on etiology. The aims of current OLP therapy are to eliminate mucosal erythema and ulceration, alleviate symptoms and reduce the risk of oral cancer. We have used review papers, case reports, cohort studies, and case-and-control studies published from 1985 to 2010 to prepare this review of literature.

  6. GAMBARAN KLINIK DAN LATAR BELAKANG PASIEN DENGAN DIAGNOSIS KLNIK SEBAGAI LICHEN PLANUS DI POLI PENYAKIT MULUT RSCM DAN RSGM

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    Sri Tjahjani Sumantri

    2015-08-01

    Full Text Available Lichen planys is disorder of the skin and mucous membrane that presenting pruritic, purple and polygonal papules. Oral lesions may persist for years and with clinical appearance that sometimes very ocnfusing. In most cases, oral lesions are present as white, reticulated or natelike areas involving the mucosa. These lesions are characteristic and called Wickham's striae. This paper presented some cases with lesions that resembled oral lichen planus.

  7. Lichen striatus associated with psoriasis vulgaris treated with oral acitretin

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    Enzo Errichetti

    2014-01-01

    Full Text Available Lichen striatus (LS is an uncommon dermatosis of unknown etiology that presents as a continuous or interrupted linear band of pink, tan, red or skin-colored papules in a blaschkoid distribution. The lesions are generally solitary and unilateral, but unusual extensive cases with multiple and bilateral lesions have been also described. Albeit LS is typically an asymptomatic and self-limited dermatosis, it may cause a significant psychological distress in some patients, thus requiring an appropriate therapy. Topical steroid is the most commonly used treatment but it is not always effective. We report a case of LS unresponsive to topical steroid therapy associated with psoriasis vulgaris successfully treated with oral acitretin.

  8. Demographic and clinical profile of oral lichen planus: A retrospective study

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    Anita D Munde

    2013-01-01

    Full Text Available Introduction: Oral lichen planus (OLP is a relatively common inflammatory mucocutaneous disorder that frequently involves the oral mucosa. The clinical presentation of OLP ranges from mild painless white keratotic lesions to painful erosions and ulcerations. An important complication of OLP is the development of oral squamous cell carcinoma, which led the World Health Organization (WHO to classify OLP as a potentially malignant disorder. The demographic and clinical characteristics of OLP have been well-described in several relatively large series from developed countries, whereas such series from developing countries are rare. Objective: The objective of this retrospective study was to investigate the epidemiological and clinical characteristics of 128 OLP patients in rural population of India. Materials and Methods: In this study, the diagnostic criteria proposed by van der Meij et al. in 2003 based on the WHO definition of OLP were used to identify cases. Results: In 128 patients, M:F ratio was 1.61:1. The buccal mucosa was the most common site (88.20%. White lichen was seen in 83.59% and red lichen in 16.40% cases. Reticular type of OLP was the most common form (83.5% followed by erosive (15.6% and atrophic OLP (0.78%. The incidence of systemic diseases included hypertension (11%, diabetes mellitus (2.4%, and hypothyroidism (0.78%. Histopathologically epithelial dysplasia was present in 4 cases. Conclusion: Most of the characteristics are consistent with previous studies with differences in few. Lichen planus is a chronic disease where treatment is directed to control of symptoms. Long-term follow-up is essential to monitor for symptomatic flare ups and possible malignant transformation.

  9. Plaque control improves the painful symptoms of oral lichen planus gingival lesions. A short-term study.

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    Salgado, Daniela S; Jeremias, Fabiano; Capela, Marisa V; Onofre, Mirian A; Massucato, Elaine Maria S; Orrico, Silvana R P

    2013-11-01

    Lichen planus is a mucocutaneous disease with manifestation in the oral mucosa, the gingiva being one of the most affected regions. In some cases, the lesion may be painful and lead to fragility of the tissues, so that precise diagnosis and adequate treatment are indispensible factors for improving the clinical condition. The aim of this study was to evaluate the effectiveness of plaque control in the improvement of clinical features and painful symptoms of oral lichen planus with gingival involvement. Twenty patients diagnosed with gingival lichen planus confirmed by histopathological examination were selected. The patients were evaluated by a trained examiner, with regard to the clinical features of the lesions [Index of Escudier et al. (Br J Dermatol, 157, 2007, 765)]; painful symptoms (Visual Analog Scale); and periodontally, as regards the visible plaque and gingival bleeding indices. Periodontal treatment consisted of supragingival scaling and oral hygiene instruction, with professional plaque removal afterward for a period of 4 weeks. The entire sample was evaluated at the baseline and at the conclusion of treatment, and the results were analyzed by the Wilcoxon nonparametric test. The data demonstrated that the majority of patients were women (90%), with a mean age of 55.9 years. Periodontal treatment resulted in statistically significant reduction (P lichen planus with gingival involvement. © 2013 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  10. DNA methylation patterns of genes related to immune response in the different clinical forms of oral lichen planus.

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    Cruz, Aline Fernanda; de Resende, Renata Gonçalves; de Lacerda, Júlio César Tanos; Pereira, Núbia Braga; Melo, Leonardo Augusto; Diniz, Marina Gonçalves; Gomes, Carolina Cavalieri; Gomez, Ricardo Santiago

    2017-10-04

    The oral lichen planus is a chronic inflammatory disease. Although its aetiology is not well understood, the role of T lymphocytes in its inflammatory events is recognised. Identifying the epigenetic mechanisms involved in the pathogenesis of this immune-mediated condition is fundamental for understanding the inflammatory reaction that occurs in the disease. The purpose of this work was to evaluate the methylation pattern of 21 immune response-related genes in the different clinical forms of oral lichen planus. A cross-sectional study was performed to analyse the DNA methylation patterns in three distinct groups of oral lichen planus: (i) reticular/plaque lesions; (ii) erosive lesions; (iii) normal oral mucosa (control group). After DNA extraction from biopsies, the samples were submitted to digestions by methylation-sensitive and methylation-dependent enzymes and double digestion. The relative percentage of methylated DNA for each gene was provided using real-time polymerase chain reaction arrays. Hypermethylation of the STAT5A gene was observed only in the control group (59.0%). A higher hypermethylation of the ELANE gene was found in reticular/plaque lesions (72.1%) compared to the erosive lesions (50.0%). Our results show variations in the methylation profile of immune response-related genes, according to the clinical type of oral lichen planus after comparing with the normal oral mucosa. Further studies are necessary to validate these findings using gene expression analysis. © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  11. Efficacy and safety of oral alitretinoin in severe oral lichen planus--results of a prospective pilot study.

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    Kunz, M; Urosevic-Maiwald, M; Goldinger, S M; Frauchiger, A L; Dreier, J; Belloni, B; Mangana, J; Jenni, D; Dippel, M; Cozzio, A; Guenova, E; Kamarachev, J; French, L E; Dummer, R

    2016-02-01

    Patients with severe oral lichen planus refractory to standard topical treatment currently have limited options of therapy suitable for long-term use. Oral alitretinoin (9-cis retinoic acid) was never systematically investigated in clinical trials, although case reports suggest its possible efficacy. To assess the efficacy and safety of oral alitretinoin taken at 30 mg once daily for up to 24 weeks in the treatment of severe oral lichen planus refractory to standard topical therapy. We conducted a prospective open-label single arm pilot study to test the efficacy and safety of 30 mg oral alitretinoin once daily for up to 24 weeks in severe oral lichen planus. Ten patients were included in the study. Primary end point was reduction in signs and symptoms measured by the Escudier severity score. Secondary parameters included pain and quality of life scores. Safety parameters were assessed during a follow-up period of 5 weeks. A substantial response at the end of treatment, i.e. >50% reduction in disease severity measured by the Escudier severity score, was apparent in 40% of patients. Therapy was well tolerated. Adverse events were mild and included headache, mucocutaneous dryness, musculoskeletal pain, increased thyroid-stimulating hormone and dyslipidaemia. Alitretinoin given at 30 mg daily reduced disease severity of severe oral lichen planus in a substantial proportion of patients refractory to standard treatment, was well tolerated and may thus represent one therapeutic option for this special group of patients. © 2015 European Academy of Dermatology and Venereology.

  12. Lichen planus induced by pegylated interferon alfa-2a therapy in a patient monitored for delta hepatitis.

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    Kaya, Safak; Arslan, Eyup; Baysal, Birol; Baykara, Sule Nergiz; Uzun, Ozlem Ceren; Kaya, Sehmuz

    2015-01-01

    Interferons are used for treatment of chronic hepatitis B. They can induce or exacerbate some skin disorders, such as lichen planus. In this study, as we know, we presented the first case developing lichen planus while receiving interferon treatment due to delta hepatitis. A 31-year-old male patient presented to our outpatient clinic with HBsAg positivity. With his analyses, HBV DNA was negative, anti-delta total was positive, ALT was 72 U/L (upper limit 41 U/L), and platelet was 119 000/mm(3). He was therefore started on subcutaneous pegylated interferon alfa-2a therapy at 180 mcg/week for delta hepatitis. At month 4 of therapy, the patient developed diffuse eroded lace-like lesions in oral mucosa, white plaques on lips, and itchy papular lesions in the hands and feet. Lichen planus was considered by the dermatology clinic and topical treatment (mometasone furoate) was given. The lesions persisted at month 5 of therapy and biopsy samples were obtained from oral mucosal lesions and interferon dose was reduced to 135 mcg/week. Biopsy demonstrated nonkeratinized stratified squamous epithelium; epithelial acanthosis, spongiosis, and apoptotic bodies were observed in the epidermis and therefore lichen planus was considered. At month 6 of therapy, lesions did not improve and even progressed and interferon treatment was therefore discontinued.

  13. Relationships of personality factors to perceived stress, depression, and oral lichen planus severity.

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    Mohamadi Hasel, Kurosh; Besharat, Mohamad Ali; Abdolhoseini, Amir; Alaei Nasab, Somaye; Niknam, Seyran

    2013-06-01

      The objective of this study is to examine relationships of hardiness and big five personality factors to depression, perceived stress, and oral lichen planus (OLP) severity. Sixty Iranian patients with oral lichen planus completed measures of perceived stress, hardiness, big five, and depression. Linear regressions revealed that control and challenge significantly predicted least perceived stress. On the contrary, big five factor of neuroticism predicted more perceived stress. Furthermore, control, commitment, and extraversion negatively predicted depression levels, but neuroticism positively predicted depression levels. Additionally, more levels of the challenge factor predicted fewer OLP scores while more levels of perceived stress predicted more OLP scores. The components of control challenge and neuroticism factors had a significant role in predicting perceived stress. On the other hand, the components of control and commitment and extraversion factors had a prominent role in predicting depression in patients with OLP, so personality constructs may have an effective role in triggering experience of stress, depression, and OLP itself. Additionally, interventions that enhance individual protective factors may be beneficial in reducing stress and depression in some severe diseases.

  14. Langerhans cells in lichen planus and lichenoid mucositis an immunohistochemical study

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    M Devi

    2014-01-01

    Full Text Available Aim: The aim of this study is to identify and evaluate Langerhans cell (LC in lichen planus (LP, lichenoid mucositis (LM and normal mucosa (NM using CD1a monoclonal antibody immunohistochemically. Materials and Methods: A total of 15 cases of oral lichen planus and 15 cases of LM were selected based on clinical examination and confirmed by histopathological analysis. The biopsies from the 10 patients were taken from normal buccal mucosa as control. Paraffin blocks of tissue were made, which are used for routine hematoxylin and eosin staining and immunohistochemical staining using biotin streptavidin methods (CD1a monoclonal antibody. Analysis of CD1a expression was performed by evaluating the labeling index (LI for each slide. Results: The mean CD1a LI for LP was significantly higher than that of LM and NM in the basal and supra basal layer. The mean CD1a positive cells in the connective tissues for LP were higher than that of LM and NM. Conclusion: This study clearly demonstrates a statistically significant increase in number of LC in LP than in LM, indicating the possible different immunopathogenic mechanisms.

  15. Case report and review of esophageal lichen planus treated with fluticasone

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    Ynson, Marie Lourdes; Forouhar, Faripour; Vaziri, Haleh

    2013-01-01

    Lichen planus is a fairly common chronic idiopathic disorder of the skin, nails and mucosal surfaces. Esophageal involvement of this disease on the other hand is rare and only about 50 cases have been reported in literature. Given its rarity, it can be difficult to diagnose and may be easily misdiagnosed as reflux esophagitis. Currently, there are no clear recommendations on the optimal management of this disease and little is known about the best treatment approach. Systemic steroids are usually the first line treatment and offer a favorable response. In this report, we would like to present a novel approach in the management of esophageal lichen planus in a middle-aged woman treated successfully with swallowed fluticasone propionate 220 mcg twice a day for 6 wk, as evidenced by objective clinical findings. Based on our review of related literature and experience in this patient, we feel that a trial of swallowed fluticasone may be a prudent approach in the management of these patients since it has a more favorable side effect profile than systemic treatment. PMID:23539434

  16. A prodigious lichen planus pigmentosus: The Wolf’s isotopic response

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    Yugandar I, Shiva Kumar, Sai Prasad, Srilakshmi P, Akshaya N, Abhiram R, Sujalalitha K, Meghana GB

    2014-07-01

    Full Text Available Lichen planus is a pruritic, benign, papulosquamous, inflammatory dermatosis of unknown etiology that affects either or all of the skin, mucous membrane, hair and nail. In its classic form, it presents with violaceous, scaly, flat-topped, polygonal papules. A female patient aged 43 years with a history of pruritic eruptions for a period of one month over the right armpit and back of the right chest (C8, T1, T2, T3 Dermatomes. She had a history of herpes zoster in the same localization, which had been treated with topical and oral acyclovir two months prior to this visit. This variant may represent as an example of the Wolf’s isotopic response. We presented our case because of its rarity as a Dermatomal distribution of lichen planus pigmentosus (LPP and its appearance in the area of healed herpes zoster as an isotopic response. The case well highlights this unusual condition and represents the first case reported in Indian dermatology literature to our best of knowledge. The clinical and histological features of this case are described here.

  17. Expression of COX-2 and bcl-2 in oral lichen planus lesions and lichenoid reactions

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    Arreaza, Alven J; Rivera, Helen; Correnti, María

    2014-01-01

    Oral lichen planus and lichenoid reactions are autoimmune type inflammatory conditions of the oral mucosa with similar clinical and histological characteristics. Recent data suggest that oral lichenoid reactions (OLR) present a greater percentage of malignant transformation than oral lichen planus (OLP). Objective To compare the expression of bcl-2 and COX-2 in OLP and OLR. Methods The study population consisted of 65 cases; 34 cases diagnosed as OLR and 31 as OLP. A retrospective study was done, and bcl-2 and COX-2 expression was semiquantitatively analysed. Results Fifty-three per cent (18/34) of the ORL samples tested positive for COX-2, whereas in the OLP group, 81% of the samples (25/31) immunostained positive for COX-2. The Fisher’s exact test for the expression of COX-2 revealed that there are significant differences between the two groups, P = 0.035. With respect to the expression of the bcl-2 protein, 76% (26/34) of the samples were positive in OLR, while 97% (30/31) were positive in the group with OLP. The Fisher’s exact test for the expression of bcl-2 revealed that there are significant statistical differences between the two groups, P = 0.028. Conclusions The expression of bcl-2 and COX-2 was more commonly expressed in OLP when compared with OLR. PMID:24834112

  18. Triggers of oral lichen planus flares and the potential role of trigger avoidance in disease management.

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    Chen, Hannah X; Blasiak, Rachel; Kim, Edwin; Padilla, Ricardo; Culton, Donna A

    2017-09-01

    Many patients with oral lichen planus (OLP) report triggers of flares, some of which overlap with triggers of other oral diseases, including oral allergy syndrome and oral contact dermatitis. The purpose of this study was to evaluate the prevalence of commonly reported triggers of OLP flares, their overlap with triggers of other oral diseases, and the potential role of trigger avoidance as a management strategy. Questionnaire-based survey of 51 patients with biopsy-proven lichen planus with oral involvement seen in an academic dermatology specialty clinic and/or oral pathology clinic between June 2014 and June 2015. Of the participants, 94% identified at least one trigger of their OLP flares. Approximately half of the participants (51%) reported at least one trigger that overlapped with known triggers of oral allergy syndrome, and 63% identified at least one trigger that overlapped with known triggers of oral contact dermatitis. Emotional stress was the most commonly reported trigger (77%). Regarding avoidance, 79% of the study participants reported avoiding their known triggers in daily life. Of those who actively avoided triggers, 89% reported an improvement in symptoms and 70% reported a decrease in the frequency of flares. Trigger identification and avoidance can play a potentially effective role in the management of OLP. Copyright © 2017 Elsevier Inc. All rights reserved.

  19. Can atrophic-erosive oral lichen planus promote cardiovascular diseases? A population-based study.

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    Conrotto, D; Barattero, R; Carbone, M; Gambino, A; Sciannameo, V; Ricceri, F; Conrotto, F; Broccoletti, R; Arduino, P-G

    2018-03-01

    Lichen planus has been recently associated with an increased risk of cardiovascular diseases (CVDs). The oral manifestations can be divided into white hyperkeratotic lesions (WL) and atrophic and erosive lesions (RL). The aim of this report was to compare the presence of CVDs between patients affected by WL or RL, to test the hypothesis that RL are associated with an increased incidence of CVDs. Patients were analysed through a complete collection of all the risk factors for CVDs. The primary endpoint was the occurrence of a cardiovascular event-acute coronary syndrome (ACS), any revascularization or stroke/TIA. A multivariable logistic regression model, adjusted for age at diagnosis, body mass index, smoking, alcohol consumption, diabetes, hypertension, CVDs familiarity and periodontitis, was performed. A prospective cohort of 307 patients has been evaluated; 185 (60.3%) had WL and 122 RL (39.7%). Twenty-four patients had a CVD. ACS occurred more frequently in RL (adjusted odds ratio 5.83; 95% CI: 1.16-29.39), mainly due to the higher risk of it after the histological diagnosis of Oral lichen planus OLP (odds ratio 4.23; 95% CI: 0.66-27.23). Patients with RL could possibly have a higher risk of developing ACS. Further analysis on larger cohort is however warranted. © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd. All rights reserved.

  20. Comparing clinical effects of photodynamic therapy as a novel method with topical corticosteroid for treatment of Oral Lichen Planus.

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    Bakhtiari, Sedigheh; Mojahedi, Seyyed Masoud; Azari-Marhabi, Saranaz; Namdari, Mahshid; Rankohi, Zahra Elmi

    2017-06-29

    Oral lichen planus is an autoimmune disorder with several challenges in treatment. Photodynamic therapy has been proposed as a new treatment option for the disease. The present study compared the clinical effects of the photodynamic therapy and dexamethasone mouthwash in the treatment of oral lichen planus lesions. In this randomized clinical trial, 30 patients with oral lichen planus were included.15 patients were treated with 5% methylene blue mediated photodynamic therapy using Fotosan device for 30seconds (630nm wavelength and 7.2-14.4J/CM2 dose) for 4 sessions in the days 1,4,7,14. In another group, the treatment was done on 15 patients by 0.5mg tab dexamethasone solution in 5cc water, rinsed 4 times in a day within two weeks. The sign score, symptoms scores (pain), clinical severity and treatment efficacy were measured at the days 15,30,60,90 after beginning of the treatment. The results were subjected to Mann-whitney U test in both groups. No significant difference existed between two modalities regarding the treatment efficacy index, sign score, symptom score and clinical severity on the 15, 30, 60 and 90 post-treatment days. Decreases in patient's symptoms were statistically significant in both groups. Photodynamic therapy was as effective as the dexamethasone mouth wash in the treatment of oral lichen planus It could be used as a safe modality in the treatment of oral lichen planus lesions without identified side effects. Copyright © 2017. Published by Elsevier B.V.

  1. The results of the analysis of lichen planus episodes in the Krasnodar region for 2012-2015years and its clinical features

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    Tlish M.M.

    2016-09-01

    Full Text Available Aim: to study the features of lichen planus in the Krasnodar region. Materials and methods. Total 68 clinical cases have been analyzed. The patients were subdivided into age groups in accordance with physiological age gradation. The Classification of lichen planus proposed by the Federal clinical guidelines for the management of patients with lichen planus (Moscow, 2015 was used. The diagnosis in each case was confirmed by histological examination of biopsy specimens of the skin. The data on the prevalence of lichen planus was obtained from the annual reports of the Clinical dermatovenerology dispensary of Krasnodar city from year 2012 to 2015. Results. Women were found to suffer

  2. Quality of Life and Sexual Distress in Women With Erosive Vulvovaginal Lichen Planus.

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    Cheng, Harriet; Oakley, Amanda; Conaglen, John V; Conaglen, Helen M

    2017-04-01

    Erosive vulvovaginal lichen planus (EVLP) is a chronic and painful genital dermatosis. Little is published about its impact on quality of life. This study aimed to evaluate quality of life and sexual function in women with EVLP. Women with genital dermatoses were surveyed using the Dermatology Life Quality Index (DLQI) and Hospital Depression and Anxiety Scales. A subgroup completed the Female Sexual Distress Scale and Female Sexual Function Index subscales. Patient characteristics including age, diagnosis, and current treatment were recorded. Results from women with EVLP were compared with other diagnoses. Data from 77 women who participated between March 2013 and March 2014 were analyzed. Of these, 17 had EVLP. Comparator groups included women with vulval lichen sclerosus (n = 48) and vulval dermatitis (n = 12). In women with EVLP, 59% reported at least moderate impact on quality of life; mean DLQI scores: EVLP, 7.18; lichen sclerosus, 3.79; dermatitis, 8.67; p = .008. Overall, scores suggested depression in 14% and anxiety in 16% of participants. Sexual distress scores 11 or higher were recorded by 69% of women with EVLP, 63% of women with lichen sclerosus, and 56% of women with dermatitis. In those completing all sections of the survey (n = 40), DLQI was significantly correlated with depression (p = .004), sexual distress (p = .001), and sexual satisfaction (p = .01). Sixty-nine percent of women with EVLP reported sexual distress. Women with EVLP reported lesser quality of life than those with lichen sclerosus. Quality of life, anxiety and depression, sexual distress, and sexual function were all related in these participants.

  3. Loss of Aβ-nerve endings associated with the Merkel cell-neurite complex in the lesional oral mucosa epithelium of lichen planus and hyperkeratosis.

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    Carrión, Daniela Calderón; Korkmaz, Yüksel; Cho, Britta; Kopp, Marion; Bloch, Wilhelm; Addicks, Klaus; Niedermeier, Wilhelm

    2016-03-30

    The Merkel cell-neurite complex initiates the perception of touch and mediates Aβ slowly adapting type I responses. Lichen planus is a chronic inflammatory autoimmune disease with T-cell-mediated inflammation, whereas hyperkeratosis is characterized with or without epithelial dysplasia in the oral mucosa. To determine the effects of lichen planus and hyperkeratosis on the Merkel cell-neurite complex, healthy oral mucosal epithelium and lesional oral mucosal epithelium of lichen planus and hyperkeratosis patients were stained by immunohistochemistry (the avidin-biotin-peroxidase complex and double immunofluorescence methods) using pan cytokeratin, cytokeratin 20 (K20, a Merkel cell marker), and neurofilament 200 (NF200, a myelinated Aβ- and Aδ-nerve fibre marker) antibodies. NF200-immunoreactive (ir) nerve fibres in healthy tissues and in the lesional oral mucosa epithelium of lichen planus and hyperkeratosis were counted and statistically analysed. In the healthy oral mucosa, K20-positive Merkel cells with and without close association to the intraepithelial NF200-ir nerve fibres were detected. In the lesional oral mucosa of lichen planus and hyperkeratosis patients, extremely rare NF200-ir nerve fibres were detected only in the lamina propria. Compared with healthy tissues, lichen planus and hyperkeratosis tissues had significantly decreased numbers of NF200-ir nerve fibres in the oral mucosal epithelium. Lichen planus and hyperkeratosis were associated with the absence of Aβ-nerve endings in the oral mucosal epithelium. Thus, we conclude that mechanosensation mediated by the Merkel cell-neurite complex in the oral mucosal epithelium is impaired in lichen planus and hyperkeratosis.

  4. Clinical Management Protocol for Dental Implants Inserted in Patients with Active Lichen Planus.

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    Aboushelib, Moustafa Nabil; Elsafi, Mohammed Hamdy

    2017-01-01

    To propose a treatment protocol for management of implant candidates suffering from active lichen planus. Twenty-three patients who were diagnosed with active lichen planus were referred to a dental practice seeking dental implants. Patients received dental implants using open flap technique and sequential osteotomy. After a healing time of 6 weeks, implants were put into occlusal contact using interim prostheses. Of the 55 inserted implants, 42 failed after a short clinical service time (7 to 11 weeks). Failed implants were surgically removed, and osteotomy sites were carefully cleaned using manual curettes and scrubbing of osteotomy walls. CD4/CD8 cell count and gingival biopsies were collected from the surgical sites. Patients were put on an ascending dose (5 mg/10 days) of oral corticosteroids until a daily dose of 20 mg/day was achieved and maintained for 2 weeks. All patients received ten sessions of low-energy soft tissue laser irradiation at the implant insertion sites to assess soft tissue healing through improving blood circulation, reduction of inflammation, and sterilization of the osteotomy region. After approximately 8 weeks, a new set of 42 implants was placed, and definitive restorations were cemented using early loading technique. Marginal bone levels around inserted implants were periodically evaluated every 3 months using digital periapical radiographs (α = 0.05). Primary blood tests revealed a high CD8 cell count, while soft tissue biopsies revealed infiltration of inflammatory cells at the epithelium soft tissue interface of the examined tissue. Repetition of immunological investigations after administration of the oral corticosteroids and soft tissue laser irradiation revealed reduction of CD8 cell counts and disappearance of inflammatory cell infiltration of the examined soft tissue biopsy. Patients reported marked improvement of the oral mucosa after treatment. All implants (n = 42) were functional after 3 years of clinical observation

  5. Serum level of Interleukin-8 in subjects with diabetes, diabetes plus oral lichen planus, and oral lichen planus: A biochemical study

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    Atefeh Tavangar

    2016-01-01

    Full Text Available Background: Correlation between diabetes mellitus (DM and oral lichen planus (OLP seems probable. Since Interleukin-8 (IL-8 is an important inflammatory mediator involved in both conditions, this study aimed to measure and compare the serum level of IL-8 in DM, OLP, and DM + OLP patients in comparison with healthy individuals. Materials and Methods: This cross sectional study was conducted on 75 patients (30 OLP, 5 OLP and type II DM, 20 type II DM, and 20 healthy controls. Serum levels of IL-8, fasting blood sugar (FBS and 2-h postprandial blood sugar were measured in the four groups. Data were analyzed using SPSS version 20 by one-way ANOVA and post_hocleast significant difference test. Results: Type II DM patients with OLP had the highest mean serum level of IL-8 followed by OLP, DM and control groups, respectively. Pairwise comparison of groups revealed significant differences in serum IL-8 between the control and OLP and also control and OLP+DM (P < 0.05 groups. No other significant differences were noted. The mean levels of FBS and 2-h postprandial blood sugar were the highest in OLP+DM patients followed by DM, OLP and control groups, respectively. Conclusion: The ascending trend of serum level of IL-8 in the control, DM, OLP, and DM+OLP patients may indicate the role of this factor in the pathogenesis of DM and OLP. Moreover, it may play a synergistic role in patients suffering from both conditions.

  6. INTERDISCIPLINARY APPROACH IN COMPEX TREATMENT OF ORAL LICHEN RUBER PLANUS /Review and a Case report/

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    Atanaska Dinkova

    2010-07-01

    Full Text Available Lichen planus(LPis a common chronic muco­cuta­neous disease of unknown etiology. Usually, it presents with lesions on the flexor surfaces of the upper extremities, genitalia and mucous membranes. Oral lesions can be the initial as well as the only manifestations of this condition. Patients with LP can present first to the general dental practitioner so sufficient knowledge on this condition is important for the proper diagnosis, treatment and prevention of further complications. The clinical management of LRP requires liaison between dental and medical specialists.This article provides a review of the current literature on LP and a case report of a 55 years old female suffering with this condition. A multidisciplinary approach in the diagnosis and management of this case is described.

  7. Hypertrophic lichen planus as a presenting feature of human immunodeficiency virus infection

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    Kumari Rashmi

    2009-01-01

    Full Text Available Lichen planus (LP is a chronic papulosquamous dermatosis in which both skin and mucous membranes may be involved. To date, there have been only five reports of human immunodeficiency virus (HIV-positive patients with hypertrophic LP. In the present report, we describe a 37-year-old female who presented with widely distributed, hyperpigmented, pruritic scaly lesions involving the face, trunk, and upper and lower extremities for one month. She also had swelling of both lower legs with low grade fever for past one week. She was diagnosed to be a HIV-positive patient who had severe, widespread hypertrophic LP lesions along with acute eruptive lesions of LP. These LP lesions were a presenting feature of HIV infection in our case.

  8. Diagnostics of oral lichen planus based on analysis of volatile organic compounds in saliva

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    Kistenev, Yury; Borisov, Alexey; Shapovalov, Alexander; Baydik, Olga; Titarenko, Maria

    2017-03-01

    The ability of diagnostics of oral lichen planus (OLP) based on spectral analysis of saliva using the THz spectroscopy is presented. The study included 8 patients with clinically proven OLP. The comparison group consisted of 8 healthy volunteers. Absorption spectra of the saliva was measured using time-domain spectrometer T-spec (EXPLA) in the range 0.2-3THz and have been considered as the feature vectors of the state. The spatial distribution of the objects under study in the feature space was analyzed using principle component analysis. The groups under study were shown to separate in full. Thus, the saliva analysis by the THz spectroscopy technique can be potentially used as a method of noninvasive diagnostics of the OLP.

  9. Oral symptoms and salivary findings in oral lichen planus, oral lichenoid lesions and stomatitis

    DEFF Research Database (Denmark)

    Larsen, Kristine Roen; Johansen, Jeanne Duus; Reibel, Jesper

    2017-01-01

    BACKGROUND: To examine if patients with oral lichen planus, oral lichenoid lesions and generalised stomatitis and concomitant contact allergy have more frequent and severe xerostomia, lower unstimulated and chewing-stimulated saliva and citric-acid-stimulated parotid saliva flow rates, and higher...... salivary concentration of total protein and sIgA than cases without contact allergy and healthy controls. METHODS: Forty-nine patients (42 women, aged 61.0 ± 10.3 years) and 29 healthy age- and gender-matched subjects underwent a standardised questionnaire on general and oral health, assessment...... in patients (46.9%) than in healthy controls, whereas the saliva flow rates did not differ. The patients had higher sIgA levels in unstimulated and chewing-stimulated saliva than the healthy controls. The total protein concentration in saliva was lower in the unstimulated saliva samples whereas it was higher...

  10. Lichen Planus Pemphigoides Presenting Preferentially Over Preexisting Scars: A Rare Instance of Isotopic Phenomenon

    Science.gov (United States)

    Kumar, Piyush; Savant, Sushil S; Das, Anupam; Hassan, Shahid; Barman, Panchami Deb

    2015-01-01

    An 18-year-old girl presented with multiple itchy hyperpigmented papules and plaques, along with tense blisters over the lower limbs and buttocks for last 3 months. These papules, plaques, and bullae were mostly localized to preexisting scars. The histopathological findings from papule and bulla were consistent with lichen planus (LP) and bullous pemphigoid, respectively. Direct immunofluorescence (DIF) of perilesional skin around bulla showed linear deposition of IgG and C3. Considering clinical, histopathological and DIF findings, diagnosis of LP pemphigoides (LPP) was made. The preferential localization of LPP lesions over preexisting scars was a very interesting finding in our case an extremely rare instance of the isotopic phenomenon. PMID:26677275

  11. Comparative Evaluation of EGF in Oral Lichen Planus and Oral Squamous Cell Carcinoma

    Directory of Open Access Journals (Sweden)

    Farzaneh Agha-Hosseini

    2015-10-01

    Full Text Available Oral lichen planus (OLP is classified as a potential malignant disorder, and epidermal growth factor (EGF may play a key role in cancer development. The aim of this study was to compare serum and saliva EGF among patients with OLP and oral squamous cell carcinoma (OSCC. A cross-sectional study was performed on 27 patients with OLP (10 reticular and 17 atrophic-erosive forms, 27 patients with OSCC and 27 healthy control group. The study was conducted at the Cancer Department, Clinic of Oral Medicine, Tehran University of Medical Sciences. The serum and saliva EGF were assayed by ELISA method. Statistical analysis of ANOVA was used. The mean serum EGF in OLP and OSCC patients was significantly lower compared to healthy control group (P

  12. In situ expression and serum level of thymic stromal lymphopoietin in oral lichen planus.

    Science.gov (United States)

    Sun, Mingxia; Tan, Wanye; Liu, Shaohua; Liu, Guixiang; Zhang, Xiaoying; Wang, Ning; Qu, Xun; Wei, Fengcai

    2014-11-01

    Oral lichen planus (OLP) is a chronic inflammatory disease of oral mucosa in which the CD8(+) T cell-mediated cytotoxicity is regarded as a major mechanism of pathogenesis. The main objective of this study is to investigate in situ expression and secretion of thymic stromal lymphopoietin (TSLP) in specimens and sera from patients with oral lichen planus. Thirty-six patients with OLP and 35 donors enrolled in specimen and serum collection. Immunohistochemical method and immunofluorescence double-staining method were used to detect the expression of thymic stromal lymphopoietin and its receptor (TSLPR) together with CD8 in OLP specimens. Enzyme-linked immunosorbent assay (ELISA) was used to detect TSLP secretion. More TSLP- or TSLPR-positive cells showed in OLP specimens than in normal controls, and TSLP-positive cells were mainly in the epithelium, while TSLPR-positive cells mainly in the lamina propria. Furthermore, the number of TSLP-positive cells in the stratum basal was associated with the amount of mononuclear cells infiltrating in the lamina propria of OLP specimens. Among infiltrating mononuclear cells in the lamina propria, some CD8-positive cells also expressed TSLPR. The TSLP serum level of patients with OLP was significantly higher than of healthy donors, but there was no statistically difference between two clinical subtypes of OLP. Our findings provided the first evidence that TSLP may enroll in the pathology of OLP and the TSLP-TSLPR interaction may play an important role in it. © 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  13. CLA and CD62E expression in oral lichen planus lesions.

    Science.gov (United States)

    Werneck, Juliana Tristão; Dias, Eliane Pedra; Gonçalves, Lucio Souza; Silva Junior, Arley

    2016-03-01

    There are few reports on the migration of CLA+ T cells through E-selectin in cutaneous lichen planus, with only one study on oral lichen planus (OLP). This study aimed to analyze CLA expression and assess whether there is a correlation with E-selectin (CD62E) in OLP lesions. Biopsies were performed on 11 patients including two areas: one without clinical and histopathological features of OLP [perilesional group (PLG)] and the other with clinical and histopathological features of OLP [OLP group (OLPG)]. The specimens obtained were divided into two: One was fixed in formalin for routine analysis (H&E), and the other was frozen for CD3, CD4, CD8, CLA, and CD62E immunofluorescence markers. More CD4+ (median 1409, range 860-2519), CD8+ (median 1568, range 654-3258), and CLA+ T cells (median 958, range 453-2198) and higher CD62E expression (median 37, range 27-85) were identified in OLPG (P = 0.003; P = 0.003; P = 0.004; P = 0.003, respectively) than those in PLG. The median prevalence analysis was also significantly higher for CLA+CD8+ T cells in OLPG (OLPG = 39.4%, range 18.4-64.2; PLG = 29.4%, range 12.1-47.1) (P = 0.026). None of the correlations between CD3+ or CLA+ T cells and CD62E in OLPG and in PLG were significant. The significant presence of CLA+ T cells and E-selectin expressions in the OLPG suggests their involvement in the etiopathogenesis of OLP; however, only a weak correlation between CLA+ T cells and E-selectin was observed. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  14. Evaluation of the content quality of websites for recurrent aphthous ulcers and oral lichen planus.

    Science.gov (United States)

    Hu, Xiaosheng; Pan, Hui; He, Wenxiu; Hua, Hong; Yan, Zhimin

    2017-12-29

    The Internet is one of the most popular resources for people to obtain medical information; however, only a limited number of studies have reported the quality of the available health information related to oral mucosal diseases. The present study aimed to evaluate the quality of information on websites for recurrent aphthous ulcers (RAU) and oral lichen planus (OLP), in both Chinese and English. Common search engines, BaiDu, Google, and Yahoo in Chinese; and Bing, Google, and Yahoo in English were used to identify websites providing content related to the oral mucosal diseases. The first 100 links for keywords "recurrent aphthous ulcers" and "oral lichen planus" were visited and content was downloaded within 24 h. Two separate trained researchers use the validated DISCERN rating instrument and JAMA benchmarks to evaluate the content. The rating scores were analyzed and the quality was assessed according to the scores and content of websites. A total of 145 websites for RAU and 128 of OLP were analyzed. Based on the DISCERN instrument, the quality of the content in websites for both diseases, whether in English or Chinese, was not high, generally scoring 2 to 3 (max. 5). Only 13 of the RAU websites and 21 of the OLP websites fulfilled the four criteria of the JAMA benchmarks. Generally, the scores of the English websites were higher than those of the Chinese websites. During the twelve searches, only four (Yahoo of RAU in Chinese, Bing and Yahoo of RAU in English, and Google of OLP in Chinese) showed moderate correlation between the website's ranking and their rating scores. People cannot obtain high quality medical information if they only look at the top ranked sites on the viewing lists. Websites belonging to universities or medical centers had relatively higher scores compared with the others. The quality of the content on websites relating to RAU and OLP in Chinese and English was moderate. More good quality websites and information are needed in the future.

  15. Association of vdr, cyp27b1, cyp24a1 and mthfr gene polymorphisms with oral lichen planus risk.

    Science.gov (United States)

    Kujundzic, Bojan; Zeljic, Katarina; Supic, Gordana; Magic, Marko; Stanimirovic, Dragan; Ilic, Vesna; Jovanovic, Barbara; Magic, Zvonko

    2016-05-01

    The current study investigated the association between VDR EcoRV (rs4516035), FokI (rs2228570), ApaI (rs7975232) and TaqI (rs731236), CYP27B1 (rs4646536), CYP24A1 (rs2296241), and MTHFR (rs1801133) gene polymorphisms and risk of oral lichen planus (OLP) occurrence. The study group consisted of 65 oral lichen planus patients and 100 healthy blood donors in the control group. Single nucleotide polymorphisms were genotyped by real time PCR or PCR-restriction fragment length polymorphism (RFLP) method. Heterozygous as well as mutated genotype of vitamin D receptor (VDR) FokI (rs2228570) polymorphism was associated with increased oral lichen planus risk in comparison with wild type genotype (odds ratio (OR) = 3.877, p = 0.017, OR = 38.153, p = 0.001, respectively). A significantly decreased OLP risk was observed for heterozygous genotype of rs2296241 polymorphism in CYP24A1 gene compared with the wild type form (OR = 0.314, p = 0.012). VDR gene polymorphisms ApaI and TaqI were in linkage disequilibrium (D' = 0.71, r(2) = 0.22). Identified haplotype AT was associated with decreased OLP risk (OR = 0.592, p = 0.047). Our results highlight the possible important role of VDR FokI (rs2228570) and CYP24A1 rs2296241 gene polymorphisms for oral lichen planus susceptibility. Identification of new molecular biomarkers could potentially contribute to determination of individuals with OLP predisposition.

  16. Potential pathogenetic role of Th17, Th0, and Th2 cells in erosive and reticular oral lichen planus.

    Science.gov (United States)

    Piccinni, M-P; Lombardelli, L; Logiodice, F; Tesi, D; Kullolli, O; Biagiotti, R; Giudizi, Mg; Romagnani, S; Maggi, E; Ficarra, G

    2014-03-01

    The role of Th17 cells and associated cytokines was investigated in oral lichen planus. 14 consecutive patients with oral lichen planus were investigated. For biological studies, tissues were taken from reticular or erosive lesions and from normal oral mucosa (controls) of the same patient. mRNA expression for IL-17F, IL-17A, MCP-1, IL-13, IL-2, IL-10, IL-1β, RANTES, IL-4, IL-12B, IL-8, IFN-γ, TNF-α, IL-1α, IL-18, TGF-β1, IL-23R, IL-7, IL-15, IL-6, MIG, IP-10, LTB, VEGF, IL-5, IL-27, IL-23A, GAPDH, PPIB, Foxp3, GATA3, and RORC was measured using the QuantiGene 2.0. Results showed that Th17-type and Th0-type molecules' mRNAs, when compared with results obtained from tissue controls, were increased in biopsies of erosive lesions, whereas Th2-type molecules' mRNAs were increased in reticular lesions. When the CD4+ T-cell clones, derived from oral lichen planus tissues and tissue controls, were analyzed, a higher prevalence of Th17 (confirmed by an increased CD161 expression) and Th0 CD4+ T clones was found in erosive lesions, whereas a prevalence of Th2 clones was observed in reticular lesions. Our data suggest that Th17, Th0, and Th2 cells, respectively, may have a role in the pathogenesis of erosive and reticular oral lichen planus. © 2013 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  17. Evaluation of Cellular Proliferative Activity in Patients with Oral Lichen Planus and Hepatitis C through AgNOR Method

    OpenAIRE

    Carli, João Paulo De; Silva, Soluete Oliveira da; Linden, Maria Salete Sandini; Busin, Carmen Silvia; Paranhos, Luiz Renato; Souza, Paulo Henrique Couto

    2014-01-01

    The objective of this study was to evaluate the cellular proliferative potential of oral lichen planus (OLP) lesions from patients without hepatitis C virus (HCV) by means of AgNOR method, as well as the cellular proliferative potential of the normal oral mucosa from patients with HCV, treated or untreated by interferon and ribavirin. A cross-sectional study was developed to investigate four groups: 10 HCV+ patients without clinical signs of OLP who had never been treated for HCV infection - ...

  18. LCK, survivin and PI-3K in the molecular biomarker profiling of oral lichen planus and oral squamous cell carcinoma

    OpenAIRE

    Oluwadara, Oluwadayo; Giacomelli, Luca; Christensen, Russell; Kossan, George; Avezova, Raisa; Chiappelli, Francesco

    2009-01-01

    T cell signaling is critical in oral lichen planus (OLP) based on the pathogenesis of this chronic inflammatory autoimmune mucocutaneous lesion. Lck plays a key role in T cell signaling; ultimately this signaling affects other targets such as PI-3K. Excessive activity in PI-3K inhibits apoptosis and promotes uncontrolled cell growth. Molecular biomarker profiling in OLP, Chronic Interface Mucosities (CIM), Epithelial Dysplasia (EpD) and Oral Squamous Cell Carcinoma (SCCA) with application of ...

  19. Histomorphometric analysis of nuclear and cellular volumetric alterations in oral lichen planus, lichenoid lesions and normal oral mucosa using image analysis software.

    Science.gov (United States)

    Venkatesiah, Sowmya S; Kale, Alka D; Hallikeremath, Seema R; Kotrashetti, Vijayalakshmi S

    2013-01-01

    Lichen planus is a chronic inflammatory mucocutaneous disease that clinically and histologically resembles lichenoid lesions, although the latter has a different etiology. Though criteria have been suggested for differentiating oral lichen planus from lichenoid lesions, confusion still prevails. To study the cellular and nuclear volumetric features in the epithelium of normal mucosa, lichen planus, and lichenoid lesions to determine variations if any. A retrospective study was done on 25 histologically diagnosed cases each of oral lichen planus, oral lichenoid lesions, and normal oral mucosa. Cellular and nuclear morphometric measurements were assessed on hematoxylin and eosin sections using image analysis software. Analysis of variance test (ANOVA) and Tukey's post-hoc test. The basal cells of oral lichen planus showed a significant increase in the mean nuclear and cellular areas, and in nuclear volume; there was a significant decrease in the nuclear-cytoplasmic ratio as compared to normal mucosa. The suprabasal cells showed a significant increase in nuclear and cellular areas, nuclear diameter, and nuclear and cellular volumes as compared to normal mucosa. The basal cells of oral lichenoid lesions showed significant difference in the mean cellular area and the mean nuclear-cytoplasmic ratio as compared to normal mucosa, whereas the suprabasal cells differed significantly from normal mucosa in the mean nuclear area and the nuclear and cellular volumes. Morphometry can differentiate lesions of oral lichen planus and oral lichenoid lesions from normal oral mucosa. Thus, morphometry may serve to discriminate between normal and premalignant lichen planus and lichenoid lesions. These lesions might have a high risk for malignant transformation and may behave in a similar manner with respect to malignant transformation.

  20. Brn2 Is a Transcription Factor Regulating Keratinocyte Differentiation with a Possible Role in the Pathogenesis of Lichen Planus

    Science.gov (United States)

    Shi, Ge; Sohn, Kyung-Cheol; Choi, Dae-Kyoung; Kim, Yu-Jin; Kim, Seong-Jin; Ou, Bai-Sheng; Piao, Yong-Jun; Lee, Young Ho; Yoon, Tae-Jin; Lee, Young; Seo, Young-Joon; Kim, Chang Deok; Lee, Jeung-Hoon

    2010-01-01

    Terminal differentiation of skin keratinocytes is a vertically directed multi-step process that is tightly controlled by the sequential expression of a variety of genes. In this study, we investigated the role of the POU domain-containing transcription factor Brn2 in keratinocyte differentiation. Immunohistochemical analysis showed that Brn2 is expressed primarily in the upper granular layer. Consistent with its epidermal localization, Brn2 expression was highly induced at 14 days after calcium treatment of cultured normal human epidermal keratinocytes. When Brn2 was overexpressed by adenoviral transduction, Brn2 led to increased expression of the differentiation-related genes involucrin, filaggrin, and loricrin in addition to inhibition of their proliferation. Chromatin immunoprecipitation demonstrated that Brn2 bound to the promoter regions of these differentiation-related genes. We injected the purified Brn2 adenovirus into rat skin, which led to a thickened epidermis with increased amounts of differentiation related markers. The histopathologic features of adenovirus-Brn2 injected skin tissues looked similar to the features of lichen planus, a human skin disease showing chronic inflammation and well-differentiated epidermal changes. Moreover, Brn2 is shown to be expressed in almost all cell nuclei of the thickened epidermis of lichen planus, and Brn2 also attracts T lymphocytes. Our results demonstrate that Brn2 is probably a transcriptional factor playing an important role in keratinocyte differentiation and probably also in the pathogenesis of lichen planus lesions. PMID:20967260

  1. The efficacy of aloe vera in management of oral lichen planus: a systematic review and meta-analysis.

    Science.gov (United States)

    Ali, S; Wahbi, W

    2017-10-01

    The main objective of oral lichen planus management is to control symptomatic outbreaks via eliminating lesions and alleviating symptoms. Corticosteroids, calcineurin inhibitors, and most of the available modalities are associated with adverse effects, which may limit their use. The aim of this review was to assess the effect of aloe vera on pain alleviation and/or clinical improvement in patients with symptomatic oral lichen planus. MEDLINE-PubMed; CENTRAL, and LILACS were searched in May 2016 to identify all clinical trials evaluating aloe vera vs placebo or corticosteroids for treatment of oral lichen planus. The included studies were five clinical trials and two case reports. From the included studies, there is weak evidence that aloe vera is more efficient than placebo and has comparable effect to triamcinolone acetonide. The meta-analyses show heterogeneity and reveals that aloe vera is inferior to the control in general. Although corticosteroids are still the gold standard, aloe vera shows promising results especially with no adverse effects compared with various adverse effects of corticosteroids. We recommend conducting new randomized clinical trials with larger sample size, sufficiently long follow-up period as well as standardized aloe vera formulations and outcome measures. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  2. Epidemiological evidence of the association between lichen planus and two immune-related diseases. Alopecia areata and ulcerative colitis. Gruppo Italiano Studi Epidemiologici in Dermatologia.

    Science.gov (United States)

    1991-05-01

    Between September 1986 and February 1988, a case-control study involving 27 Italian dermatological centers collaborating in the Gruppo Italiano Studi Epidemiologici in Dermatologia was conducted, concerning the relationship between history of several medical conditions and exposures to drugs and the risk of lichen planus. The cases were all consecutive patients with a new diagnosis of lichen planus, and the controls were patients under dermatological care observed under the same conditions. A total of 711 cases and 1395 controls met the admission criteria and were interviewed by trained investigators. Patients with histories of alopecia areata were found to be at risk for lichen planus (relative risk = 2.7; 95% confidence interval, 1.1 to 6.5). Five patients (0.7%) in the group with lichen planus had a history of ulcerative colitis, while none of the controls had this disease. The risk of lichen planus was also increased in patients with a history of chronic active hepatitis, but this increase was not statistically significant (relative risk = 4.7; 95% confidence interval, 0.7 to 29.4).

  3. Psychoneuroimmunology in oral biology and medicine: the model of oral lichen planus.

    Science.gov (United States)

    Prolo, Paolo; Chiappelli, Francesco; Cajulis, Elaina; Bauer, Janet; Spackman, Susan; Romeo, Horacio; Carrozzo, Marco; Gandolfo, Sergio; Christensen, Russell

    2002-06-01

    Rheumatoid arthritis involves psychoneuroendocrine-immunopathological comorbidities. In the stoma, patients with rheumatoid arthritis frequently show signs of periondontal disease consequent to elevated levels of crevicular proinflammatory cytokines. It is not clear whether rheumatoid arthritis may manifest in association with immunopathological manifestations of the oral soft mucosa. Oral lichen planus (OLP), first described by E. Wilson in 1859, is a T-cell-mediated inflammatory disease whose lesions characteristically lack B cells, plasma cells, immunoglobulin. or complement. It is increasingly well characterized and recognized as a model for psychoneuroimmunology research in oral biology and medicine. To date, we have shown an association between changes in hypothalamic-pituitary-adrenal (HPA) regulation, systemic markers of cellular immunity and mood states, with clinical stages of OLP (i.e., atrophic vs. erosive vs. bullous lesions). We report significant associations (p < 0.05) between the stage of OLP, HPA deregulation, and altered distribution and functional responses of naïve CD4(+) cells. We emphasize the need to study in greater details the psychoneuroendocrine-immune inter-relationships in OLP, and we propose a novel neuroimmune hypothesis for OLP.

  4. Salivary concentration of the antimicrobial peptide LL-37 in patients with oral lichen planus

    Directory of Open Access Journals (Sweden)

    Sotiria Davidopoulou

    2014-12-01

    Full Text Available Background: The antimicrobial peptide LL-37 is a significant molecule of innate immunity and recent studies indicate that it plays an important role in maintaining oral health. Yet limited knowledge exists on its role in oral diseases and oral lichen planus (OLP in particular. Objective: The study aimed to examine: 1 the salivary concentration of LL-37 in patients with OLP and healthy subjects, 2 the relation between the type (reticular or erosive and size of OLP lesions and LL-37 concentration, and 3 the effect of the therapeutic modalities on LL-37 levels. Design: The salivary peptide concentration in samples from 20 patients and 30 healthy subjects at the same age range was determined by ELISA. Results: Despite the wide variation in peptide concentration found in both groups, the healthy subjects exhibited significantly lower levels than patients. Patients with the erosive form had significantly higher peptide concentrations than patients with the reticular form. Systemic treatment with corticosteroids resulted in a significant decrease of the salivary peptide concentration, while other treatment modalities, such as administration of vitamins A and E or local application of corticosteroids had no effect. Improved clinical appearance of the lesions was followed by a decrease in the salivary LL-37 level. Conclusions: Salivary concentration of LL-37 correlates to the manifestation of mucosa lesions in OLP patients, the highest levels being observed in the most severe cases. This increase in peptide levels may protect against lesion infection and promote a quick wound healing.

  5. Oral lichen planus versus oral lichenoid reaction: Difficulties in the diagnosis

    Directory of Open Access Journals (Sweden)

    Do Prado Renata

    2009-01-01

    Full Text Available Lichen planus (LP is a mucocutaneous disease with well-established clinical and microscopic features. The oral mucosa and skin may present clinical and microscopic alterations similar to those observed in LP, called lichenoid reactions (LRs, which are triggered by systemic or topical etiological agents. The difficulties faced to establish the differential diagnosis between the two pathologies were investigated in the literature. It was observed that the etiology of LP is still under discussion, with a tendency to self-immunity, while the etiology of LRs is related to the contact with specific agents, such as metallic restorative materials, resins, and drugs, allowing the establishment of a cause-effect relationship. In this case, the disease is caused by the antigen fixation in the epithelial cells, which are destructed by the immune system. Based on these data, protocols are suggested for this differentiation. The important role played by the integration between the clinician and the oral pathologist in the diagnostic process is highlighted. The treatment of LP comprises mainly the utilization of corticosteroids and the LR is treated by removal of the causal factor. Differentiation between the two diseases allows an effective and correct therapeutic approach.

  6. Four cases of mucous membrane pemphigoid with clinical features of oral lichen planus.

    Science.gov (United States)

    Fukuda, Aoi; Himejima, Akio; Tsuruta, Daisuke; Koga, Hiroshi; Ohyama, Bungo; Morita, Shosuke; Hashimoto, Takashi

    2016-06-01

    Mucous membrane pemphigoid (MMP) and oral lichen planus (OLP) show similar clinical features on the oral mucosa. As clinical manifestations of oral mucosal lesions, MMP shows blisters and erosions, whereas OLP shows lace-like whitish lesions in an annular arrangement with erythema and erosions. Histopathologically, MMP shows subepithelial bullae with infiltrates of lymphocytes and neutrophils, whereas OLP shows band-like interface infiltration of lymphocytes with damage in basal cells. However, these two diseases are frequently difficult to distinguish both clinically and histopathologically. We report four patients with oral MMP who showed OLP-like clinical and histopathological lesions. We performed direct immunofluorescence, indirect immunofluorescence of normal human skin and 1 m NaCl-split skin, enzyme-linked immunosorbent assays for BP180, BP230, and desmogleins 1 and 3, and immunoblotting of normal human epidermal and dermal extracts, recombinant proteins of BP180-NC16a and -C-terminal domains, concentrated culture supernatant of HaCaT cells, and purified laminin-332. The results of various immunological studies suggested the diagnoses of various types of MMP for all four patients. Because MMP and OLP require different treatments, all dentists and dermatologists should have knowledge about the disease entity and the serological diagnostic methods for various types of MMP. © 2015 The International Society of Dermatology.

  7. The frequency and malignant transformation rate of oral lichen planus and leukoplakia--a retrospective study.

    Science.gov (United States)

    Brzak, Bozana Loncar; Mravak-Stipetić, Marinka; Canjuga, Ivana; Baricević, Marinka; Balicević, Drinko; Sikora, Miroslav; Filipović-Zore, Irina

    2012-09-01

    The aim of this retrospective study was to determine the frequency and malignant transformation rate of oral lichen planus and leukoplakia in a large group of oral medicine patients. Study included 12 508 patients who were referred between 1998 and 2007 to the Department of Oral Medicine. The frequency of OLP was 4.30%, leukoplakia 1.11%, and combined diagnoses 0.14%. In primary biopsies dysplasia was found in 12.96% of patients with leukoplakia and not in one with OLP and combined lesions. The highest frequency of leukoplakia was found in smokers. Women were found as predominant sufferers of both diseases and their combination. During the observed period often years malignant transformation of OLP was not detected, unlike leukoplakia where it was 0.64%. The frequency of OLP and leukoplakia in our study are comparable to other similar studies. The highest frequency of malignant transformation was observed in those patients who did not respond to our invitation to regular check-up. It is therefore neccessary to perform a detailed examination of the oral cavity in these patients and to raise patients awareness of the disease and the importance of regular follow-up.

  8. Photodynamic therapy of oral leukoplakia and oral lichen planus using methylene blue: A pilot study

    Directory of Open Access Journals (Sweden)

    Savarimuthu Wilfred Prasanna

    2015-01-01

    Full Text Available Premalignant lesions like oral lichen planus (OLP, oral leukoplakia (OL has a fair probability of transforming into malignancy and they are perverse toward conventional therapies. Photodynamic therapy (PDT has been considered as an alternative/complimentary therapeutic modality for the management of premalignant lesions. In this study, methylene blue-mediated photodynamic therapy (MB-PDT was used as a possible alternative method for the treatment of OLP and OL. A total of 15 OLP lesions and 13 OL lesions were enrolled in the study. The patients were irradiated using metal halide lamp filtered at 630 ± 10 nm, with a light exposure dose of 120 J/cm2 per sitting. For the OLP lesions, MB-PDT was performed once a week for four weeks and for the OL lesions, MB-PDT was performed twice a week for three weeks. Lesions were evaluated pre- and post- and at follow-up sessions by changes in sign and symptom scores, and size of lesions. We have observed a 53.3% of complete reduction in the treated OLP lesions and their decrease in size, sign and symptom score after treatment and at follow-up session was statistically significant. We have also observed complete response for one OL lesion of the 13 treated lesions. The result indicates that MB-PDT is an effective modality in management of OLP and OL. Among the two types of premalignancies treated with MB-PDT, OLP lesions responded much better than that of OL.

  9. Assessing the clinical effectiveness of an algorithmic approach for mucosal lichen planus (MLP): A retrospective review.

    Science.gov (United States)

    Ashack, Kurt A; Haley, Laura L; Luther, Chelsea A; Riemer, Christie A; Ashack, Richard J

    2016-06-01

    Mucosal lichen planus (MLP) is a therapeutic challenge in need of a new treatment approach because of its debilitating effect on patient's quality of life. We sought to evaluate a standardized treatment plan for patients with MLP. A second objective was to describe the effect of mycophenolate mofetil in this patient population. The study retrospectively analyzed 53 patients with MLP treated using a standardized algorithm. The number of MLP lesions, disease activity, and pain at the last visit were compared with baseline scores determined at the initial visit. Results were analyzed using the paired samples t test and confirmed with the Wilcoxon matched pairs signed rank test. The average number of lesions was reduced from 3.77 to 1.67 (P < .001). The average disease activity was reduced from 2.73 to 0.90 (P < .001). Average pain reported decreased from 2.03 to 1.03 (P < .001). This study was a retrospective analysis of a small patient population. There was no universal symptom severity scale used at the time of treatment for some patients. The standardized treatment plan reduced symptoms for patients with MLP. Mycophenolate mofetil appears to be a reasonable treatment option for these patients. Copyright © 2016 American Academy of Dermatology, Inc. Published by Elsevier Inc. All rights reserved.

  10. Oral Lichen Planus: An Update on Etiology, Pathogenesis, Clinical Presentation, Diagnosis and Management

    Science.gov (United States)

    Gupta, Sonia; Jawanda, Manveen Kaur

    2015-01-01

    The mouth is a mirror of health or disease, a sentinel or early warning system. The oral cavity might well be thought as a window to the body because oral manifestations accompany many systemic diseases. In many instances, oral involvement precedes the appearance of other symptoms or lesions at other locations. Oral lichen planus (OLP) is a chronic mucocutaneous disorder of stratified squamous epithelium of uncertain etiology that affects oral and genital mucous membranes, skin, nails, and scalp. LP is estimated to affect 0.5% to 2.0% of the general population. This disease has most often been reported in middle-aged patients with 30-60 years of age and is more common in females than in males. The disease seems to be mediated by an antigen-specific mechanism, activating cytotoxic T cells, and non-specific mechanisms like mast cell degranulation and matrix metalloproteinase activation. A proper understanding of the pathogenesis, clinical presentation, diagnosis of the disease becomes important for providing the right treatment. This article discusses the prevalence, etiology, clinical features, oral manifestations, diagnosis, complications and treatment of oral LP. PMID:26120146

  11. Urine metabolic profiling for the pathogenesis research of erosive oral lichen planus.

    Science.gov (United States)

    Li, Xu-Zhao; Yang, Xu-Yan; Wang, Yu; Zhang, Shuai-Nan; Zou, Wei; Wang, Yan; Li, Xiao-Nan; Wang, Ling-Shu; Zhang, Zhi-Gang; Xie, Liang-Zhen

    2017-01-01

    Oral lichen planus (OLP) is a relatively common chronic immune-pathological and inflammatory disease and potentially oral precancerous lesion. Erosive OLP patients show the higher rate of malignant transformation than patients with non-erosive OLP. Identifying the potential biomarkers related to erosive OLP may help to understand the pathogenesis of the diseases. Metabolic profiles were compared in control and patient subjects with erosive OLP by using ultra-performance liquid chromatography-quadrupole time-of-flight-mass spectrometry (UPLC-QTOF-MS) coupled with pattern recognition methods An integrative analysis was used to identify the perturbed metabolic pathways and pathological processes that may be associated with the disease. In total, 12 modulated metabolites were identified and considered as the potential biomarkers of erosive OLP. Multiple metabolic pathways and pathological processes were involved in erosive OLP. The dysregulations of these metabolites could be used to explain the pathogenesis of the disease, which could also be the potential therapeutic targets for the disease. Copyright © 2016 Elsevier Ltd. All rights reserved.

  12. Identification of AgNORs and cytopathological changes in oral lichen planus lesions.

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    Ferreira, Stefânia Jeronimo; Machado, Maria Ângela Naval; de Lima, Antônio Adilson Soares; Johann, Aline Cristina Batista Rodrigues; Grégio, Ana Maria Trindade; Azevedo-Alanis, Luciana Reis

    2017-01-01

    To evaluate cytopathological changes in epithelial cells of the oral mucosa of patients with oral lichen planus (OLP) compared with patients without OLP. Swabs were collected from the oral mucosa of 20 patients with OLP (case group) and 20 patients without OLP (control group) using liquid-based cytology. After Papanicolaou staining, the smears were characterized based on Papanicolaou classification and degree of maturation. Nuclear area (NA) measurements, cytoplasmic area (CA) measurements, and the NA/CA ratio were determined from 50 epithelial cells per slide. For quantification of argyrophilic nucleolar organizer regions (AgNORs), the smears were stained with silver nitrate, and the number of AgNORs was counted in 100 cells. In both groups, there was a predominance of Papanicolaou Class I nucleated cells in the superficial layer. The average values of NA (p>0.05) and CA (p=0.000) were greater in the case group (NA=521.6, CA=22,750.3) compared with the control group (NA=518.9, CA=18,348.0). The NA/CA ratio was 0.025 for the case group and 0.031 for the control group (p=0.004). There was no significant difference between the mean AgNORs values of both groups (p>0.05). The oral mucosa of patients with OLP exhibited significant cytomorphometric changes. However, there was no evidence of malignancy. Copyright © 2016 Elsevier GmbH. All rights reserved.

  13. A clinical study on oral lichen planus with special emphasis on hyperpigmentation

    Science.gov (United States)

    Chitturi, Ravi Teja; Sindhuja, Pandian; Parameswar, R. Arjun; Nirmal, Ramdas Madhavan; Reddy, B. Venkat Ramana; Dineshshankar, Janardhanam; Yoithapprabhunath, Thukanayakanpalayam Ragunathan

    2015-01-01

    Background: Oral lichen planus (OLP) is a unique disorder affecting generally the older age group. Numerous studies have been done on various aspects of OLP such as pathogenesis, rate of malignant transformation, etc. However, very few studies are available with respect to clinical features especially association of hyperpigmentation and OLP. This study aims at studying the clinical aspects of OLP and study the association between hyperpigmentation and OLP in a south Indian population. Materials and Methods: A total of 58 patients with OLP who attended the outpatient department of our institution were included in the study and a complete history, followed by thorough intraoral examination was done. All the data were recorded and assessed for statistical analysis using SPSS software. Results: We found that the male to female ratio affected with OLP was 1:1 and the most common form of OLP that was seen was the reticular subtype. Also, buccal mucosa was the most common affected site and more than 60% patients had hyperpigmentation associated with the site affected by OLP. We found a statistically significant relation between the reticular type of OLP and the older age group (51–70 years) with hyperpigmentation. Conclusion: Although further studies are required to say anything conclusively, post-inflammatory changes occurring the mucosa due to OLP could be a cause for hyperpigmentation in the sites affected. PMID:26538905

  14. Role of distinct CD4(+) T helper subset in pathogenesis of oral lichen planus.

    Science.gov (United States)

    Wang, Hui; Zhang, Dunfang; Han, Qi; Zhao, Xin; Zeng, Xin; Xu, Yi; Sun, Zheng; Chen, Qianming

    2016-07-01

    Oral lichen planus (OLP) is one of the most common chronic inflammatory oral mucosal diseases with T-cell-mediated immune pathogenesis. In subepithelial and lamina propria of OLP local lesions, the presence of CD4(+) T helper (CD4(+) Th) cells appeared as the major lymphocytes. These CD4(+) T lymphocytes can differentiate into distinct Th cell types such as Th1, Th2, Treg, Th17, Th22, Th9, and Tfh within the context of certain cytokines environment. Growing evidence indicated that Th1/Th2 imbalance may greatly participate into the cytokine network of OLP immunopathology. In addition, Th1/Th2 imbalance can be regulated by the Treg subset and also greatly influenced by the emerging novel CD4(+) Th subset Th17. Furthermore, the presence of novel subsets Th22, Th9 and Tfh in OLP patients is yet to be clarified. All these Th subsets and their specific cytokines may play a critical role in determining the character, extent and duration of immune responses in OLP pathogenesis. Therefore, we review the roles of distinct CD4(+) Th subsets and their signature cytokines in determining disease severity and susceptibility of OLP and also reveal the novel therapeutic strategies based on T lymphocytes subsets in OLP treatment. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  15. Cutaneous and Mucosal Lichen Planus: A Comprehensive Review of Clinical Subtypes, Risk Factors, Diagnosis, and Prognosis

    Science.gov (United States)

    2014-01-01

    Lichen planus (LP) is a chronic inflammatory disorder that most often affects middle-aged adults. LP can involve the skin or mucous membranes including the oral, vulvovaginal, esophageal, laryngeal, and conjunctival mucosa. It has different variants based on the morphology of the lesions and the site of involvement. The literature suggests that certain presentations of the disease such as esophageal or ophthalmological involvement are underdiagnosed. The burden of the disease is higher in some variants including hypertrophic LP and erosive oral LP, which may have a more chronic pattern. LP can significantly affect the quality of life of patients as well. Drugs or contact allergens can cause lichenoid reactions as the main differential diagnosis of LP. LP is a T-cell mediated immunologic disease but the responsible antigen remains unidentified. In this paper, we review the history, epidemiology, and clinical subtypes of LP. We also review the histopathologic aspects of the disease, differential diagnoses, immunopathogenesis, and the clinical and genetic correlations. PMID:24672362

  16. Why the general dentist needs to know how to manage oral lichen planus.

    Science.gov (United States)

    Price, Stephanie M; Murrah, Valerie A

    2015-01-01

    Oral lichen planus (OLP) is a frequently mismanaged chronic disease that requires care throughout a patient's life, and therefore a condition the general dentist must know how to manage. Patients with OLP often suffer considerable physical discomfort and an inability to perform proper oral hygiene, eventually resulting in poor periodontal health. In addition, these patients are confronted with the psychological stress of knowing that OLP is not curable. This is accompanied by a fear of other negative health developments, particularly oral cancer. The objective of this study was to identify major issues surrounding the management of OLP by the general dentist. A literature review of over 1100 articles was performed. An eclectic compilation of the issues revealed 12 major areas of concern. This article reviews those concerns and presents strategies for coping with the myriad signs, symptoms, and complications associated with this disease, as well as educational approaches and legal considerations. A rationale is provided to place the responsibility for the management of these patients under the person best positioned to coordinate care for this condition--the general dentist. A general dentist can contribute to the overall oral health of an OLP patient with timely diagnosis, effective treatment, thorough patient education, and the orchestration of efforts by a team of health care providers.

  17. Immunohistochemical detection of Mycoplasma salivarium in oral lichen planus tissue.

    Science.gov (United States)

    Mizuki, Harumi; Abe, Ryosuke; Kogi, Shintaro; Mikami, Toshinari

    2017-09-01

    Oral lichen planus (OLP) is a T-cell-mediated inflammatory disease; however, its exact etiology is unknown. Hyperkeratosis is often observed in OLP lesions. Previous studies have revealed the localization of Mycoplasma salivarium in the epithelial cells of oral leukoplakia with hyperkeratosis. Herein, we investigated the presence of M. salivarium in OLP tissue by immunohistochemistry to determine the causative factor of OLP. Forty-one formalin-fixed, paraffin-embedded samples obtained from 31 patients with OLP were examined. Ten samples of normal-appearing oral mucosa were used as controls. Immunohistochemistry (IHC) was performed using anti-M. salivarium monoclonal antibodies. Mycoplasma salivarium was detected in the epithelium and lymphocyte infiltrate area in 24 of 41 OLP samples (58.5%). The bacteria were intracellularly localized in epithelial cells, while it was unclear whether they were also localized in lymphocyte cells or in the extracellular spaces among the lymphocytes in the subepithelial lymphocyte infiltrate area. Little or no staining was observed in the epithelium in the normal-appearing mucosa samples. Sawtooth rete ridge formation was observed in 21 OLP samples (51.2%), and a significant positive correlation between sawtooth rete ridge formation and IHC positivity was demonstrated. However, the role of M. salivarium in the epithelium and lamina propria of OLP tissue remains unknown. © 2017 The Authors Journal of Oral Pathology & Medicine Published by John Wiley & Sons Ltd.

  18. Prevalence of oral leukoplakia and lichen planus in 1167 Iranian textile workers.

    Science.gov (United States)

    Jahanbani, J

    2003-11-01

    To evaluate the prevalence of oral precancerous lesions in textile workers. A cross-sectional study was undertaken to assess a total of 1167 textile factory workers randomly selected from a total of 6947. An overall 97 women and 1070 men aged 18-69 years (mean=31.8 years) were studied. Regular smoking during the past 6 months was considered as the smoker group. Leukoplakia lesions were classified in accordance to Axell criteria [Axell T, Pindborg JJ, Smith CJ and Van-der-waal I (1996). J Oral Pathol Med 25: 49]. The results showed that 115 workers (9.9%) had red and white lesions. Among these 43 positive detections (3.7%) had leukoplakia and six cases (0.5%) had lichen planus. The smoking habits of the workers were limited to cigarette smoking. There was a statistically significant positive correlation between tobacco smoking and oral leukoplakia (Pleukoplakia in this relatively young cohort with generally mild tobacco use. The prevalence of leukoplakia had an inverse relationship with the level of education.

  19. The Effectiveness of Topical Pimecrolimus in the Treatment of Oral Lichen Planus

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    Mehmet Kamil Mülayim

    2016-12-01

    Full Text Available Objectives: Oral lichen planus (OLP is a chronic inflammatory disorder of unknown etiology that affects the skin and the mucosa, especially the oral mucosa. Several therapeutic agents have been investigated for the treatment of OLP. All agents used in the OLP therapy are palliative. Potent topical steroids are used as the conventional therapy for OLP. Since side-effects or steroid resistance may be encountered, alternative treatments may be necessary. This study aimed to evaluate the efficacy and safety of the topical pimecrolimus in the treatment of OLP. Methods: Seventeen patients with OLP were recruited into this study. Topical pimecrolimus 1% cream was applied twice a day to the affected areas. Patients were followed up for 3-6 months. Photographs of the lesions were taken and analyzed for areas of ulceration, erythema, and reticulation in every clinical examination. Results: We found that topical pimecrolimus 1% cream was an effective treatment for OLP. Two patients could not complete the treatment protocol because of the side effects such as local irritation and nausea. Conclusion: Topical pimecrolimus may be a valuable second treatment choice for patients with steroid-related side-effects or steroid-resistant OLP. However further randomized controlled studies have to be conducted to compare conventional treatment of topical corticosteroid with topical pimecrolimus.

  20. Close association between metal allergy and nail lichen planus: detection of causative metals in nail lesions.

    Science.gov (United States)

    Nishizawa, A; Satoh, T; Yokozeki, H

    2013-02-01

    Lichen planus (LP) is a common skin disorder of unknown aetiology that affects the skin, mucous membranes and nails. Although metal allergies have been implicated in the development of oral LP (OLP), the contribution of these allergies to nail LP (NLP) has yet to be studied in detail. To elucidate the link between metal allergy and NLP. We retrospectively analysed 115 LP patients with respect to the contribution of metals to either NLP or OLP. We also attempted to detect the specific metals involved in these nail lesions. Of the 79 patients that received a metal patch test (PT), 24 (30%) were positive for at least one of the metal compounds tested. Notably, the prevalence of positive reactions to metals in the NLP patients was significantly higher as compared with the OLP patients (59% vs. 27%, P braces were detected in the involved nail tissues. This study suggests that metal allergies are more closely associated with NLP vs. OLP, and that deposited metals in the nail apparatus contribute to the development of lichenoid tissue reactions in the nail bed and matrix. © 2012 The Authors. Journal of the European Academy of Dermatology and Venereology © 2012 European Academy of Dermatology and Venereology.

  1. Tantangan dalam Perawatan Oral Lichen Planus pada Pasien Diabetes Melitus (Laporan Kasus

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    Ravina Naomi Tarigan

    2012-10-01

    Full Text Available Oral lichen planus (OLP is a chronic inflammatory condition that effects oral mucous membranes with a variety of clinical presentations including reticular, atrophic, plaque and ulcerative lesions. Corticosteroid is one of the effective therapy for OLP in reducing the sign and symptoms of this disease, but this therapy have a serious side effect, therefore to administering one must consider the patient’s systemic condition. We reported a case of OLP in 52 years old female patient who has no history of diabetes mellitus and unknown glucose level. Management of this patient included application of corticosteroid swish, topical 0.05% clobetasol propionate and 0,1% triamcinolone acetonide, antimycotics, improvement the oral hygiene status and referral to internal medicine specialist. The next treatments plan challenging because unstable blood glucose level which in turn effects the drug choice and teeth extraction plan. We concluded that the treatment of OLP requires a complete assessment of medical status and lab studies specially on the first visit so the drug selection with corticosteroid therapy and the treatment planning of predisposing factor are effective in reducing the sign and symptoms of OLP with minimum systemic side effect.DOI: 10.14693/jdi.v16i1.19

  2. Relevant contact sensitivities in patients with the diagnosis of oral lichen planus.

    Science.gov (United States)

    Yiannias, J A; el-Azhary, R A; Hand, J H; Pakzad, S Y; Rogers, R S

    2000-02-01

    The concept of contact allergy aggravating or inducing oral lichenoid mucositis diagnosed as oral lichen planus (OLP) is well recognized but somewhat controversial. We sought to identify clinically relevant contact allergens that may be important in the management of patients with OLP. We retrospectively reviewed patients with OLP who had patch tests performed at Mayo Clinic Rochester and Mayo Clinic Scottsdale from 1994 to 1997 and 1988 to 1997, respectively. Patch tests were performed on 46 patients with a clinical and histopathologic diagnosis of OLP. Of these, 25 (54%) had positive patch test results. Eighteen (72%) of the patients with positive results had clinically relevant reactions. Of the patients with positive metal reactions, 5 had improvement after removal of the metal prosthesis or restoration. Six others noted that their most troublesome areas were adjacent to metal dental restorations. Six patients with reactions to flavorings and one patient with an acrylate dental retainer sensitivity had improvement after avoiding these allergens. Our findings support the concept that contact allergy to metals, flavorings, and plastics can be important in the pathogenesis and management of patients with oral lichenoid mucositis diagnosed as OLP.

  3. Altered expression of extracellular matrix proteins and integrins in oral lichen planus (OLP).

    Science.gov (United States)

    Becker, J; Schuppan, D

    1995-04-01

    The immunohistochemical distribution of collagens type I, III, IV, V, VI, of undulin and tenascin, and of integrins alpha 2, alpha 3, alpha 4, alpha 5, alpha 6 and beta 4, was studied in 14 biopsies of oral lichen planus (OLP), 5 biopsies of orthokeratinized gingiva and 4 biopsies of oral fibrous hyperplasia. The localization of extracellular matrix proteins showed altered expression in OLP when compared to normal oral mucosa, with two principal patterns corresponding to the reticular or atrophic type. Whereas in the reticular type a focal loss of immunoreactivity for collagen types I, III, V, VI and undulin was noted in areas with a cellular infiltrate, in the atrophic variant almost complete loss of immunoreactivity of the subepithelial extracellular matrix was found. There was no clear correlation between the distribution of extracellular matrix proteins and their integrin receptors. The present findings suggest that the autoimmune reaction in OLP might not be primarily targeted to oral keratinocytes but to an unknown antigen in the connective tissue stroma. The changes in the subepithelial extracellular matrix associated with the inflammatory reaction might, especially in the atrophic variant, impair the cross-talk between epithelium and mesenchyme and favour both the loss of barrier function and the development of erosions in the clinical course of the disease.

  4. Salivary cortisol and dehydroepiandrosterone (DHEA) levels, psychological factors in patients with oral lichen planus.

    Science.gov (United States)

    Girardi, Carla; Luz, Clarice; Cherubini, Karen; de Figueiredo, Maria Antonia Zancanaro; Nunes, Maria Lúcia Tiellet; Salum, Fernanda Gonçalves

    2011-09-01

    The aim of this study was to determine the salivary levels of dehydroepiandrosterone (DHEA) and cortisol and scores of depression, anxiety and stress in patients with oral lichen planus (OLP). Thirty-one patients with a diagnosis of OLP were selected; they were matched by sex and age with 31 control patients. Symptoms of depression, anxiety and stress were investigated by the instruments Beck Depression Inventory, Beck Anxiety Inventory and Lipp's Inventory of Stress Symptoms for Adults, respectively. Saliva was collected in the morning and at night for the determination of DHEA and cortisol levels by radioimmunoassay. There was no significant difference between the groups with respect to depression (P=0.832), anxiety (P=0.061) or stress (P=0.611), or with respect to morning and night salivary levels of DHEA (P=0.888, P=0.297) and cortisol (P=0.443, P=0.983). The results suggest an association of OLP with anxiety. However, DHEA and cortisol levels did not differ between groups, which does not support any neuroendocrine aetiology for OLP. Copyright © 2011. Published by Elsevier Ltd.

  5. Prevalence of Diabetes Mellitus and Impaired Fasting Blood Glucose in Patients with Lichen Planus

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    Shadi Peyghambari

    2012-02-01

    Full Text Available Background: The relationship between Lichen Planus (LP and diabetes was studied previously, but the re-sults were in conflict. The aim of this study was to find the prevalence of diabetes mellitus (DM in patients with LP among Iranian patients. Methods: In this study, 80 patients with LP were enrolled. They referred to dermatology clinic of our hospital during one year. A self-designed checklist for the study included duration of the disease, the pattern of the dis-tribution of lichenoid lesions and fasting blood sugar (FBS. Results: From 80 patients with LP, 16 (20% had diabetes. Also, 14 patients (17.5% had impaired fasting glucose. The mean age of diabetic patients was significantly higher than non-diabetic group (p=0.039. In addi-tion, the duration of LP in patients with DM was significantly higher than non-diabetic patients (p=0.024. Conclusion: In our study, we saw a high prevalence of DM among patients with LP. Comparing our findings with the overall prevalence of DM in Iran, there was a significant difference between the prevalence of DM among patients with LP and the overall prevalence (p=0.001. Regarding our findings screening for FBS in pa-tients with LP is required in Iran.

  6. Programmed cell removal biomarkers calreticulin and CD47 implicated in oral lichen planus.

    Science.gov (United States)

    Allon, I; Vered, H; Hirshberg, A

    2015-10-01

    To investigate the expression of the programmed cell removal markers, calreticulin (CRT) and CD47, known to be involved in various autoimmune diseases, in patients with oral lichen planus (OLP), and to investigate the association with clinical behavior. Biopsies of 78 patients with OLP were included. The clinical data were collected from patients' charts. The expression of CRT and CD47 was immunomorphometrically analyzed in the epithelial (CRTep, CD47ep) and inflammatory cells (CRTinf, CD47inf), and the results were correlated with the clinical presentation. The epithelial and inflammatory cells expressed CRT (2.83 ± 6.62 and 5.13 ± 3.72) and CD47 (7.92 ± 4.6 and 10.7 ± 7.16). The expressions of CD47ep and CD47inf were associated (R = 0.64, P CD47 in OLP suggests a general programmed cell removal response in OLP. Symptomatic patients may benefit from CRT/CD47 targeted therapy in the future. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

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

    Science.gov (United States)

    Arduino, Paolo G; Karimi, Dora; Tirone, Federico; Sciannameo, Veronica; Ricceri, Fulvio; Cabras, Marco; Gambino, Alessio; Conrotto, Davide; Salzano, Stefano; Carbone, Mario; Broccoletti, Roberto

    2017-11-01

    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. © 2017 The authors.

  8. Investigation of Conjunctival Involvement in Patients with Lichen Planus Without Ocular Symptoms

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    Pinar Ozuguz

    2015-11-01

    Full Text Available Aim: Lichen planus is characterized by violeceous, poligonal, flat-topped and itch papules, either isolated or in groups, commonly located in flexural surfaces, mucosa and scalp. Mucous membranes are frequently affected (30-70%. Mucous membrane lesions can be seen in the absence of skin lesions and in about 15-25% of the cases mucosal lesions are the only sign of the disease. Besides, buccal mucosa and tongue; lesions in anogenital mucosa, urinary bladder, conjunctiva, larynx and occasionally even in esophagus and tympanic membrane of the ear can be seen. We aimed to investigate involvement of conjunctiva in patients with clinical and histopathological diagnosis of LP. Material and Method: 31 patients and 16 healthy controls were enrolled to the study. Conjunctival scrapings taken under eyelid local anesthesia from both patient and controls. The scrapings collected in cytospin, and by using immunohistochemical method, lymphocyte cell counts were done. The data obtained from the patients and the control group compared with the Mann-Whitney U tests and the results were statistically significant. Discussion: Our study supports the disease can affect all the mucosal surfaces by detection of histopathological involvement in patients with LP without clinical symptoms of eye disease.

  9. Cutaneous and Mucosal Lichen Planus: A Comprehensive Review of Clinical Subtypes, Risk Factors, Diagnosis, and Prognosis

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    Farzam Gorouhi

    2014-01-01

    Full Text Available Lichen planus (LP is a chronic inflammatory disorder that most often affects middle-aged adults. LP can involve the skin or mucous membranes including the oral, vulvovaginal, esophageal, laryngeal, and conjunctival mucosa. It has different variants based on the morphology of the lesions and the site of involvement. The literature suggests that certain presentations of the disease such as esophageal or ophthalmological involvement are underdiagnosed. The burden of the disease is higher in some variants including hypertrophic LP and erosive oral LP, which may have a more chronic pattern. LP can significantly affect the quality of life of patients as well. Drugs or contact allergens can cause lichenoid reactions as the main differential diagnosis of LP. LP is a T-cell mediated immunologic disease but the responsible antigen remains unidentified. In this paper, we review the history, epidemiology, and clinical subtypes of LP. We also review the histopathologic aspects of the disease, differential diagnoses, immunopathogenesis, and the clinical and genetic correlations.

  10. Eradication of damaged keratinocytes in cutaneous lichen planus forms demonstrated by evaluation of epidermal and follicular expression of CK15, indices of apoptosis and regulatory protein S100.

    Science.gov (United States)

    Upeniece, Ilze; Groma, Valerie; Skuja, Sandra; Cauce, Vinita

    The study of cytoskeleton arrangement and its contribution to survival of cell-to-cell contacts appears to be essential for understanding of numerous cellular and tissue processes. Applying CK15, S100 labeling and TUNEL reaction to cutaneous lichen planus subtypes, we found CK15 expression in the outer and inner root sheath of hair follicles, the basal epidermal layer, and eccrine glands. Its follicular expression was decreased in nearby inflammatory infiltrates. The CK15 immunopositivity was mostly described as weak (92.3%) for lichen planus but equally subdivided into weak, moderate and strong in lichen planopilaris (2 = 32.514; df = 4; p lichen planopilaris involving the scalp: 81.2 ±10.7; 87.8 ±10.7 and 88.0 ±10.5 for the basal, spinous and upper epidermal layers, respectively. S100 positive epidermal and follicular cells did not differ in the lesions demonstrated in the study groups; still immunoreactivity was more pronounced in the scalp region of lichen planopilaris. Damage of cell-to-cell contacts was confirmed by electron microscopy. Apart from immunocyte-mediated keratinocyte death, cytoskeleton-based injury and loss of cell-to-cell and matrix contacts may be of great importance, leading to eradication of degrading cells and thus contributing to the pathogenesis of lichen planus.

  11. Eradication of damaged keratinocytes in cutaneous lichen planus forms demonstrated by evaluation of epidermal and follicular expression of CK15, indices of apoptosis and regulatory protein S100

    Directory of Open Access Journals (Sweden)

    Ilze Upeniece

    2016-11-01

    Full Text Available The study of cytoskeleton arrangement and its contribution to survival of cell-to-cell contacts appears to be essential for understanding of numerous cellular and tissue processes. Applying CK15, S100 labeling and TUNEL reaction to cutaneous lichen planus subtypes, we found CK15 expression in the outer and inner root sheath of hair follicles, the basal epidermal layer, and eccrine glands. Its follicular expression was decreased in nearby inflammatory infiltrates. The CK15 immunopositivity was mostly described as weak (92.3% for lichen planus but equally subdivided into weak, moderate and strong in lichen planopilaris (2 = 32.514; df = 4; p < 0.001. The greatly varying apoptotic index was the highest in the lichen planopilaris involving the scalp: 81.2 ±10.7; 87.8 ±10.7 and 88.0 ±10.5 for the basal, spinous and upper epidermal layers, respectively. S100 positive epidermal and follicular cells did not differ in the lesions demonstrated in the study groups; still immunoreactivity was more pronounced in the scalp region of lichen planopilaris. Damage of cell-to-cell contacts was confirmed by electron microscopy. Apart from immunocyte-mediated keratinocyte death, cytoskeleton-based injury and loss of cell-to-cell and matrix contacts may be of great importance, leading to eradication of degrading cells and thus contributing to the pathogenesis of lichen planus.

  12. Clinicopathological Profile and Malignant Transformation in Oral Lichen Planus: A Retrospective Study

    Science.gov (United States)

    Bandyopadhyay, Alokenath; Behura, Shyam Sundar; Nishat, Roquaiya; Dash, Kailash Chandra; Bhuyan, Lipsa; Ramachandra, Sujatha

    2017-01-01

    Objectives: The aim of this study was to analyze the histopathologically diagnosed cases of oral lichen planus (OLP) in terms of age, gender, clinical variant, site, hyperpigmentation, systemic illness, grade of dysplasia, and associated malignant transformation. This study also intended to do a review of reported cases of OLP with malignant transformation. Materials and Methods: One hundred and forty-three cases of histopathologically diagnosed OLP between 2010 and 2016 were retrospectively reviewed. Demographic and clinicopathological data including malignant transformation were obtained. The data obtained were analyzed using the Statistical Package for the Social Sciences (SPSS) software for Windows version 20.0 (IBM SPSS, SPSS Inc., Chicago, IL, USA). A review of published literature on OLP with malignant transformation was also done from 1988 to 2017 and tabulated. Results: OLP in this study showed a male predilection with most of the patients in the third decade. The buccal mucosa (bilateral presentation) was the most common site (79.72%), and reticular type was the most common clinical type (79.02%) followed by erosive type (20.98%). The majority (92.31%) of cases were diagnosed with OLP without dysplasia. The rest (7.69%) of dysplastic cases were predominantly seen in the buccal mucosa of 58 years and above, female patients manifesting mainly as erosive type. Two patients (1.4%) previously diagnosed clinically and histopathologically as OLP developed oral squamous cell carcinoma. Conclusion: The present investigation revealed the predominance of OLP among middle-aged male population and the prevalence of bilateral involvement of buccal mucosa. Two of our cases showed malignant transformation over an average period of 3.5 years. The outcome of this study emphasizes the role of clinical follow-up of patients with OLP. PMID:28584781

  13. ALK1 expression in oral lichen planus: a possible relation to microvessel density.

    Science.gov (United States)

    Hazzaa, Hala H A; El-Wakeel, Naglaa M; Attia, Enas A S; Abo Hager, Eman A

    2016-05-01

    To assess the expression of activin receptor-like kinase 1 (ALK1) and investigate its possible relationship with microvessel density (MVD) in different forms of oral lichen planus (OLP) compared to controls' biopsies. Biopsies from 20 reticular/papular OLP (R/PLP), 20 atrophic/erosive OLP (A/ELP) patients, and 20 healthy subjects were immunohistochemically analyzed and statistically compared and correlated for ALK1 expression and MVD as assessed by CD34 expression. All OLP specimens revealed the presence of positive cytoplasmic CD34 immunostaining in endothelial cells, with statistically high significant MVD in each of R/PLP (Median; M = 4.40) and A/ELP (M = 7.69) compared to controls (M = 1.16) (P < 0.001). Statistically significant MVD was found in A/ELP compared to R/PLP (P < 0.001). All control specimens revealed negative ALK1 immunostaining of the few inflammatory cells found, while 85% of A/ELP cases and 70% of R/PLP cases showed positively immunostained sections for ALK-1, with statistically significant higher ALK1 expression In A/ELP (M = 1.95) compared to R/PLP (M = 0.86) (P = 0.005). No significant correlation between CD34 and ALK1 was detected in R/PLP (r = 0.081), while a barely moderate positive correlation was found in A/ELP (r = 0.396). ALK1 expression and MVD are increased in OLP, particularly in A/ELP type. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  14. Oral Lichen Planus and Features in the Short Chain Fatty Acid Pattern Produced by Colonic Fermentation

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    Umida A. Shukurova

    2016-03-01

    Full Text Available The aim of the study was to assess the content of short chain fatty acids (SCFAs in feces of patients with different clinical forms of oral lichen planus (OLP. Materials and Methods: The study included 139 patients with different clinical forms of OLP in the acute stage. The diagnosis of OLP was performed according to both clinical and histopathological criteria. Patients were distributed in four groups according to the clinical form of OLP. Group 1 included 36 patients with the reticular form of OLP; Group 2 included 34 patients with the exudative-hyperemic form of OLP; Group 3 included 27 patients with the erosive-ulcerative form of OLP; Group 4 included 42 patients with the bullous form of OLP. The four groups to be compared were randomized by sex and age. The control group consisted of 40 healthy, age-matched, randomly selected persons without clinical and instrumental signs of OLP and other diseases of the oral cavity. The concentration of SCFAs in feces was evaluated by gas-liquid chromatography. The profiles (specific concentration of C2, C3, and C4 acids, the ratio of iso-acids to straight-chain acids (iso-Cn/Cn and iso-C5/C5 were also calculated. Results: Three types of SCFA changes reflecting the activity of certain groups of microorganisms were found. For all types of the SCFA disorders, we found a marked increase in the iso-C5/C5 ratio. The severity of dysbiosis increased with the severity of clinical forms of OLP. Changes in the qualitative and quantitative contents of SCFAs reflect the disturbances in gut microbiocenosis in LPO patients, which may be one cause for aggravation of the pathological process.

  15. Effect of Cedar Honey in the Treatment of Oral Lichen Planus

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    Majid Sanatkhani

    2014-07-01

    Full Text Available Introduction:Oral Lichen Planus(OLPis a chronic mucocutaneus disease with an immunological etiology. This study was conducted to evaluate the effect of Cedar honey in treatment of erosive- atrophic OLP.Materials and Methods: Thirty patients with confirmed clinical and histopathologic of OLP participated in a randomized clinical trial in Mashhad Dental School.Patients were randomly allocated in two groups. Both groups received the standard treatment of OLP (dexamethasone mouthwash 0.5mg 3 times daily and fluconazole capsule 100 mg daily.Intervention group received Cedar honey (20 ml 3 times daily , swish and swallow techniquein addition to standard treatment. The patients were followed for 4 weeks.The pain and severity of the lesions were recorded at the initial visit and follow ups. All recorded data were analyzed with chi- square, T test, ANOVA using SPSS version 11.5and p-value less than 0.05 was considered significant.Results: Thirty patients were included in the study. Both groups had markedly reduction in pain, size of erosive area and atrophic lesions specially in first follow up but there was not a significant different between two groups (p>0.05. Honey was effective in healing of ulcerative lesions.(The average recovery in experimental group was 69% while the average relief of ulcerative lesion in control group was 50%.but this difference was not significant(p=0.896Conclusion :No significant difference was found in the treatment of atrophic and erosive lesions of OLP by using honey as an alternative treatment, but it may be effective in ulcerative lesions of OLP , although more research with larger sample size is necessary.

  16. Clinicopathological Profile and Malignant Transformation in Oral Lichen Planus: A Retrospective Study.

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    Bandyopadhyay, Alokenath; Behura, Shyam Sundar; Nishat, Roquaiya; Dash, Kailash Chandra; Bhuyan, Lipsa; Ramachandra, Sujatha

    2017-01-01

    The aim of this study was to analyze the histopathologically diagnosed cases of oral lichen planus (OLP) in terms of age, gender, clinical variant, site, hyperpigmentation, systemic illness, grade of dysplasia, and associated malignant transformation. This study also intended to do a review of reported cases of OLP with malignant transformation. One hundred and forty-three cases of histopathologically diagnosed OLP between 2010 and 2016 were retrospectively reviewed. Demographic and clinicopathological data including malignant transformation were obtained. The data obtained were analyzed using the Statistical Package for the Social Sciences (SPSS) software for Windows version 20.0 (IBM SPSS, SPSS Inc., Chicago, IL, USA). A review of published literature on OLP with malignant transformation was also done from 1988 to 2017 and tabulated. OLP in this study showed a male predilection with most of the patients in the third decade. The buccal mucosa (bilateral presentation) was the most common site (79.72%), and reticular type was the most common clinical type (79.02%) followed by erosive type (20.98%). The majority (92.31%) of cases were diagnosed with OLP without dysplasia. The rest (7.69%) of dysplastic cases were predominantly seen in the buccal mucosa of 58 years and above, female patients manifesting mainly as erosive type. Two patients (1.4%) previously diagnosed clinically and histopathologically as OLP developed oral squamous cell carcinoma. The present investigation revealed the predominance of OLP among middle-aged male population and the prevalence of bilateral involvement of buccal mucosa. Two of our cases showed malignant transformation over an average period of 3.5 years. The outcome of this study emphasizes the role of clinical follow-up of patients with OLP.

  17. Modulation of serum smooth muscle antibody levels by levamisole treatment in patients with oral lichen planus.

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    Wu, Kai-Ming; Wang, Yi-Ping; Lin, Hung-Pin; Chen, Hsin-Ming; Chia, Jean-San; Sun, Andy

    2013-06-01

    Serum autoantibodies have been found in patients with oral lichen planus (OLP). This study evaluated whether OLP patients had significantly higher frequencies of serum smooth muscle antibody (SMA) than healthy control individuals, and assessed whether levamisole treatment could modulate the serum SMA levels in OLP patients. This study used an indirect immunofluorescence technique to measure the baseline serum SMA levels in a group of 647 OLP patients and 53 controls. Ninety-five SMA-positive OLP patients were treated with levamisole under a regular follow-up schedule, and their serum SMA levels were measured after treatment. The frequencies of serum SMA in patients with OLP (21.9%), erosive OLP (EOLP, 21.6%), major EOLP (17.9%), minor EOLP (24.2%), and nonerosive OLP (24.4%) were all significantly higher than that (0%) in healthy controls (all p levamisole under a regular follow-up schedule. Treatment with levamisole for a period of 2-29 months (mean, 9.4 ± 6.0 months) effectively reduced the high mean serum SMA titer (71.0 ± 7.2) at baseline to an undetectable level (0) in all SMA-positive OLP patients, regardless of different initial serum SMA titers. There was a significantly higher frequency of serum SMA (21.9%) in OLP patients than in healthy controls. Treatment with levamisole for 2-29 months significantly reduced the high serum SMA to an undetectable level, and significantly improved the signs and symptoms in all treated OLP patients. Copyright © 2013. Published by Elsevier B.V.

  18. Lack of evidence of hepatitis in patients with oral lichen planus in China: A case control study.

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    Song, Jiangyuan; Zhang, Zhihui; Ji, Xiaoli; Su, Sha; Liu, Xiaodan; Xu, Si; Han, Ying; Mu, Dongdong; Liu, Hongwei

    2016-03-01

    China has been one of the countries with high prevalence of chronic hepatitis B virus (HBV) and hepatitis C virus (HCV) liver disease. And lichen planus is an extrahepatic manifestation of patients with chronic HCV infection. This case-control study was conducted to investigate the relationship between oral lichen planus (OLP) and HBV/HCV infection in China. A total of 776 patients, including 150 patients with OLP (Group OLP), 429 inpatients from the Trauma Ward of Oral and Maxillofacial Surgery Department (Group A), 110 patients with other oral mucosal diseases, but without a reported association with HCV infection (Group B) and 87 patients with oral lichenoid lesion (Group OLL), were compared with their seroprevalence of anti-HCV antibody (HCVAb), hepatitis B surface antigen (HBsAg) and the parameters of liver functions. Moreover, the clinical characteristics of OLP were also observed, such as gender, age, chief complaint, course of the disease, clinical type, sites involved and so on. The positive rates of HCVAb and HBsAg in OLP patients were 0.7% and 4%, respectively. Neither HCVAb nor HBsAg was associated with OLP as demonstrated by both the univariate and the multivariate analyses. The clinical features and liver functions of OLP patients with negative or positive HBsAg were nearly the same. Our findings verify that there is no association between OLP and hepatitis and there is no need to run a screening test for HCV or HBV in OLP patients in China.

  19. Esophageal involvement is frequent in lichen planus: study in 32 patients with suggestion of clinicopathologic diagnostic criteria and therapeutic implications.

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    Kern, Johannes S; Technau-Hafsi, Kristin; Schwacha, Henning; Kuhlmann, Jan; Hirsch, Gunther; Brass, Volker; Deibert, Peter; Schmitt-Graeff, Anette; Kreisel, Wolfgang

    2016-12-01

    Lichen planus (LP) is a classic skin disease that can involve the skin, hair, and nails, as well as the oral and genital mucosa. Histopathology is characterized by a T-lymphocytic, lichenoid, and interface dermatitis. Multiple case reports and small case series have shown that LP can involve the esophagus. However, the diagnostic criteria, incidence, and best treatment options remain uncertain. This study aimed to refine the diagnostic criteria, estimate prevalence, and present an outlook on treatment options to prevent long-term sequelae. Thirty-two consecutive patients with LP of the skin, hair, nails, oral mucosa, and/or genital mucosa underwent a comprehensive clinicopathologic assessment. Esophagogastroduodenoscopy was performed, and biopsies were evaluated histologically, immunohistochemically, and by direct immunofluorescence. Patients diagnosed with esophageal lichen planus (ELP) were followed up prospectively where possible. In total, 20 of 32 patients had ELP. Ten of these 20 patients were classified as having proven ELP, with clear-cut endoscopically visible lesions; the other 10 were classified as having probable ELP. Eight of 10 patients with proven ELP were started on new or additional therapy because of esophageal findings. Treatment with a topical budesonide formulation or systemic corticosteroids was successful in most patients with proven ELP and reversed functional esophageal stenosis. ELP can be found in more than 50% of patients with proven mucocutaneous LP when clinical and pathologic findings are correlated carefully. Topical or systemic corticosteroids are the first-line therapy for ELP. Timely medical therapy seems to prevent scarring stenosis of the esophagus.

  20. [Analysis of type C behavior in patients with oral lichen planus].

    Science.gov (United States)

    Guo, Y S; Li, S; Lyu, M Y; Yang, D; Hua, H

    2017-02-18

    To assess type C behavior in patients with oral lichen planus (OLP) in order to provide basis for clinical prevention, treatment and psychological intervention of OLP. Type C behavior scale was used on 85 OLP patients and 85 control patients, who were in accordance with the inclusion criteria, in order to investigate their type C behavior. The scale included 9 items: anxiety, depression, anger, anger toward inside (anger-in), anger toward outside (anger-out), reasoning, domination, optimism, and social support. Scores of the 9 items between OLP patients and control group were calculated under the instruction of the scale and were statistically analyzed, and OLP group was further stratified statistically by sex, reticulate-erosive-ulcerative (REU) pathological type and course of diseases, and the scores of each group were analyzed and compared. Among the 85 OLP patients, there were more females, more non-erosive lesion type, and the most common site for OLP was the buccal mucosa. The scores of the type-C behavior questionnaire for anxiety, depression, anger and optimism were respectively 43.01±7.47, 44.02±7.61, 21.56±5.26, 22.15±4.00 among the OLP patients and were 37.94±8.70, 39.58±7.35, 18.12±5.39, 24.05±3.23 among control group, with significant differences(Poptimism scores (39.12±5.66, 16.29±3.95, 22.05±4.12) with significant differences (Poptimism scores remained declining. The patients suffering more than 3 years of OLP had higher anger-toward-outside scores (17.36±3.35) than the patients suffering less than 3 years of OLP (15.19±3.99), with a significant difference (Poptimism. This research provides the C behavior characteristic of OLP for further psychological consultation or intervention during OLP treatment.

  1. [Study of association between oral lichen planus and depression in female patients].

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    Wu, Xiao-hong; He, Xu-dong; Wu, Song-hong; Xia, Hua

    2011-10-01

    To explore the relationship among oral lichen planus(OLP), depression and gonadal hormones in female patients with OLP. Sixty-seven cases of female out-patients with OLP were divided into erosion group (n=25) and non-erosion group(n=42). Meanwhile, 30 female out-patients with other benign oral lesion and without oral mucosa diseases were used as control group. Self-rating anxiety scale(SAS), self-rating depression scale(SDS), Hmiton anxiety scale(HAMA), Hmiton depression scale(HAMD) and life event scale(LES) were evaluated in all participants who were tested simultaneously with FSH, LH, E2, T, PRL as well as CORT and were screened with DSM-IV criteria for major depression. The data were analyzed by Chi-square test, Student's t test and Spearman rank correlation using SPSS10.0 software package. Ten cases (40% )met the DSM-IV diagnosis of depression in the erosion group, and 6(14.3% , 1(3.3%) in the non-erosion group and control group, respectively. The scores of SAS, SDS, HAMA, HAMD and the level of CORT in both the erosion and non-erosion groups were higher than those in the control group,but there was no significant difference between the erosion group and the non-erosion group. The score of LES in the erosion group was higher than the non-erosion group and control group, and there was no significant difference between the non-erosion group and control group. The total and negative life event scores of LES were positively correlated with the scores of SAS,SDS,HAMA and HAMD. The level of E2 and T in the erosion group was lower than the non-erosion group and control group. There was a negative correlation between the scores of SDS, HAMD and the level of E2 and T in the erosion group. Depression plays an important role in the development of OLP, and one mechanism may be gonadal hormone disturbance, with stress as the triggering factor. The estrin treatment is helpful to improve the treatment effect on OLP of erosion style, especially, for female patient with

  2. Cell proliferation in lichen planus of the buccal mucosa with special regard to a therapy with an aromatic retinoid (RO 10-9359). Proliferationsverhalten des oralen lichen planus unter besonderer Beruecksichtigung einer Therapie mit aromatischem Retinoid (RO 10-9359)

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    Bauer, G.

    1982-01-01

    The proliferative activity of buccal mucosa epithelium in 16 patients suffering from oral lichen planus was studied by using (/sup 3/H)-thymidine labelling technique in vitro and histometric methods. Autoradiographic sections of two groups of lesions (12 with atrophic and 4 with acanthotic epithelium) were compared with the buccal mucosa of 19 healthy controls investigated in the same way. Determinations comprised separate and combined labelling indices of the basal and suprabasal progenitor compartment (LIsub(bas), LIsub(sbas), LIsub(total)) in relation to basal cells as well as to surface of the epithelium. The following results were obtained. The values of LIsub(total) per 100 basal cells were increased in both groups of lesions, whereby the relation of LIsub(bas):LIsub(sbas) shifted markedly to LIsub(bas), in particular in the atrophic lesions. When relating the total of labelled nuclei to surface length, however, an increase could be confirmed only in acanthotic lesions, whereas most atrophic lesions showed a decrease. This indicates an impaired capacity of the atrophic epithelium to maintain regenerative steady state. This imbalance could also be confirmed by counting the total of basal cells per surface length, which were significantly lowered in atrophic lesions as compared with acanthotic ones as well as normal mucosa. From the results it can be concluded that the renewal activity of the epithelium in atrophic lesions of lichen planus mucosae becomes virtually deficient, though determination of LIsub(total) referred to basal cells simulates a slight increase. Thus, for detecting intrinsic imbalances in the proliferative equilibrium of squamous epithelium, correlation of progenitor compartment labelling to external surface as the site of continuous cell loss is required.

  3. [A randomized single-blind controlled clinical trial of tacrolimus mouth rinse on erosive oral lichen planus].

    Science.gov (United States)

    Zuo, Wen-xin; Li, Xiao-yu; Cai, Gan-ying; Chen, Yan-qing

    2013-12-01

    To evaluate the efficacy and safety of tacrolimus mouth rinse on the treatment of erosive and ulcerative oral lichen planus (OLP). A randomized single-blind open trial of tacrolimus mouth rinse with dexamethasone as control was designed. The VAS and REU scoring system was utilized to compare the signs and symptoms. The scores and therapeutic effects were analyzed with SPSS 17.0 software package. There was no significant difference in effective rate between the treatment group and control group (X(2)=0.295,0.413, P>0.01) at 4-week and 12-week after treatment. There was significant difference in REU scores between the 2 groups (P<0.01) 4 weeks after treatment. Tacrolimus mouth rinse effects quickly and is worthy of application in the treatment of erosive and ulcerative OLP.

  4. Efficacy of topical chamomile management vs. placebo in patients with oral lichen planus: a randomized double-blind study.

    Science.gov (United States)

    Lopez Jornet, P; Aznar-Cayuela, C

    2016-10-01

    The purpose of this study was to compare the clinical therapeutic efficacy of topical applications of chamomile vs. a placebo for treating oral lichen planus (OLP). This double-blind study, randomly divided 60 patients with OLP into two groups, 30 treated with 2% Chamaemelum nobile gel (0.5 mL/3 times a day) and 30 treated with a placebo (Trial Registration NCT02421770). A visual analogue scale was used to rate pain, itching and burning sensation, and Thongprasom Index, the Oral Health Impact Profile 14 (OHIP-14) and the Hospital Anxiety-Depression Scale. Patients were evaluated at baseline and after 4 weeks of treatment. Patients treated with chamomile showed significant improvements after 4 weeks for pain (P chamomile showed a partial or total response, while only five subjects (17%) in the placebo group showed any improvement. The topical application of 2% chamomile gel is an effective treatment for OLP. © 2016 European Academy of Dermatology and Venereology.

  5. Dysplastic change rate in cases of oral lichen planus: A retrospective study of 112 cases in an Iranian population

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    Irani, Soussan; Esfahani, Alireza Monsef; Ghorbani, Anahita

    2016-01-01

    Backgrounds: Lichen planus is a chronic systemic disease and oral mucosa is commonly involved. Oral lichen planus (OLP) most commonly affects middle-aged women. The prevalence of the disease ranges between 0.5% and 2.6% in the general population and the range of malignant transformation varies between 0% and 10%. Objectives: To assess the rate of malignant transformation of OLP samples. Materials and Methods: This retrospective study was carried out on 112 medical records of patients with histological diagnosis of OLP who attended the Department of Pathology at the Educational Hospital from 2005 to 2012. H&E-stained slides were reviewed by two pathologists using strict clinical and histopathological diagnostic World Health Organization (WHO) criteria. Dysplastic changes were diagnosed and graded according to the latest WHO classification. Results: Of the 112 cases diagnosed as OLP, there were 39 males and 73 females and the patients’ ages ranged from 15 to 86 years (mean age 44.5 years). The erosive form with fifty cases was the most common clinical type and the papular type with one case was the least common clinical type. Regarding the site, the buccal mucosa was the most common site with 52 cases. Totally, dysplastic changes were found in 12 samples, among them five cases showed mild dysplasia and seven cases showed moderate dysplasia. One case developed oral squamous cell carcinoma after 3 years. Conclusion: OLP is considered as a premalignant condition by the WHO and several authors. Although the malignancy rate is not so high, to reduce morbidity and mortality from cancer arising on OLP lesions, a regular follow-up examination is recommended. PMID:27721603

  6. Frequently Increased but Functionally Impaired CD4+CD25+ Regulatory T Cells in Patients with Oral Lichen Planus.

    Science.gov (United States)

    Zhou, Leilei; Cao, Tianyi; Wang, Yufeng; Yao, Hui; Du, Guanhuan; Chen, Guangjie; Niu, Xiaoyin; Tang, Guoyao

    2016-06-01

    Oral lichen planus (OLP) is a T cell-mediated chronic inflammatory mucosal disease, and CD4(+)CD25(+) regulatory T cells (Tregs) are considered involved in the pathogenesis of OLP. In this study, to investigate whether there are intrinsic factors that might cause functional changes in Tregs in this disease, we evaluated the frequency of Tregs in peripheral blood and oral lesions and the expression levels of function-related transcription factors, forkhead/winged-helix transcription factor box P3 (FOXP3), transforming growth factor β (TGF-β), interleukin 10 (IL-10), and TGF-β receptors (TβRI and TβRII) mRNAs in Tregs of patients with oral lichen planus (OLP). We also investigated the frequency of pro-inflammatory cytokines (IFN-γ and IL-17A) producing Foxp3(+) regulatory cells. Increased proportions of Tregs were found in OLP patients. The expression of FOXP3 on mRNA and protein level was elevated in the Tregs of OLP. The expression of TGF-β was lower both on the mRNA and serum level, whereas the expression of IL-10 showed no significant difference between the OLP patients and normal controls. The percentages of CD4(+)FOXP3(+)IL-17(+) T cells were significantly higher than that of normal controls, whereas the percentages of CD4(+)FOXP3(+)IFN-γ(+) T cells did not differ significantly. Furthermore, impaired suppressive function of CD4(+)CD25(+) T cells was demonstrated in OLP patients by in vitro proliferation assay. These data indicate that Tregs in OLP are frequently expanded but functionally deficient. This could explain, at least in part, why the increased Tregs in OLP fail to control the pathogenesis and development of this autoimmune disease.

  7. A retrospective case-control study of hepatitis C virus infection and oral lichen planus in Japan: association study with mutations in the core and NS5A region of hepatitis C virus

    Science.gov (United States)

    2012-01-01

    Background The aims of this study were to assess the prevalence of hepatitis C virus (HCV) infection in Japanese patients with oral lichen planus and identify the impact of amino acid (aa) substitutions in the HCV core region and IFN-sensitivity-determining region (ISDR) of nonstructural protein 5A (NS5A) associated with lichen planus. Methods In this retrospective study, 59 patients (group 1-A) with oral lichen planus among 226 consecutive patients who visited our hospital and 85 individuals (group 1-B, controls) with normal oral mucosa were investigated for the presence of liver disease and HCV infection. Risk factors for the presence of oral lichen planus were assessed by logistic regression analysis. We compared aa substitutions in the HCV core region (70 and/or 91) and ISDR of NS5A of 12 patients with oral lichen planus (group 2-A) and 7 patients who did not have oral lichen planus (group 2-B) among patients (high viral loads, genotype 1b) who received interferon (IFN) therapy in group1-A. Results The prevalence of anti-HCV and HCV RNA was 67.80% (40/59) and 59.32% (35/59), respectively, in group 1-A and 31.76% (27/85) and 16.47% (14/85), respectively, in group 1-B. The prevalence of anti-HCV (P lichen planus. The adjusted odds ratios for these three factors were 6.58, 3.53 and 2.58, respectively, and each was statistically significant. No significant differences in viral factors, such as aa substitutions in the core region and ISDR of NS5A, were detected between the two groups (groups 2-A and -B). Conclusion We observed a high prevalence of HCV infection in patients with oral lichen planus. Longstanding HCV infection, hypoalbuminemia, and smoking were significant risk factors for the presence of oral lichen planus in patients. It is advisable for Japanese patients with lichen planus to be tested for HCV infection during medical examination. PMID:22490000

  8. The Prevalence of Hepatitis C Virus (HCV) among Lichen Planus Patients and Its Clinical Pattern at the University of Abuja Teaching Hospital (U.A.T.H), Gwagwalada, Abuja, Nigeria

    Science.gov (United States)

    Bob, Ukonu Agwu; Augustine, Uhunmwangho

    2012-01-01

    Objective: The relationship between hepatitis C virus and Lichen Planus have been widely reported in the literature; although there are wide geographical variations in the reported prevalence of hepatitis C virus infection in patients with lichen planus. This study seeks to determine the prevalence of hepatitis C virus among lichen planus patients and its clinical morphological type in the University of Abuja Teaching Hospital, Gwagwalada Abuja, Nigeria. Materials/Methods: This study was conducted between January 2010 and December, 2011 at the out patients Dermatological unit of the department of medicine at the University of Abuja Teaching Hospital Gwagwalada Abuja, Nigeria. Consecutive patients who had body eruptions suspected to be lichen planus were recruited and histology done for confirmation. The control group included patients’ relations and some dermatology patients known to have low risk of hepatitis C virus infection and liver function tests done for both subjects and control after obtaining oral consent from them to participate in the study. Result: Anti- HCV antibodies were detected in nine cases (21.4%) and one case (3.3%) in the control group. This was statistically significant difference between the HCV antibody among the subject and control group (Plichen planus was the most frequent clinical type. Liver function test was not statistically significant among the subject and control group. Conclusion: Lichen planus and Hepatitis C virus appear to have a relationship and the prevalence rate was higher among the subject as compared to the control group in our environment. PMID:22980383

  9. [Determination of human papillomavirus in oral leukoplakia,oral lichen planus and oral squamous cell carcinoma].

    Science.gov (United States)

    Cao, Jie; Jin, Jian-qiu; Deng, Da-jun; Liu, Hong-wei

    2016-02-18

    To investigate the possibility for human papillomavirus (HPV) infection to be a predictable signal for the carcinogenesis of oral mucosa by comparing the prevalences of HPV in each stage of oral mucosal carcinogenesis and to compare the sensitivity differences of the two methods in detecting HPV infection in oral cavity. The hybrid capture (HC-II) was used to detect infection of HPV in 255 samples taken from 12 cases of healthy oral mucosa, 211 cases of patients with pathological diagnosis and 32 cases of patients with clinical diagnosis. The diagnosed cases included 8 cases of benign lesions of the oral mucosa, precancerous lesions [74 cases of oral leukoplakia (OLK) with hyperplasia and 42 cases of OLK with oral epithelial dysplasia (OED)], 91 cases of precancerous condition [oral lichen planus (OLP)] and 28 cases of oral squamous cell carcinoma (OSCC). And in situ hybridization (ISH) was used to detect infection of HPV in 33 cases of OSCC and 76 cases of OLK, including 30 cases of hyperplasia, 15 cases of mild OED, 15 cases of moderate OED and 16 cases of severe OED. The prevalence of HPV in OLP samples was higher (12.12%, 8/66) than that of OLK (2.59%, 3/116) (χ(2)=4.666, P=0.031) and OSCC(7.14%, 2/28, χ(2)=0.513, P=0.474). The prevalence of HPV in OSCC (7.14%, 2/28) was higher than that of OLK (2.59%, 3/116), and no significant difference was found. There was only one case of smoke spot and statistical analysis was not carried out. ISH was used to detect type 16/18 and type 31/33 HPV DNA in 109 cases of oral mucosal lesions in paraffin sections and only one case of OSCC was HPV positive. Thirty-seven cases were detected by HC-II and ISH methods at the same time. The same negative results by the two methods were found in 94.6% samples (35/37). In the other two samples, one was OSCC with early infiltration and the other was OLK with hyperplasia, The HC-II results were positive while the ISH results were negative. The patients with OLP and HPV testing results

  10. Clinical and Histologic Features Compared with AgNOR Count in Oral Leukoplakia, Erosive Lichen Planus, Oral Submucous Fibrosis and Oral Squamous Cell Carcinoma

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    Sarbjeet Singh

    2006-01-01

    The aim of the study was to correlate and compare AgNOR count in speckled leukoplakia, oral lichen planus, oral submucous fibrosis and in oral squamous cell carcinoma and to assess if AgNOR count could contribute to the pre-therapeutic assessment of the biologic aggressiveness of the disease and to detect malignant potential of premalignant lesion and conditions which could render us to assess the prognosis of the disease.

  11. Evaluation of diagnostic value of AgNOR and PAP in early detection of dysplastic changes in leukoplakia and lichen planus - a preliminary case-control study.

    Science.gov (United States)

    Rao, Dhanya S; Ali, I M; Annigeri, Rajeshwari G

    2017-01-01

    Early detection of oral cancer has been the most effective approach to reduce morbidity and mortality of cancer patients. If a lesion is clinically considered suspicious, an easily practicable, non-invasive, painless, safe, and accurate screening method for detection of the dysplastic changes is necessary. In an attempt to procure this, a study was conducted with the aim of determining the diagnostic accuracy of rapid Papanicolaou stain (PAP) and silver-stained nucleolar organizer regions (AgNOR) in brush biopsies of potentially malignant lesions for early detection of oral cancer. Brush biopsies taken from 25 cases of leukoplakia and lichen planus each were stained with rapid PAP and silver nitrate stains. Histopathological correlation was performed and further compared with rapid PAP and AgNOR for its diagnostic validity. Statistically significant increase in the mean AgNOR count was seen from normal epithelium to lichen planus to that of leukoplakia. When compared with rapid PAP, a linear correlation was seen in AgNOR counts and stages of dysplasia in leukoplakia which was also found to be statistically significant. Diagnostic accuracy for AgNOR in leukoplakia was found to be 84%, lichen planus 73%, whereas RAPID PAP showed 72% accuracy. AgNOR analysis may be useful as a quantitative marker of incipient cellular alterations and hence would be helpful in assessing suspicious lesions and thus can be regarded as a valuable adjunct. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  12. Correlation of STATs family expression in oral lichen planus tissue with peripheral blood PD-1 and PD-L1 expression as well as immune function

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    Hong Zhang

    2016-12-01

    Full Text Available Objective: To study the correlation of STATs family expression in oral lichen planus tissue with peripheral blood PD-1 and PD-L1 expression as well as immune function. Methods: A total of 47 patients diagnosed with oral lichen planus in our hospital between May 2015 and March 2016 were selected as the oral lichen planus group (OLP group of the study, and healthy volunteers receiving physical examination during the same period were selected as the control group of the study. Peripheral blood mononuclear cells were collected to detect the expression of PD-1, PD-L1 and immune cell surface marker molecules, serum was collected to detect the content of Th1 and Th2 cytokines as well as immunoglobulin, and oral lichen planus lesion tissue and adjacent normal tissue were collected to determine STATs family expression. Results: p-STAT1, p-STAT3 and p-STAT5a expression in lesion tissue were significantly higher than those in normal tissue while p-STAT2, p-STAT4 and p-STAT5b expression were not significantly different from those in normal tissue; PD-1 and PD-L1 mRNA expression as well as the mean fluorescence intensity of CD19+ in peripheral blood mononuclear cells of OLP group were significantly higher than those of control group and positively correlated with p-STAT1, p-STAT3 and p-STAT5a expression while the mean fluorescence intensity of CD3+, CD4+, CD8+ and CD16+CD56+ were significantly lower than those of control group and negatively correlated with p-STAT1, p-STAT3 and p-STAT5a expression; serum IFN-γ and IL-2 content of OLP group were significantly lower than those of control group and negatively correlated with p-STAT1, p-STAT3 and p-STAT5a expression while IL-4, IL-10, IgG, IgM and IgA content were significantly higher than those of control group and positively correlated with p-STAT1, p-STAT3 and p-STAT5a expression. Conclusion: p-STAT1, p-STAT3 and p-STAT5a expression abnormally increase in oral lichen planus tissues, and the Th1/Th2 cellular

  13. Oral lichen planus versus epithelial dysplasia: difficulties in diagnosis Líquen plano bucal versus displasia epitelial: dificuldades diagnósticas

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    Fernando Augusto Cervantes Garcia de Sousa

    2009-10-01

    Full Text Available Histopathological diagnosis of oral lichen planus is not easy since some cases of epithelial dysplasia may present traits which are very similar to those from lichen planus. AIM: to compare cell alterations which suggest malignancy present in oral lichen planus with those from epithelial dysplasia. MATERIAL AND METHODS: histological cross-sections of oral lichen planus and dysplasia, dyed by hematoxylin-eosin, were analyzed by means of light microscopy. RESULTS: variance analysis (alpha=5% revealed a statistically significant difference between the average number of cell alterations in the lichen planus (5.83±1.61 and epithelial dysplasia (4.46±1.26. The chi-squared test did not show statistically significant differences between oral lichen planus and epithelial dysplasia in relation to the following cell alterations: increase in nucleus/cytoplasm ratio, nuclear hyperchromatism, irregular chromatin distribution and enlarged nuclei (p>0.05. CONCLUSION: Some cell alterations which suggest malignancy present in the oral lichen planus may also be found in epithelial dysplasia, impairing its diagnosis and, consequently, stressing the importance of following these patients in the long run.O diagnóstico histopatológico do líquen plano bucal não é fácil, pois alguns casos de displasia epitelial podem apresentar características bastante semelhantes às do líquen plano. OBJETIVO: Comparar as alterações celulares sugestivas de malignidade presentes no líquen plano bucal com as da displasia epitelial. MATERIAL E MÉTODOS: Cortes histológicos de líquen plano bucal e displasia, corados com hematoxilina-eosina, foram analisados por meio da microscopia de luz. RESULTADOS: A análise de variância (alfa=5% revelou haver diferença estatisticamente significante entre o número médio de alterações celulares no líquen plano bucal (5,83±1,61 e na displasia epitelial (4,46±1,26. O teste de qui-quadrado não mostrou diferença estatisticamente

  14. Low-dose oral isotretinoin therapy in lichen planus pigmentosus: an open-label non-randomized prospective pilot study.

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    Muthu, Sendhil Kumaran; Narang, Tarun; Saikia, Uma N; Kanwar, Amrinder Jit; Parsad, Davinder; Dogra, Sunil

    2016-09-01

    Lichen planus pigmentosus (LPP) is a cosmetically distressing pigmentary disorder often posing a therapeutic challenge. Isotretinoin has been shown to be effective in oral and cutaneous LP, but its role in LPP is yet unknown. To evaluate the efficacy and safety of isotretinoin in the management of LPP. In this prospective study, 32 clinically and histologically proven patients with LPP were recruited. Subjects were treated with fixed low-dose (20 mg/day) oral isotretinoin once daily for 6 months along with topical sunscreens. Response was graded as mild (50%) improvement based on decrease in intensity and progression of hyperpigmentation. Twenty-seven patients (17 females and 10 males), aged 20-62 years, completed the study. Twenty-three (85.2%) patients had active disease and pruritus at presentation. Treatment outcome was moderate improvement in 15 patients (55.7%) followed by good in seven (21.8%) and mild in two (6.2%). Pruritus subsided at the earliest at 9-14 days, and disease stabilized by 4-6 weeks in treatment-responsive patients. Patients with a shorter duration (≤5 years) of disease and limited body area involvement had a better outcome. Low-dose isotretinoin seems to be a promising treatment modality in stabilizing and decreasing the pigmentation in LPP particularly in early and limited disease. © 2016 The International Society of Dermatology.

  15. A Randomized Placebo-controlled Double Blind Clinical Trial of Quercetin for Treatment of Oral Lichen Planus

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    Maryam Amirchaghmaghi

    2015-03-01

    Full Text Available Background and aims. Standard treatment of oral lichen planus (OLP includes topical or systemic corticosteroids that have many adverse effects. A trend toward alternative natural or herbal drugs has attended recently. This study was con-ducted to evaluate the effect of quercetin in treatment of erosive-atrophic OLP. Materials and methods. Thirty patients participated in this randomized clinical trial from April 2010 to June 2010 (Trial Registration Number: NCT01375101. Patients were randomly allocated in two groups. Both groups received the standard treatment (dexamethasone mouthwash and nystatin suspension. Experimental group received oral 250 mg quercetin hydrate capsules (bid and the control group received placebo capsules. The pain and severity of the lesions were recorded at the initial visit and the follow-ups. All recorded data were analyzed with chi-square, Mann-Whitney, t-test, Wilcoxon and Friedman tests using SPSS 11.5. Results. There were no significant differences between the two groups in severity of the lesions and pain in the follow-ups.According to the Friedman test, there was a significant reduction in pain (P = 0.01 and severity indices (P = 0.00 in the case group. These differences were not observed in the control group (P = 0.26, SI; and P = 0.86, PI. No adverse effect of quercetin was reported. Conclusion. According to the results, no significant therapeutic effect can be considered for quercetin in treatment of OLP.

  16. The role of anxiety, depression, and psychological stress on the clinical status of recurrent aphthous stomatitis and oral lichen planus.

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    Gavic, Lidia; Cigic, Livia; Biocina Lukenda, Dolores; Gruden, Vladimir; Gruden Pokupec, Josipa Sanja

    2014-07-01

    In spite of all the efforts, recurrent aphthous stomatitis (RAS) and oral lichen planus (OLP) still have unexplained etiology. The role of anxiety, depression, and psychological stress in occurrence and intensity of symptoms in RAS and OLP patients has been investigated in this study. A total of 110 patients with RAS in the acute phase and 112 patients with OLP also in acute phase participated in this study. All patients filled out questionnaires related to the primary disease (RAS/OLP) after which they took the following psychological tests: Beck Depression Inventory (BDI), The State-Trait Anxiety Inventory (STAI), and Ways of Coping Questionnaire (WCQ). According to multiple regression analysis, in patients with RAS, the highest correlation was found between results of the pain intensity and STAI test (β= 0.66; p < 0.000). In the patients with OLP, the highest correlation was found between the level of hyperkeratosis and WCQ test (β = 0.53; P < 0.000), inflammation and results of BDI test (β = 0.33; P < 0.002), and results of dynia test and STAI test (β = 0.31; P < 0.004). In this study, a high correlation between anxiety, depression, and psychological stress with symptoms of RAS and OLP has been observed. © 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  17. Incidence of Oral Lichen Planus in Perimenopausal Women: A Cross-sectional Study in Western Uttar Pradesh Population

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    Mohan, Ravi Prakash Sasankoti; Gupta, Akanksha; Kamarthi, Nagaraju; Malik, Sangeeta; Goel, Sumit; Gupta, Swati

    2017-01-01

    Background: Hormonal fluctuations during menopause lead to endocrine changes in women, especially in their sex steroid hormone production. Studies have documented the role of estrogen and progesterone (Pg) on autoimmune disorders such as multiple sclerosis, systemic lupus erythematosus, and rheumatoid arthritis. Lichen planus (LP), an autoimmune disorder, seen frequently in perimenopausal women, may also get affected by sex steroid hormones, but no direct relationship has been established yet. Aim: The aim of this study is to find the incidence of oral LP (OLP) in perimenopausal women and evaluate the factors associated with it. Materials and Methods: This cross-sectional study was conducted over a period of 1 year. All the perimenopausal women (44.69 ± 3.79 years) who came to the dental outpatient department were evaluated for the presence of LP and various factors associated with it. Depression Anxiety Stress Scale-21 questionnaire was used for psychometric evaluation of perimenopausal women. Results: According to our study, incidence of LP in postmenopausal women was 10.91%, which is higher than incidence of LP in general population, i.e., 0.5% to 2.0%. Incidence of LP increased with the severity of depression in perimenopausal women (P = 0.000). Conclusion: The incidence of OLP is higher in perimenopausal women than in general population and increases significantly with increase in the severity of depression. LP in perimenopausal women can be mediated by declined level of estrogen and Pg directly or indirectly through causing depression that can trigger LP. PMID:28706407

  18. Efficacy of laser phototherapy in comparison to topical clobetasol for the treatment of oral lichen planus: a randomized controlled trial

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    Dillenburg, Caroline Siviero; Martins, Marco Antonio Trevizani; Munerato, Maria Cristina; Marques, Márcia Martins; Carrard, Vinícius Coelho; Filho, Manoel Sant'Ana; Castilho, Rogério Moraes; Martins, Manoela Domingues

    2014-06-01

    Oral lichen planus (OLP) is a relatively common chronic mucocutaneous inflammatory disease and a search for novel therapeutic options has been performed. We sought to compare the efficacy of laser phototherapy (LPT) to topical clobetasol propionate 0.05% for the treatment of atrophic and erosive OLP. Forty-two patients with atrophic/erosive OLP were randomly allocated to two groups: clobetasol group (n=21): application of topical clobetasol propionate gel (0.05%) three times a day; LPT group (n=21): application of laser irradiation using InGaAlP diode laser three times a week. Evaluations were performed once a week during treatment (Days 7, 14, 21, and 30) and in four weeks (Day 60) and eight weeks (Day 90) after treatment. At the end of treatment (Day 30), significant reductions in all variables were found in both groups. The LPT group had a higher percentage of complete lesion resolution. At follow-up periods (Days 60 and 90), the LPT group maintained the clinical pattern seen at Day 30, with no recurrence of the lesions, whereas the clobetasol group exhibited worsening for all variables analyzed. These findings suggest that the LPT proved more effective than topical clobetasol 0.05% for the treatment of OLP.

  19. Diurnal trajectories of salivary cortisol, salivary α-amylase and psychological profiles in oral lichen planus patients.

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    Pippi, R; Patini, R; Ghiciuc, C M; Sandu, R B; Pasquali, V; Scaccianoce, S; Dima-Cozma, L C; Patacchioli, F R

    2014-01-01

    Although many reports have been published on the link between oral lichen planus (OLP) and the stress-related neuro-psycho-endocrine clinical features of the disease over the last 20 years, the data still remain controversial. Therefore, the aim of this study was to explore the personality traits of OLP subjects and assess the subjects' capability of coping with stress challenges. Cortisol and alpha-amylase were measured as reliable markers of the hypothalamic-pituitary-adrenal (HPA) axis and autonomic nervous system (ANS) activities in salivary samples collected by the participants at their home during the sampling day (07:30, 12:00, and 19:30). Compared with the healthy controls, the OLP patients demonstrated a less effective coping ability, had higher scores in stress perception and loneliness, and had no significant variation in their anxiety and depressive symptoms. The OLP patients also showed dysregulation of the HPA axis activity with a significant reduction of diurnal salivary cortisol production, which was particularly significant in the morning hours. No significant variation was found in the OLP salivary alpha-amylase diurnal fluctuation and production, which was measured at the same time point as that for cortisol. In conclusion, we report that OLP subjects had a reduced capability of coping with stress events and presented a dysregulation of HPA axis activity with hypocortisolism detected in the morning hours.

  20. Evaluation of ploidy status using DNA-image cytometry of exfoliated mucosal cells in oral lichen planus

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    Ravi Teja Chitturi

    2014-01-01

    Full Text Available Background: Oral lichen planus (OLP is one of the potentially malignant disorders (PMDs with a malignancy rate of 0.2-2%. Aneuploidy is considered to be one of the important markers for malignant transformation and DNA-image cytometry (DIC has been successfully employed in oral mucosal PMDs and also in tumors of the cervix, lung and biliary tract. Aims: In this study, we intend to assess the ploidy status of exfoliated cells in OLP using DIC. Materials and Methods: Exfoliated cells from 48 patients with different subtypes of OLP (reticular, plaque type, erosive and atrophic and 10 controls were stained using Feulgen reaction and assessed for integrated optical density using image analysis software and the ploidy status was assessed. Results: All the patients in the control group and most of the patients (93.5% who had reticular or plaque type of OLP (29 out of 31 exhibited diploid nuclei in the smears, whereas 11 patients who had erosive or atrophic types of OLP showed aneuploid nuclei. Conclusions: The patients with erosive or atrophic types of OLP are at more risk and assessment of ploidy status by exfoliative cytology can be used as an adjuvant for diagnosis.

  1. Increased expression of Smad proteins, and in particular Smad3, in oral lichen planus compared to normal oral mucosa.

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    Danielsson, K; Wahlin, Y B; Coates, P J; Nylander, K

    2010-09-01

    Oral lichen planus (OLP) is a chronic inflammatory disease of the oral mucosa which the World Health Organisation (WHO) considers a premalignant condition. One step in malignant development is so called epithelial mesenchymal transition (EMT), a process whereby epithelial cells acquire mesenchymal characteristics. EMT occurs during embryogenesis and wound healing but also in some human diseases such as cancer and fibrosis. A factor known to induce EMT is transforming growth factor-β (TGF-β), which uses the Smad proteins as mediators for its signalling. TGF-β is also often over-expressed in squamous cell carcinoma of the head and neck (SCCHN). In the present study we mapped expression of Smad proteins in OLP lesions by immunohistochemistry, and compared to expression in normal and sensitive oral mucosa. The latter group of patients had developed SCCHN after shorter or longer periods of diffuse oral symptoms. The aim was to see if there were any signs of EMT related changes in the OLP lesions, as judged by changes in the TGF-β pathway. Changes in the TGF-β pathway related to EMT are seen in the very earliest stages of oral malignancy and become more severe as lesions progress. © 2010 The Authors. Journal of Oral Pathology & Medicine © 2010 John Wiley & Sons A/S.

  2. Thorough clinical evaluation of skin, as well as oral, genital and anal mucosa is beneficial in lichen planus patients.

    Science.gov (United States)

    Stojanovic, Larisa; Lunder, Tomaz; Rener-Sitar, Ksenija; Mlakar, Bostjan; Maticic, Mojca

    2011-03-01

    Lichen planus (LP) is a common mucocutaneous disease of unknown aetiology with various geographical prevalence, may be related to some serious disorders such as squamous cell carcinoma and often remains underdiagnosed. The aim of this retrospective study was to thoroughly determine localization and clinical characteristics of LP lesions in a cohort of 173 Slovenian patients in association to the presence of accompanying symptoms and history of potential stressful events. Isolated cutaneous lesions of LP were found in 56.6% and isolated oral LP in 3.5% of patients. Thirty-four percent presented orocutaneous LP, whereas genitocutaneous LP was noted in 1.2%, orogenito-cutaneous LP in 4% and orogenital LP in 0.5% of patients. Underlying stressful events were noted in 36 out of 137 (26.3%) patients. Despite obviously visible localization of the lesions various medical specialists should be familiar with LP and thoroughly examine the complete skin, as well as oral, genital and anal mucosa in each LP patient to avoid a delay in diagnosing this disease and possibly disclose a much serious underlying condition. Psychological support should be offered, if needed.

  3. The Effect of Pimecrolimus Cream 1% Compared with Triamcinolone Acetonide Paste in Treatment of Atrophic-Erosive Oral Lichen Planus

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    Atessa Pakfetrat

    2015-03-01

    Full Text Available Introduction: Oral lichen planus (OLP is a common chronic mucocutaneous disease. Patients with atrophic and erosive types of OLP often have symptoms of soreness, and require proper treatment. The main treatment for OLP has been the administration of topical or systemic corticosteroids. The objective of this study was to compare the efficacy of adcortyl cream (triamcinolone acetonide in orabase with topical pimecrolimus cream for the treatment of erosive OLP.   Materials and Methods: Twenty-eight patients with OLP were enrolled in a single blind clinical trial and assigned to either a pimecrolimus 1% cream group or an adcortyl 0.1% cream group. The medication was applied every day for 2 months and patients were assessed every 2 weeks.   Results: The mean lesion size and mean pain and burning sensation scores did not differ between the pimecrolimus and adcortyl cream groups. The pimecrolimus cream was well tolerated. No clinical drug-related adverse events were observed.   Conclusion:  Topical pimecrolimus cream may be recommended as a safe and effective alternative therapy in the treatment of OLP. Pimecrolimus cream is as effective as adcortyl cream in managing the signs and symptoms of OLP.

  4. Association between the clinical severity of oral lichen planus and anti-TPO level in thyroid patients.

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    Alikhani, Milad; Ghalaiani, Parichehr; Askariyan, Elham; Khunsaraki, Zahra Ahmadi; Tavangar, Atefeh; Naderi, Aliasghar

    2017-01-05

    This study considered a possible relationship between the severity of oral lichen planus (OLP), serum anti-TPO autoantibodies (TPOAb) titer and thyroid disease in OLP patients. Forty-six OLP patients with positive TPOAb results (> 35 IU/ml) who had also been diagnosed with thyroid disease were included in the study group. The control group consisted of 46OLP patients with no thyroid disease. The study and control groups (92) were divided to two subgroups of erosive OLP (EOLP) and non-erosive OLP (NEOLP). Serum TPOAb levels and IL-8 (to measure OLP severity) were evaluated using the independent t-test, chi-square and conditional logistic regression analysis (α = 0.05). A significant positive correlation was found between serum IL-8 and TPOAb levels in the study group (r = 0.783; p = 0.001). The positive blood levels of TPOAb were significantly associated with an increased risk of EOLP (OR = 4.02 at 95%CI; 1.21-13.4; p = 0.023). It is possible to used positive serum TPOAb levels in patients with OLP as in indicator of possible undetected thyroid disorders in those patients. Because erosive OLP has been associated with TPOAb in thyroid patients, it may be useful to determine TPOAb levels of such patients to diagnose a possible undetected thyroid disorders and follow-up for malignancy.

  5. Efficacy of tacrolimus and clobetasol in the treatment of oral lichen planus: a systematic review and meta-analysis.

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    Chamani, Goli; Rad, Maryam; Zarei, Mohammad Reza; Lotfi, Sodabeh; Sadeghi, Masoumeh; Ahmadi, Zahra

    2015-09-01

    This study was carried out to assess and compare the efficacy of tacrolimus and clobetasol in the treatment of oral lichen planus (OLP). The Cochrane Central Register of Controlled Trials, PubMed, Scopus, Science Direct, Springer Journals, and Elsevier databases were searched using specific keywords relevant to the research question for articles published from 1998 to December 31, 2012. Finally, 15 articles that assessed the effects of tacrolimus, clobetasol, and pimecrolimus on improvements in OLP were reviewed. In addition, a meta-analysis of odds ratios (ORs) was carried out for data in 10 of the 15 articles. The results showed that the ORs for improvements in OLP in patients taking clobetasol or tacrolimus, compared with those taking placebo or other drugs, were 1.19 and 8.00, respectively. It appears that topical tacrolimus is an effective alternative to topical clobetasol and may be considered as a first-line therapy in the management of OLP. © 2015 The International Society of Dermatology.

  6. Myeloid dendritic cells stimulated by thymic stromal lymphopoietin promote Th2 immune responses and the pathogenesis of oral lichen planus.

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    Masaki Yamauchi

    Full Text Available Oral lichen planus (OLP is a chronic inflammatory disease characterized by subepithelial T-cell infiltration. Recent studies reported that specific T helper (Th subsets, especially Th2 cells, are involved in the pathogenesis of OLP. Thymic stromal lymphopoietin (TSLP is mainly secreted by epithelial cells and potently activates myeloid dendritic cells (mDCs to induce Th2-mediated inflammation. Here, we investigated the expression of TSLP and related molecules in OLP. Buccal mucosa specimens from patients with OLP, hyperkeratosis, and ulcer were analyzed by immunohistochemistry for expression of TSLP, its receptor (TSLPR, and inflammatory cells. TSLP was detected in/around the epithelium of patients with OLP and hyperkeratosis, whereas TSLPR, CD11c (mDC, and GATA3 (Th2 were strongly expressed in the subepithelial layer only in OLP patients. Double immunofluorescence staining showed that TSLPR expression mainly co-localized with CD11c. Moreover, the number of CD11c- and GATA-3 positive cells was correlated in OLP patients. In lesions selectively extracted by laser microdissection, the mRNA expression of Th2 (IL-4, MDC, TARC, GATA3- and Th17 (IL-17, RORγt-related molecules in OLP patients was significantly higher than in other groups. These results suggest that CD11c+ mDCs expressing TSLPR contribute to aberrant Th2 immune responses and the pathogenesis of OLP via TSLP stimulation.

  7. The Effects of NBF Gingival Gel Application in the Treatment of the Erosive Lichen Planus: Case Report

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    Mirjana Popovska

    2016-01-01

    Full Text Available The therapy of erosive lichen planus (ELP has been particular problem in the treatment of oral lesions. This case of ELP in male patient 29 years old was treated with topic application of the NBF gingival gel, three times a day after meal, previously rinsed with Clorhexidine gluconate 0.12%. After 5 days of treatment, initial improvements were recorded, and after two weeks of application of the NBF gingival gel we observed significant improvement. Clinical monitoring after the fifth day showed mild epithelialization of the eroded mucosa, yet still present erythematous base of the lesion. After the second week the erythema area was significantly reduced and the eroded surfaces of the mucosa were minimal, measured less than 0.5 mm. After the third week there were no erosions to detect on the oral mucosa, yet still present vague redness, which completely pulled after the fourth week. Treatment ended after the fifth week when the topical application of the NBF gingival gel was terminated, and therapy was done, and clinically achieved effects remained stable even after the third month of the treatment. Topic application of the NBF gingival gel with ELP patients showed positive clinical effects in relatively short time period.

  8. Immunohistochemical expression of Bcl-2 and Ki-67 in oral lichen planus and leukoplakia with different degrees of dysplasia.

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    Pigatti, Fernanda Mombrini; Taveira, Luís Antônio de Assis; Soares, Cléverson Teixeira

    2015-02-01

    Oral lichen planus (OLP) is a chronic inflammatory disease of unknown cause. Malignant transformation in OLP lesions may be favored by changes in the expression of proteins that regulate cell proliferation and apoptosis. This study aimed to investigate these issues by immunohistochemical staining for Bcl-2 and Ki-67 and by correlating histopathological findings in samples from lesions of OLP and leukoplakia with epithelial dysplasia. Data for patients with OLP or leukoplakia with moderate or severe epithelial dysplasia recorded during 2006-2011 were retrospectively reviewed. The study samples represented 37 subjects with OLP (n = 14), leukoplakia with moderate (n = 8) or severe (n = 6) epithelial dysplasia, and normal buccal mucosa (controls, n = 9). New sections were subjected to histological examination and immunohistochemistry for Bcl-2 and Ki-67 in the basal layer, suprabasal layer, and inflammatory infiltrate, respectively. All basal layer sections stained either negative or positive in leukoplakia, 85.7% of sections indicated positivity in leukoplakia (64.3%) sections stained positive for Ki-67 in >50% of cells. All suprabasal sections stained either negative or positive in leukoplakia (42.9% and 57.1%, respectively), and control (88.9% and 11.1%, respectively) samples. Suprabasal staining for Ki-67 was negative or positive in leukoplakia (7.1% and 92.9%, respectively), and controls (88.9% and 11.1%, respectively). Staining for Bcl-2 in inflammatory infiltrate in OLP was positive in 92.9% of sections. Expression of Bcl-2 may play a dual role in tumor development and progression. Increased cell proliferation in the epithelium may present a predisposition to cancer in OLP. The expression of Ki-67 can be considered as an adjunct marker for proliferative activity in lesions with malignant potential. The prognostic value of these immunomarkers in the evaluation of precancerous oral lesions requires further investigation. © 2014 The International Society

  9. Oral health-related quality of life of patients with oral lichen planus, oral leukoplakia, or oral squamous cell carcinoma.

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    Karbach, Julia; Al-Nawas, Bilal; Moergel, Maximilian; Daubländer, Monika

    2014-08-01

    To compare oral health-related quality of life (OHRQoL) of patients with oral lichen planus (OLP), oral leukoplakia (OL), or oral squamous cell carcinoma (OSCC). Seventy-three patients with OLP, 44 with OL, and 37 with OSCC participated in this prospective study. The German version of the 14-item Oral Health Impact Profile (OHIP-G 14) was used to measure OHRQoL. Descriptive statistics and multivariate analysis of clinical forms, age, gender, alcohol consumption, and smoking habits were evaluated. No association to cumulative OHIP-14 score (P = .086) among the 3 groups was found. However, patients with OLP showed a higher "physical pain" score and a lower "social disability" score (P = .026) than patients with OSCC, followed by patients with OL. Women with OLP had a lower OHRQoL than men. After differentiation of clinical forms of OLP (symptomatic vs asymptomatic), an impact on these patients' OHRQoL in the dimensions "physical pain" and "physical disability" was found. Patients with OLP or OSCC and high OHIP-G 14 scores reported physical pain, which emphasizes the need for physical therapy. For improved OHRQoL, patients with symptomatic forms of OLP would gain more from a treatment compared with those with asymptomatic forms. In contrast, patients with asymptomatic OLP or OL and thus with a minimal impact on their OHRQoL might be at risk of delayed consultation, diagnosis, and treatment of their condition. Copyright © 2014 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.

  10. Declined hTERT expression of peripheral blood CD4(+) T cells in oral lichen planus correlated with clinical parameter.

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    Zhang, Jing; Wei, Ming-Hui; Lu, Rui; Du, Ge-Fei; Zhou, Gang

    2016-08-01

    Oral lichen planus (OLP) is a chronic, T-cell-mediated inflammatory autoimmune disease. Human telomerase reverse transcriptase (hTERT), a catalytic subunit bearing the enzymatic activity of telomerase, may have a unique function in regulating the activation, proliferation, and function of T lymphocytes. The goal of this study was to investigate the expression of hTERT in CD4(+) and CD8(+) T cells from patients with OLP and its correlation with clinical parameter. The disease severity of OLP was assessed by RAE (reticular, atrophic, erosive) scoring system. Expressions of hTERT in CD4(+) T cells and CD8(+) T cells isolated from peripheral blood of patients with OLP were detected by real-time PCR, and their correlations with clinical features were analyzed. hTERT mRNA levels in CD4(+) T cells of OLP were significantly lower than that of controls, while the levels in CD8(+) T cells showed no statistical difference. The expression of hTERT in CD4(+) T cells and CD8(+) T cells was neither associated with disease severity nor gender. CD4(+) T cells of OLP patients with the age ≤50 had markedly decreased hTERT levels compared with controls, but CD8(+) T cells did not. A divergent hTERT pattern between CD4(+) and CD8(+) T cells was implicated in OLP. Decreased hTERT in CD4(+) T cells might be responsible for the immune dysfunction in OLP. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  11. Cost of illness of oral lichen planus in a U.K. population--a pilot study.

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    Ni Riordain, Richeal; Christou, Joanna; Pinder, Denise; Squires, Vanessa; Hodgson, Tim

    2016-05-01

    To assess the economic burden of oral lichen planus (OLP) from the perspective of the healthcare provider in a U.K. population. This prevalence-based cost-of-illness analysis was carried out via a cross-sectional study conducted in the Oral Medicine Unit of the Eastman Dental Hospital. This study was conducted in three phases - phase 1 involved framing of the cost-of-illness analysis, development of the cost inventory and design of the patient questionnaire for ease of data collection. Data collected from patients were inputted during phase 2, and costings were determined. The final phase consisted of the calculation of the cost of illness of OLP. One hundred patients were enrolled in the study, 30 males and 70 females, with an average age of 59.9 years (±13.4 years). The average OLP patient, based on our cohort, attends the oral medicine unit 2.64 times per year, their general medical practitioner 1.13 times annually, their general dental practitioner 0.82 times in a year and fills on average 3.37 prescriptions annually. This leads to an average annual cost of £398.58 (€541.16) per patient per year from the perspective of the healthcare provider. The annual average cost of OLP to the healthcare provider in the U.K. is substantial. The prevalence-based cost-of-illness data generated in this study will facilitate comparison with other chronic oral mucosal diseases and with chronic diseases managed in allied medical specialties. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  12. Aberrant expression of interleukin-22 and its targeting microRNAs in oral lichen planus: a preliminary study.

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    Shen, Zhengyu; Du, Guanhuan; Zhou, Zengtong; Liu, Wei; Shi, Linjun; Xu, Hui

    2016-08-01

    Oral lichen planus (OLP) is a T cell-mediated autoimmune disease involving oral mucosa. Interleukin-22 (IL-22) as the signature cytokine of T helper 22 cells is increasingly recognized as a key regulator in various autoimmune diseases. Our previous study reported that IL-22 immunoexpression in OLP was significantly increased compared with the normal controls. The objective of this preliminary study was to compare the IL-22 expression levels in oral biopsies from patients with OLP (n = 50) against normal oral mucosa (n = 19) using RT-qPCR and Western blot, identify the potential targeting miRNAs of IL-22, and examine the miRNA expression levels in OLP. Interleukin-22 expression level in OLP was significantly increased compared with the normal controls. The Dual-Luciferase reporter assay system in human embryonic kidney 293 (HEK293) cells demonstrated that miR-562 and miR-203 were the target miRNAs of IL-22, which was consistent with predictions from bioinformatics software analyses. Interestingly, miR-562 expression in OLP was significantly decreased, but miR-203 expression in OLP was significantly increased compared with the normal controls. This preliminary study for the first time reported that aberrant expression levels of miR-562 and miR-203 were associated with high expression of IL-22 and demonstrated the target relationship between miRNAs and IL-22 in HEK293 cells. Our data indicated that IL-22 and its targeting miRNAs contribute to the pathogenesis of OLP. Further studies are required to investigate the regulatory pathways of IL-22 and miR-562 and miR-203 in OLP. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  13. The oxidative stress parameters and the effect of dyslipidemia on the parameters of oxidative stress in lichen planus

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    Arzu Kılıç

    2015-12-01

    Full Text Available Background and Design: Various reports have demonstrated an association between inflammatory skin disorders and oxidative stress. Additionally, dyslipidemia and systemic disorders have been found to associate with chronic inflammatory skin diseases. In this study, we aimed to investigate the oxidative stress parameters and the effect of dyslipidemia on the parameters of oxidative stress in lichen planus (LP. Materials and Methods: Fifty-four patients with LP and 60 control subjects were enrolled in the study. Total cholesterol, triglyceride, highdensity lipoprotein cholesterol (HDL-C, low-de nsity lipoprotein cholesterol (LDL-C, and very low density lipoprotein cholesterol (VLDL-C levels were studied in all participants. After participants with associated systemic diseases were excluded, total antioxidant status (TAS, paraoxonase (PON, arylesterease, stimulated PON and total thiol levels (TTL levels were studied in 36 patients with LP and control group. Results: 62.96% of the patients were detected to have dyslipidemia. Total cholesterol and LDL-C levels were found to be significantly higher and HDL-C levels were found to be significantly lower in patient group when compared with control group. Serum TAS was found to be significantly lower in patient group than in control group. When patients with dyslipidemia were compared with patients without dyslipidemia in terms of oxidative stress parameters, serum level of TTL was found to be lower in patients with dyslipidemia. Conclusion: In this study, LP was associated with dyslipidemia. Besides, our findings showed that decreased TAS activity might have a role in the pathogenesis of LP. Our findings support that associated dyslipidemia may contribute to the etiopathogenesis of LP by reducing the antioxidant defense. Prospective studies with larger samples are needed to enlighten the possible effects of dyslipidemia on the incidence, mechanism and severity of LP

  14. Incidence of oral lichen planus in perimenopausal women: A cross-sectional study in Western Uttar Pradesh population

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    Ravi Prakash Sasankoti Mohan

    2017-01-01

    Full Text Available Background: Hormonal fluctuations during menopause lead to endocrine changes in women, especially in their sex steroid hormone production. Studies have documented the role of estrogen and progesterone (Pg on autoimmune disorders such as multiple sclerosis, systemic lupus erythematosus, and rheumatoid arthritis. Lichen planus (LP, an autoimmune disorder, seen frequently in perimenopausal women, may also get affected by sex steroid hormones, but no direct relationship has been established yet. Aim: The aim of this study is to find the incidence of oral LP (OLP in perimenopausal women and evaluate the factors associated with it. Materials and Methods: This cross-sectional study was conducted over a period of 1 year. All the perimenopausal women (44.69 ± 3.79 years who came to the dental outpatient department were evaluated for the presence of LP and various factors associated with it. Depression Anxiety Stress Scale-21 questionnaire was used for psychometric evaluation of perimenopausal women. Results: According to our study, incidence of LP in postmenopausal women was 10.91%, which is higher than incidence of LP in general population, i.e., 0.5% to 2.0%. Incidence of LP increased with the severity of depression in perimenopausal women (P = 0.000. Conclusion: The incidence of OLP is higher in perimenopausal women than in general population and increases significantly with increase in the severity of depression. LP in perimenopausal women can be mediated by declined level of estrogen and Pg directly or indirectly through causing depression that can trigger LP.

  15. Comparison of Low-Level Laser Therapy versus Ozone Therapy in the Treatment of Oral Lichen Planus.

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    Kazancioglu, Hakki Oguz; Erisen, Merve

    2015-10-01

    The treatment options for oral lichen planus (OLP) are numerous and include topical and systemic agents. Intralesional and systemic corticosteroids are used; however, the therapeutic results are often disappointing. To compare the influence of ozone, laser, and topical corticosteroid therapies in the treatment of OLP. One hundred twenty adult patients with ≤3 cm atrophic-erosive biopsy-proven OLPs in the tongue or buccal mucosa were recruited into the study. They were randomly assigned, by preoperative envelope drawing, to be treated with low-level laser therapy (LLLT group), ozone therapy (ozonated group), and topical corticosteroid therapy (positive control group). A placebo treatment containing base ointment without the active corticosteroid component was administered to patients in the negative control group. Response rate scores were determined on the basis of changes in the appearance score and pain score of the lesions between baseline and after each treatment. The study subjects consisted of 56 male and 64 female OLP patients with a combined mean age of 42.6±8.3 years (range, 28~55 years). No statistically significant difference was detected in clinical severity among the groups. The sign scores decreased in almost all scoring groups; however, statistically significant improvement was found in the ozonated and corticosteroid-treated groups. Symptom improvement was achieved after treatment with LLLT, ozone, and corticosteroid (p<0.05). The efficacy indices were significantly higher in the ozonated and corticosteroid-treated groups. Ozone and corticosteroid therapies were more effective than 808-nm LLLT in the treatment of OLP.

  16. Comparison of the dental serial patch test outcomes of lichen planus patients with and without oral involvement

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    Nihal Altunışık

    2015-12-01

    Full Text Available Background and Design: Lichen planus (LP is a chronic and enflammatory cutaneous disease. Numereous diseases and agents have been accused in the etiology of LP. The materials used in dental treatment are one of these factors. We aimed to compare the results of dental series patch test in LP patients with and without oral involvement to determine whether the dental restorative materials play a role in the etiology of LP and to detect the effect of dental materials in cases where there is no oral involvement. Materials and Methods: The study involved a total of 38 patients who were admitted to the Dermatology Department and Dentistry Faculty Oral and Maxillofacial Surgery Department and were diagnosed with LP clinically and/or histopathologically. Nineteen of patients had oral involvement and the other 19 patients had no oral involvement. All of the patients received dental serial patch test. Results: Fourteen of the 19 patients with oral involvement (73.7% and 15 patients without oral involvement (78.9% showed positive reaction against at least one material. There was no statistically significant difference between the groups in terms of patch test positivity (p=1.00. The allergens that mostly caused positive reaction against patch test in the group with oral involvement were copper sulfate and cobalt (II cloride hexahydrate (23.3%. In the group without oral involvement the most common allergen that caused positive reaction was copper sulfate (%47.3. Conclusion: The similarity of the allergens that caused positive reaction and the rate of positivity in dental serial patch test in the groups with and without oral involvement promote that the dental restorative materials may trigger the disease even in cases without oral LP. This study is a preliminary study due to the lack of a healthy control group and the small number of subjects.

  17. Hematinic deficiencies and anemia statuses in antigastric parietal cell antibody-positive erosive oral lichen planus patients with desquamative gingivitis.

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    Chang, Julia Yu-Fong; Wang, Yi-Ping; Wu, Yang-Che; Wu, Yu-Hsueh; Tseng, Chih-Huang; Sun, Andy

    2016-10-01

    Erosive oral lichen planus (EOLP) patients with desquamative gingivitis (DG) are sometimes encountered in our oral mucosal disease clinic. This study assessed hematinic deficiencies and anemia statuses in antigastric parietal cell antibody (GPCA)-positive EOLP patients with DG (GPCA+/DG+/EOLP patients). The blood hemoglobin, iron, vitamin B12, folic acid, and homocysteine concentrations and serum GPCA levels in 92 GPCA+/DG+/EOLP patients and 184 age- and sex-matched healthy controls were measured and compared between the two groups. We found that 27 (29.3%), 16 (17.4%), and 27 (29.3%) of 92 GPCA+/DG+/EOLP patients had hemoglobin (men  12.1μM). GPCA+/DG+/EOLP patients had a significantly higher frequency of hemoglobin, iron, or vitamin B12 deficiency and an abnormally high blood homocysteine level than healthy control individuals (all p < 0.001). Of 27 anemic GPCA+/DG+/EOLP patients, 13 (48.2%) had pernicious anemia, five (18.5%) had iron deficiency anemia, one (3.7%) had thalassemia trait, and the remaining eight (29.6%) had normocytic anemia. Moreover, of the 92 GPCA+/DG+/EOLP patients, 24 had macrocytosis, and only 13 (54.2%) of these 24 patients had pernicious anemia. We conclude that GPCA+/DG+/EOLP patients may have vitamin B12 deficiency, iron deficiency, and an abnormally high blood homocysteine level. In addition to pernicious anemia, GPCA+/DG+/EOLP patients may sometimes have normocytic anemia or iron deficiency anemia. Copyright © 2016. Published by Elsevier B.V.

  18. LCK, survivin and PI-3K in the molecular biomarker profiling of oral lichen planus and oral squamous cell carcinoma.

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    Oluwadara, Oluwadayo; Giacomelli, Luca; Christensen, Russell; Kossan, George; Avezova, Raisa; Chiappelli, Francesco

    2009-12-31

    T cell signaling is critical in oral lichen planus (OLP) based on the pathogenesis of this chronic inflammatory autoimmune mucocutaneous lesion. Lck plays a key role in T cell signaling; ultimately this signaling affects other targets such as PI-3K. Excessive activity in PI-3K inhibits apoptosis and promotes uncontrolled cell growth. Molecular biomarker profiling in OLP, Chronic Interface Mucosities (CIM), Epithelial Dysplasia (EpD) and Oral Squamous Cell Carcinoma (SCCA) with application of the principle of biomarker voting may represent a new frontier in the diagnosis, assessment and the arguable debate of OLP transformation to cancer. The presence of Lck, PI-3K and Survivin, a cancer specific anti-apoptotic protein was assessed, using immunohistochemistry and tissue micro-array on patient samples, in OLP, SCCA, CIM and EpD. Lck expression was very high in 78.6 % of OLP patients compared to 3.7% in SCCA; PI-3K was high in 63% of SCCA, 100% of EpD, and 35.7% OLP cases. Survivin was high in 64.3% of OLP cases, 96.3% of SCCA, and 100% of EpD. CIM cases may be slightly different molecularly to OLP. Taken together, our data suggest that biomarker protein voting can be effectively used to isolate high-risk OLP cases. Specifically, we show data with four remarkable cases demonstrating that molecular factors are predictive of histopathology. We conclude that it is safer to treat OLP as premalignant lesions, to adopt aggressive treatment measure in histopathologic described well and moderately differentiated SCCA, and to monitor progress of these diseases molecularly using individualized auto-proteomic approach. The use of Lck inhibitors in OLP management needs to be investigated in the future.

  19. Molecular Targeting of Her-2/neu Protein Is Not Recommended as an Adjuvant Therapy in Oral Squamous Cell Carcinoma and Oral Lichen Planus.

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    Kouhsoltani, Maryam; Aghbali, Amirala; Shokoohi, Behrooz; Ahmadzadeh, Ronak

    2015-12-01

    Target therapy against molecular markers of EGFR family has been recently used in the treatment protocol of several diseases. However, the role of Her-2/neu in OSCC is a matter of controversy and more studies are required to clarify the role of Her-2/neu in OSCC. We aimed to investigate the role of Her-2/neu in the process of carcinogenesis in oral epithelium as ELP is a premalignant and OSCC is a malignant lesion, but RLP shows no evidence of premalignancy and malignancy.To our Knowledge, this is the first study comparing Her-2/neu expression in erosive lichen planus (ELP), reticular lichen planus (RLP), and oral squamous cell carcinoma (OSCC). 60 samples, including 20 cases of RLP, 20 cases of ELP, and 20 cases of OSCC were evaluated immunohistochemically in this study. Our findings showed that there was not a significant increase in Her-2/neu expression from RLP to ELP and from ELP to OSCC. Therefore, Her-2/neu had no role in differentiating between RLP, ELP and OSCC and this protein does not contribute to the process of carcinogenesis in the oral epithelium. The lack of Her-2/neu overexpression indicates that molecular targeting of Her-2/neu protein is not recommended as an adjuvant therapy in OSCC and OLP.

  20. Evaluation of prolidase activity and oxidative stress in patients with oral lichen planus and oral lichenoid contact reactions.

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    Batu, Şule; Ofluoğlu, Duygu; Ergun, Sertan; Warnakulasuriya, Saman; Uslu, Ezel; Güven, Yegane; Tanyeri, Hakkı

    2016-04-01

    The aim of this study was to evaluate prolidase activity and oxidative stress in patients with oral lichen planus (OLP) and oral lichenoid contact reactions (OLCR) using serum and salivary samples and to compare these biomarkers with each other as well as with a group of healthy subjects in order to be able to opine their role in the estimation of OLP and OLCR. Eighteen recently diagnosed patients with OLP, 32 patients with OLCR and 18 healthy controls with matched periodontal status were recruited to the study. Prolidase activity, lipid peroxidation product malondialdehyde (MDA), sialic acid (SA), and advanced oxidation protein products (AOPPs) levels in both serum and saliva were determined. Additionally, salivary flow rate and its buffering capacity were estimated. Statistical analyses were performed using the chi-square test, t-test, Mann-Whitney U-test, and Spearman's rho correlation coefficient. No statistically significant differences were observed between the study groups and the control group regarding to the basic characteristics and the periodontal status (P > 0.05). There were no statistically significant differences between OLP and OLCR groups regarding to the distribution of lesions' type, severity, and location (P > 0.05). No significant differences were found between the two study groups with regard to Prolidase activity, MDA, SA, and AOPPs (P ˃ 0.05), whereas statistically significant differences were found between the two study groups and the control group with regard to all evaluated parameters except of serum prolidase (P ˂ 0.01). Moderate correlation was found between salivary MDA and the OLP/OLCR lesion severity, whereas a weak correlation was observed between serum SA and the OLP/OLCR lesion severity (P ˂ 0.05). The findings of this study suggest an increased prolidase activity and oxidative stress and imbalance in the antioxidant defense system in biological fluids of patients with OLP and OLCR when compared with the healthy subjects

  1. Phenotypically non-suppressive cells predominate among FoxP3-positive cells in oral lichen planus.

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    Schreurs, Olav; Karatsaidis, Andreas; Schenck, Karl

    2016-11-01

    Oral lichen planus (OLP) is a common T-cell-dominated oral chronic inflammatory disease occurring in periods of remission, quiescence, activity with pronounced inflammation, and acute ulceration. Cell infiltrates in OLP contain varying numbers of CD4+ T cells expressing the transcription factor FoxP3. FoxP3+ CD4+ T cells are, however, a heterogeneous cell population containing suppressive and non-suppressive cells, and their distribution in infiltrates from OLP is unknown. Biopsies were taken from normal oral mucosa (n = 8) and OLP lesions (n = 19), and a set of in situ methods for the determination of the functional phenotype of FoxP3+ CD4+ T cells was applied. Numbers of FoxP3+ CD4+ T cells were highest in the atrophic form of the disease, yet low in the ulcerative form. The main FoxP3+ CD4+ T-cell population observed was FoxP3+ CD45RA- CD25+ CD45RO+ and CD15s- , a phenotype delineating a non-suppressive subset. Numbers of cells with an actively suppressing phenotype (FoxP3+ CD45RA- CD25+ CD45RO+ and CD15s+ ) were, however, about twice as high in reticular lesions as compared with the atrophic form. Many FoxP3+ CD4+ T cells expressed T-bet, the hallmark transcription factor for IFN-γ-producing T cells, indicating that they may enhance immune and inflammatory responses rather than suppress them. The absence of actively suppressing FoxP3+ CD4+ T cells may in part explain why OLP is a remarkably persisting condition, in spite of the presence of substantially high numbers of FoxP3+ CD4+ T cells. The findings emphasize that it is crucial to examine not only numbers but also functional phenotype of FoxP3+ CD4+ T cells in human tissues. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  2. Lichens

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    Rodriguez, Cynthia M; Bennett, James P

    2012-01-01

    The prion diseases sheep scrapie and cervid chronic wasting disease are transmitted, in part, via an environmental reservoir of infectivity; prions released from infected animals persist in the environment and can cause disease years later. Central to controlling disease transmission is the identification of methods capable of inactivating these agents on the landscape. We have found that certain lichens, common, ubiquitous, symbiotic organisms, possess a serine protease capable of degrading prion protein (PrP) from prion-infected animals. The protease functions against a range of prion strains from various hosts and reduces levels of abnormal PrP by at least two logs. We have now tested more than twenty lichen species from several geographical locations and from various taxa and found that approximately half of these species degrade PrP. Critical next steps include examining the effect of lichens on prion infectivity and cloning the protease responsible for PrP degradation. The impact of lichens on prions in the environment remains unknown. We speculate that lichens could have the potential to degrade prions when they are shed from infected animals onto lichens or into environments where lichens are abundant. In addition, lichens are frequently consumed by cervids and many other animals and the effect of dietary lichens on prion disease transmission should also be considered. PMID:22453171

  3. Use of Direct-Acting Antivirals for the Treatment of Hepatitis C Virus-Associated Oral Lichen Planus: A Case Report

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    Kenji Misaka

    2016-10-01

    Full Text Available Hepatitis C virus (HCV is frequently associated with various extrahepatic manifestations such as autoimmune features and immune complex deposit diseases. Oral lichen planus (OLP is one of the representative extrahepatic manifestations of HCV infection. Direct-acting antivirals (DAA are highly effective and safe for the eradication of HCV. However, there is a lack of information regarding the association between HCV-associated OLP and interferon (IFN-free DAA therapy. Herein, we present the case of a 60-year-old female who was diagnosed with OLP during routine periodontal treatment by a dentist. The patient was referred for hepatitis C treatment using IFN-free DAA, which resulted in the improvement of the symptoms of OLP. This case represents the safety and efficacy of IFN-free DAAs in patients with HCV-associated OLP. However, long-term follow-up studies are required to elucidate the therapeutic effects of this therapy in these patients.

  4. Galectin-9 as an important marker in the differential diagnosis between oral squamous cell carcinoma, oral leukoplakia and oral lichen planus.

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    Muniz, Janusa Maria; Bibiano Borges, Cláudia Renata; Beghini, Marcela; de Araújo, Marcelo Sivieri; Miranda Alves, Polyanna; de Lima, Lilian Margareth Biagioni; Pereira, Sanívia Aparecida de Lima; Nogueira, Ruchele Dias; Napimoga, Marcelo Henrique; Rodrigues, Virmondes; Rodrigues, Denise Bertulucci Rocha

    2015-08-01

    To evaluate the expression of Galectins (Gal) 1, 3 and 9, Metalloproteinase 3 (MMP-3) and mast cell density in oral lesions of patients with potentially malignant disorders (PMD) and oral squamous cell carcinomas (OSCC) by comparison with the controls. We selected 40 cases of PMD, 40 OSCC and 13 with normal histopathological profile. Immunohistochemistry was performed for Gal-1, Gal-3, Gal-9 and MMP-3. Gal-9 was significantly higher in patients with OSCC than in others groups (p leukoplakia than those with OSCC and controls (p = 0.0001). Gal-3 was significantly lower in patients with OSCC than those with leukoplakia (p = 0.03). MMP-3 was lower in patients with leukoplakia in comparison with the lichen planus group (p = 0.013). The increased expression of Gal-9 may be helpful to differentiate of OSCC from other oral cavity lesions. Copyright © 2015 Elsevier GmbH. All rights reserved.

  5. Ceratoconjuntivite cicatricial bilateral associada a líquen plano: relato de caso Lichen planus leading to bilateral cicatrizing keratoconjunctivitis: case report

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    Camila Melo Gadelha Pereira Diniz

    2008-12-01

    Full Text Available Descrevemos um caso de ceratoconjuntivite cicatricial bilateral em uma paciente portadora de líquen plano e apresentamos revisão da literatura mundial sobre esse assunto. Cicatrização conjuntival, com formação de simbléfaro, olho seco, infiltração corneana, neovascularização e afinamento foram os sinais observados. Diagnóstico foi baseado nos achados clínicos e biópsia, após exclusão das causas típicas de ceratoconjuntivite cicatricial.To describe a case of bilateral cicatrizing keratoconjunctivitis in a patient with lichen planus and review the literature. Conjunctiva cicatrization with symblepharon formation, dry eye, corneal infiltration and neovascularization and thinning were the most observed prominent signs. Diagnosis was based on clinical findings and biopsy, after exclusion of typical causes of cicatricial keratoconjuntivitis.

  6. Comparison of the Effect of Combination of Triamcinolone Acetonide and Vitamin A Mouthwash with Triamcinolone Mouthwash Alone on Oral Lichen Planus

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    Zohreh Dalirsani

    2010-03-01

    Full Text Available Background and aims. Lichen planus is a relatively common mucocutaneous disease, with an unknown etiology. There is no complete cure for oral lichen planus (OLP, but some drugs, including corticosteroids, retinoids, cyclosporine and antibiotics are commonly used for treatment of OLP. The aim of the present study was to compare the effect of combination of triamcinolone and vitamin A mouthwash with triamcinolone mouthwash alone on OLP. Materials and methods. Twenty OLP patients were randomly divided into two groups of 10. The experimental group was treated with combination of triamcinolone and vitamin A mouthwash and the control group was treated with triamcinolone-containing mouthwash alone. The patients were examined once every two weeks and the lesion size, pain and burning sensation were recorded based on visual analogue scale during a two-month period. Data were analyzed by MannWhitney U test using SPSS software. Results. The use of combination of triamcinolone-vitamin A mouthwash was effective in decreasing the pain and burning sensation of OLP (P = 0.012. Decrease in pain and burning sensation were similar in both groups (P = 0.73. The use of combination of triamcinolone-vitamin A mouthwash led to a decrease in the size of keratotic, atrophic and erosive OLP lesions (P = 0. Decrease in the size of the lesions was significantly greater in the study group compared to the control group (P = 0.029. Conclusion. The use of combination of triamcinolone-vitamin A mouthwash is effective in decreasing the size of keratotic, atrophic or erosive lesions.

  7. Liquen plano en el Programa de Detección Precoz del Cáncer Bucal Lichen planus in the Program for the Early Detection of Oral Cancer

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    Pedro A. Ducasse Olivera

    2005-12-01

    Full Text Available El liquen plano es una enfermedad dermatológica de origen desconocido que se manifiesta en la mucosa bucal. Se realizó un estudio retrospectivo con los pacientes pesquisados mediante el Programa de Detección Precoz del Cáncer Bucal en el municipio especial Isla de la Juventud, con el objetivo de determinar el comportamiento epidemiológico de esta entidad, distribución según sexo, raza y zona bucal mas afectada, así como establecer la relación entre la aparición de las lesiones en piel y mucosas. Según los resultados, se determinó que el liquen plano oral es más común en hombres de la tercera y sexta décadas, principalmente en mestizos y blancos, la zona más afectada fue el carrillo (42.9 % y las lesiones cutáneas aparecieron solo en 2 casos (9.5 %.Lichen planus is a dermatological disease of unknown origin that manifests itself in the oral mucosa, reason for which we decided to conduct a study on it as part of the Program for the Early Detection of Oral Cancer in the Isle of Youth special municipality with the patients screened in this program aimed at determining the epidemiological behavior of this entity, distribution by sex, race, the most affected oral zone, and the relation between the appearance of injuries in the skin and mucosas. According to the results, it was concluded that the oral lichen planus is more comon in men at the third and sixth decades of life, in mestizoes and white individuals, and that the cheek was the most affected area. The cutaneous lesions appeared only in 2 of the 21 affected cases.

  8. MuGard, an oral mucoadhesive hydrogel, reduces the signs and symptoms of oral mucositis in patients with lichen planus: a double-blind, randomized, placebo-controlled pilot study.

    Science.gov (United States)

    Velez, Inez; Spielholz, Neil I; Siegel, Michael A; Gonzalez, Tulia

    2014-12-01

    To determine if MuGard, a mouthwash shown to reduce the severity of oral mucositis when started before initiating antineoplastic therapy for head and neck cancers, is effective when painful, oral lesions are present in patients with biopsy-proven erosive oral lichen planus. This was a double-blind, randomized, placebo-controlled pilot study at a college of dental medicine. Twenty patients with oral lichen planus were randomly assigned to receive either MuGard (n = 10) or saline-bicarbonate control (n = 10). One teaspoonful of the assigned mouthwash was swished for 1 minute, 5 times a day, for 14 days. Outcome measures (Oral Mucositis Assessment Scale scores and visual analog scale pain scores) were obtained before the start of treatment and repeated on days 2, 7, and 14. Significant reductions in all outcome measures occurred in the MuGard-treated group. Number-needed-to-treat (NNT) to achieve a >50% reduction in averaged pain from baseline was 1.25, and to obtain complete relief, the NNT was 2.5. MuGard significantly reduces pain and ulceration associated with oral mucositis in patients with lichen planus. Copyright © 2014 Elsevier Inc. All rights reserved.

  9. Evaluation of salivary oxidate stress biomarkers, nitric oxide and C-reactive protein in patients with oral lichen planus and burning mouth syndrome.

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    Tvarijonaviciute, Asta; Aznar-Cayuela, Cristina; Rubio, Camila P; Ceron, José J; López-Jornet, Pia

    2017-05-01

    The aim of this study was to evaluate oxidative stress factors and C-reactive protein in the saliva of patients with oral lichen planus (OLP) and burning mouth syndrome (BMS). This consecutive, cross-sectional study included 20 patients with OLP, 19 with burning mouth syndrome (BMS), and 31 control subjects. The oral cavity of each patient was examined and patients responded to a quality of life questionnaire (OHIP-14) and the xerostomia inventory. The following parameters were measured in whole non-stimulated saliva: trolox equivalent antioxidant capacity (TEAC); total antioxidant capacity (TAC); cupric reducing antioxidant capacity (CUPRAC); ferric reducing ability of plasma (FRAP); C-reactive protein (CRP); nitric oxide; nitrates; and nitrites. The OLP group presented statistically significant differences in reactive oxygen species (ROS) (29 600 cps) in comparison with the control group (39 679 cps) (P < 0.05). In the BMS group, ROS was 29 707 cps with significant difference in comparison with the control group (P < 0.05). Significantly higher salivary nitric oxide (145.7 μmol) and nitrite (141.0 μmol) levels were found in OLP patients in comparison with control group (P < 0.05). Increases in nitric oxide and C-reactive protein were found in the saliva of OLP patients in comparison with BMS and control patients. Further studies are required to confirm these findings. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  10. Oral lichen planus (OLP), oral lichenoid lesions (OLL), oral dysplasia, and oral cancer: retrospective analysis of clinicopathological data from 2002-2011.

    Science.gov (United States)

    Casparis, S; Borm, J M; Tektas, S; Kamarachev, J; Locher, M C; Damerau, G; Grätz, K W; Stadlinger, B

    2015-06-01

    This 10-year retrospective study analyzed the incidence of malignant transformation of oral lichen planus (OLP). The study also included dysplasia and oral lichenoid lesion (OLL) in the initial biopsy as a potential differential diagnosis. A total of 692 scalpel biopsies were taken from 542 patients (207 [38.2%] men and 335 [61.8%] women). Clinical and histopathological parameters were analyzed. The parameters gender (p = 0.022) and smoking behavior (p oral squamous cell carcinoma (OSCC). Smoking and joint disease appeared to be significant risk factors. Treatment with tretinoin in different concentrations (0.005-0.02%) significantly improved diagnosis. Twelve patients (8 female, 4 male) showed malignant transformation to OSCC within an average period of 1.58 years. The malignant transformation rate (MTR) was higher for OLL (4.4%) than OLP (1.2%). If the first biopsy showed intraepithelial neoplasia, the risk of developing OSCC increased (by 3.5% for squamous intraepithelial neoplasia (SIN) II and by 6.7% for SIN III). Although we cannot rule out that OLP is a premalignant oral condition, we can confirm that OLP had the lowest MTR of all diagnoses.

  11. Immunohistochemical Analysis of the Activation Status of the Akt/mTOR/pS6 Signaling Pathway in Oral Lichen Planus

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    Georgios Prodromidis

    2013-01-01

    Full Text Available Introduction. Aberrations of the Akt/mTOR/pS6 pathway have been linked to various types of human cancer, including oral squamous cell carcinoma (OSCC. The purpose of this study was to evaluate the activation status of Akt, mTOR, and pS6 in oral lichen planus (OLP in comparison with oral premalignant and malignant lesions and normal oral mucosa (NM. Materials and Methods. Immunohistochemistry for p-Akt, p-mTOR, and phospho-pS6 was performed in 40 OLP, 20 oral leukoplakias (OL, 10 OSCC, and 10 control samples of NM. Results. Nuclear p-Akt expression was detected in the vast majority of cases in all categories, being significantly higher in OL. Cytoplasmic p-Akt and p-mTOR staining was present only in a minority of OLP cases, being significantly lower compared to OL and OSCC. Phospho-pS6 showed cytoplasmic positivity in most OLP cases, which however was significantly lower compared to OL and OSCC. Conclusions. Overall, cytoplasmic p-Akt, p-mTOR, and phospho-pS6 levels appear to be significantly lower in OLP compared to OL and OSCC. However, the expression of these molecules in a subset of OLP cases suggests that activation of Akt/mTOR/pS6 may occur in the context of OLP, possibly contributing to the premalignant potential of individual cases.

  12. Altered expression of mRNA for HIF-1alpha and its target genes RTP801 and VEGF in patients with oral lichen planus.

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    Ding, M; Xu, J Y; Fan, Y

    2010-04-01

    To explore a potential causal contribution of the transcription factor HIF-1alpha and its target gene, RTP801 and VEGF, to the development of oral lichen planus (OLP). Design relevant: Twenty-two adult OLP patients were enrolled in this study. All OLP diagnoses were verified by histopathological characteristics. Normal mucous specimens were collected from 12 controls after various oral surgeries. RNA was isolated from OLP and control specimens. Microarray was performed using BiostarH-40s gene chip. Expression of HIF-1alpha, VEGF and RTP801 was evaluated using quantitative real-time polymerase chain reaction (qPCR). Unpaired t-test and one-way ANOVA was used for statistical analysis. Microarray results showed that RTP801 expression was lower in OLP than in controls (779 vs 3090). qPCR further confirmed that expression of RTP801 was similarly lower in OLP than in controls (0.363 vs 1.473, P oral mucosa of OLP is hypoxic. Genes that are activated by hypoxia, such as RTP801 and VEGF, and their signal cascades may be novel potential therapeutic targets for OLP.

  13. Successful Treatment of Oral Lichen Planus with Direct-Acting Antiviral Agents after Liver Transplantation for Hepatitis C Virus-Associated Hepatocellular Carcinoma

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    Yumiko Nagao

    2017-11-01

    Full Text Available Hepatitis C virus (HCV infection is frequently associated with various extrahepatic manifestations, such as autoimmune features and immune complex deposit diseases. Oral lichen planus (OLP is one such extrahepatic manifestation of HCV infection. Recently, direct-acting antivirals (DAA have proved to be highly effective and safe for the eradication of HCV. Herein, we report a case of OLP accompanied by HCV-related hepatocellular carcinoma (HCC that disappeared after liver transplantation and achievement of sustained virological response following interferon (IFN-free treatment with ledipasvir (LDV and sofosbuvir (SOF. The 50-year-old patient developed erosive OLP during IFN therapy, with hyperthyroidism at 53 years of age and HCC at 55 years. He received immunosuppressive drugs and IFN-free DAA treatment after liver transplantation at 60 years of age, which led to disappearance of the symptoms of OLP. The patient was treated safely and effectively with LDV/SOF, although it is not known whether the disappearance of OLP resulted from the eradication of HCV or the immunosuppressive therapy.

  14. Comparison between self-formulation and compounded-formulation dexamethasone mouth rinse for oral lichen planus: a pilot, randomized, cross-over trial.

    Science.gov (United States)

    Hambly, Jessica L; Haywood, Alison; Hattingh, Laetitia; Nair, Raj G

    2017-08-01

    There is a lack of appropriate, commercially-available topical corticosteroid formulations for use in oral lichen planus (OLP) and oral lichenoid reaction. Current therapy includes crushing a dexamethasone tablet and mixing it with water for use as a mouth rinse. This formulation is unpleasant esthetically and to use in the mouth, as it is a bitter and gritty suspension, resulting in poor compliance. Thus, the present study was designed to formulate and pilot an effective, esthetically-pleasing formulation. A single-blinded, cross-over trial was designed with two treatment arms. Patients were monitored for 7 weeks. Quantitative and qualitative data was assessed using VAS, numeric pain scales, the Treatment Satisfaction Questionnaire for Medication-9, and thematic analysis to determine primary patient-reported outcomes, including satisfaction, compliance, quality of life, and symptom relief. Nine patients completed the pilot trial. Data analysis revealed the new compounded formulation to be superior to existing therapy due to its convenience, positive contribution to compliance, patient-perceived faster onset of action, and improved symptom relief. Topical dexamethasone is useful in the treatment of OLP. When carefully formulated into a compounded mouth rinse, it improves patient outcomes. © 2016 John Wiley & Sons Australia, Ltd.

  15. Comparison of topical tacrolimus and clobetasol in the management of symptomatic oral lichen planus: A double-blinded, randomized clinical trial in Sri Lanka.

    Science.gov (United States)

    Hettiarachchi, Pilana Vithanage Kalani Shihanika; Hettiarachchi, Ruvini Manjula; Jayasinghe, Ruwan Duminda; Sitheeque, Mohaideen

    2017-11-01

    Oral lichen planus (OLP) is a common, chronic inflammatory disease of the oral mucosa. Although several studies have shown the efficacy of different treatment modalities, a definitive cure has not yet been established. The present trial compares the effectiveness of topically-applied clobetasol and tacrolimus in the symptomatic management of OLP. A randomized, comparative, double-blind study with 68 patients (43 females, 25 males; mean age: 46.76 years) was undertaken. Patients were randomly divided into two groups of 34 patients each to receive topical tacrolimus 0.1% cream or clobetasol propionate 0.05% cream for 3 weeks. After 3 weeks of treatment, the mean pain score dropped by 1.59 (right) and 1.53 (left) in the tacrolimus group, while in clobetasol group these values were 0.94 and 0.85, respectively. The mean scores for clinical appearance reduced by 1.18 (right) and 1.0 (left) in the tacrolimus group compared with a reduction of 0.5 and 0.26, respectively, in the clobetasol group. These reductions were statistically significant (P < .05). The results suggest that tacrolimus 0.1% cream is an effective alternative to topical steroid and can be considered a first-line therapy in OLP. However, further studies are needed to confirm the effectiveness of this treatment before it is recommended for use in clinical practice. © 2016 John Wiley & Sons Australia, Ltd.

  16. Randomized, placebo-controlled, double-blind trial of clobetasol propionate 0.05% in the treatment of oral lichen planus.

    Science.gov (United States)

    Arduino, P G; Campolongo, M G; Sciannameo, V; Conrotto, D; Gambino, A; Cabras, M; Ricceri, F; Carossa, S; Broccoletti, R; Carbone, M

    2018-01-03

    To perform a randomized, placebo-controlled, double-blind study, with a follow-up period of 6 months, for the use of topical clobetasol in cases of symptomatic oral lichen planus (OLP). Thirty-two participants were analyzed, with the aims of: (I) to compare the usefulness of topically applied clobetasol propionate 0.05% (mixed with 4% hydroxyethyl cellulose gel) and 4% hydroxyethyl cellulose gel alone (considered as placebo) in the management of OLP; (II) to describe which of them is quicker in decreasing signs and reported symptoms, and (III) which is able to give the proper longer remission in the follow-up. Symptoms improved in all clobetasol treated patients during the first 2 months of therapy, while only 50% of placebo control group (P=0.005) displayed similar results; of the remaining half, 12.5% did experienced a worsening whilst 37.5% remained stable. Regarding clinical signs, 87.5% of clobetasol treated patients improved, while only 62.5% of the placebo treated patients had a positive response (P=0.229). It is possible to report that clobetasol, at this dosage, has been more effective than a placebo at provoking symptoms improvement in subjects affected by atrophic erosive oral lesions. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

  17. STUDY OF FEATURES OF MICROFLORA OF PATIENTS WITH DISEASES OF THE ORAL MUCOSA. EVALUATION OF THE EFFICACY OF PRODUCTS BASED ON BACTERIOPHAGES "FAGODENT" IN THE TREATMENT OF CHRONIC APHTHOUS STOMA TITIS AND LICHEN PLANUS

    Directory of Open Access Journals (Sweden)

    E. A. Volkov

    2015-01-01

    Full Text Available Effective complex treatment of patients with pathology of the oral mucosa (OM includes drug effects on pathogenic bacteria as a possible etiological factor in the development of these diseases.Purpose. Study of characteristics of oral microflora of patients with diseases of the OM, the efficiency of the national preventive agent for topical application "Fagodent" in the form of a gel based on bacteriophages in the treatment of chronic recurrent aphthous stomatitis and lichen planus.Materials and methods. In a pilot study (up to 3 months follow-up they included 27 patients aged 19 to 80 years old with chronic recurrent aphthous stomatitis (CRAS and lichen planus (LP. To monitor the efficiency of in vitro we carried out spot-testing for bacterial lawn.Results. Results showed the frequent detection of bacteria of the staphylococci and streptococci in smears obtained from the elements of defeat in the CRAS and LP, while the PCRdiagnostics detect the presence of rare parodontopatogenov on aftah and papules. The study of the effectiveness of products based on bacteriophages "Fagodent» in vitro showed a high sensitivity of the pathogens to bacteriophages gel "Fagodent" when exposed to cultures derived from patients with CRAS. The use of prophylactic agents based on bacteriophages in the treatment of chronic recurrent aphthous stomatitis significantly reduced pain, accelerated the relief of the inflammatory process to reduce the time of repair. Application means "Fagodent" in the complex treatment of lichen planus is not significantly affected the course of the disease.Conclusion. The laboratory research and clinical observations confirm the effectiveness and appropriateness of products based on bacteriophages "Fagodent" in the treatment of chronic aphthosous stomatitis.

  18. Líquen plano oral (LPO: diagnóstico clínico e complementar Oral lichen planus (OLP: clinical and complementary diagnosis

    Directory of Open Access Journals (Sweden)

    Alan Motta do Canto

    2010-10-01

    Full Text Available O líquen plano é uma desordem comum do epitélio escamoso estratificado que acomete as mucosas oral e genital, a pele, as unhas e o couro cabeludo. O líquen plano oral (LPO afeta mulheres de meiaidade e apresenta padrões e distribuição característicos, como estriações brancas, pápulas ou placas brancas, eritema, erosões e bolhas, que podem estar associadas a medicações e/ou materiais dentários no paciente. O diagnóstico clínico somente poderá ser feito se a doença apresentar padrões clássicos, como lesões concomitantes na mucosa oral e na pele. O diagnóstico laboratorial por meio do exame histopatológico se caracteriza pela presença de projeções do epitélio em forma de dentes de serra e corpos de Civatte, e possibilita excluir condições de displasia e malignidade. A imunofluorescência direta é utilizada em suspeita de outras doenças, como pênfigo e penfigoide. O LPO é tratado com agentes anti-inflamatórios, principalmente, corticosteroides tópicos, e novos agentes e técnicas têm-se demonstrado eficazes. A transformação maligna do LPO e sua incidência exata permanecem controversas. Este trabalho tem como objetivo apresentar, com base na revisão da literatura, a etiopatogenia, o diagnóstico clínico, exames complementares e complicações do LPO.Lichen planus is a common disorder of the stratified squamous epithelium that affects oral and genital mucous membranes, skin, nails, and scalp. Oral Lichen Planus (OLP affects middle-aged women and shows distribution patterns and characteristics such as white striations, white plaques or papules, erythema, blisters and erosions, and may be associated with medication and/or dental materials used by the patient. The clinical diagnosis can only be made if the disease presents classical patterns such as concomitant lesions in the oral mucosa and skin. The laboratory diagnosis is histopathologically characterized by the presence of projections of the epithelium in the

  19. Interferon-γ regulates the function of mesenchymal stem cells from oral lichen planus via indoleamine 2,3-dioxygenase activity.

    Science.gov (United States)

    Zhang, Zhihui; Han, Ying; Song, Jiangyuan; Luo, Ruxi; Jin, Xin; Mu, Dongdong; Su, Sha; Ji, Xiaoli; Ren, Yan-Fang; Liu, Hongwei

    2015-01-01

    Little is known about mesenchymal stem cells (MSCs) in normal or inflammatory oral mucosal tissues, such as in oral lichen planus (OLP). Our objectives were to identify, isolate, and characterize MSCs from normal human oral mucosa and OLP lesions, and to evaluate indoleamine 2,3 dioxygenase (IDO) activity in mediating immunomodulation of MSCs from these tissues. Expressions of MSCs-related markers were examined in isolated cells by flow cytometry. Self-renewal and multilineage differentiations were studied to characterize these MSCs. Interferon-γ (IFN-γ), IDO, and STRO-1 were assessed by immunofluorescence. MSCs from oral mucosa and OLP or IFN-γ-pretreated MSCs were co-cultured with allogeneic mixed lymphocyte reaction assays (MLR). Proliferation and apoptosis of MLR or MSCs were detected by CCK8 and the annexin V-FITC apoptosis detection kit, respectively. IDO expression and activity were measured by real-time PCR, Western blotting, and high-performance liquid chromatography. Isolated cells from oral mucosa and OLP expressed MSC-related markers STRO-1, CD105, and CD90 but were absent for hematopoietic stem cell markers CD34. Besides, they all showed self-renewal and multilineage differentiation capacities. MSCs in OLP presented STRO-1/IDO+ phenotype by immunofluorescence. MSCs and IFN-γ-pretreated MSCs could inhibit lymphocyte proliferation via IDO activity, but not via cell apoptosis. Long-term IFN-γ could also inhibit MSC proliferation via IDO activity. Mesenchymal stem cells can be isolated from human oral mucosa and OLP tissues. Besides self-renewal and multilineage differentiation properties, these cells may participate in immunomodulation mediated by IFN-γ via IDO activity in human OLP. © 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  20. Management of symptomatic erosive-ulcerative lesions of oral lichen planus in an adult Egyptian population using Selenium-ACE combined with topical corticosteroids plus antifungal agent

    Science.gov (United States)

    Belal, Mahmoud Helmy

    2015-01-01

    Aim: Oral lichen planus (OLP) is a chronic mucocutaneous disease with an immunological etiology. This study was conducted to evaluate the effect of selenium combined with Vitamins A, C & E (Selenium-ACE) in the treatment of erosive-ulcerative OLP as an adjunctive to topical corticosteroids plus antifungal agent. Subjects and Methods: Thirty patients with a confirmed clinical and histopathologic diagnosis of OLP participated in this clinical trial. Patients were randomly allocated into one of three groups and treated as follows: (I) Topical corticosteroids, (II) topical corticosteroids plus antifungal, and (III) SE-ACE combined with topical corticosteroids plus antifungal. The patients were followed for 6 weeks. The pain and severity of the lesions were recorded at the initial and follow-up visits. All recorded data were analyzed using paired t-test and ANOVA test. A P ≤ 0.05 was considered significant. Results: The experimental groups showed a marked reduction in pain sensation and size of lesions, particularly in the final follow-up period, but there was no significant difference between the first two Groups I and II. However, healing of lesions and improvement of pain sensation was effective in Group III since a significant difference was found favoring Group III over both Groups I and II. Conclusion: No significant difference was found in treating erosive-ulcerative lesions of OLP by topical corticosteroids alone or combined with antifungal. However, when using SE-ACE in combination with topical corticosteroids plus antifungal, this approach may be effective in managing ulcerative lesions of OLP; but more research with a larger sample size and a longer evaluation period may be recommended. PMID:26681847

  1. Anemia and hematinic deficiencies in gastric parietal cell antibody-positive and antibody-negative erosive oral lichen planus patients with thyroid antibody positivity.

    Science.gov (United States)

    Chang, Julia Y-F; Chen, I-Chang; Wang, Yi-Ping; Wu, Yu-Hsueh; Chen, Hsin-Ming; Sun, Andy

    2016-11-01

    Serum gastric parietal cell antibody (GPCA), thyroglobulin antibody (TGA), and thyroid microsomal antibody (TMA) are found in some erosive oral lichen planus (EOLP) patients. This study assessed whether serum GPCA, TGA and TMA and EOLP itself played significant roles in causing anemia and hematinic deficiencies in TGA/TMA-positive EOLP patients with GPCA positivity (GPCA+/TGA/TMA/EOLP patients) or negativity (GPCA-/TGA/TMA/EOLP patients). The mean corpuscular volume (MCV) and mean blood hemoglobin (Hb), iron, vitamin B12, and folic acid levels were measured and compared between any two of the four groups of 29 GPCA+/TGA/TMA/EOLP patients, 80 GPCA-/TGA/TMA/EOLP patients, 198 all antibodies-negative EOLP patients (Abs-/EOLP patients), and 218 healthy control individuals. GPCA+/TGA/TMA/EOLP patients had significantly lower mean Hb and vitamin B12 levels as well as significantly greater frequencies of Hb, iron, and vitamin B12 deficiencies than healthy controls. GPCA+/TGA/TMA/EOLP patients had significantly lower serum vitamin B12 level and higher MCV as well as a significantly greater frequency of vitamin B12 deficiency than GPCA-/TGA/TMA/EOLP patients. Furthermore, both GPCA-/TGA/TMA/EOLP and Abs-/EOLP patients did have significantly lower mean Hb, MCV, and iron (for women only) levels, as well as significantly greater frequencies of Hb and iron deficiencies than healthy controls. However, there were no significant differences in measured blood data between GPCA-/TGA/TMA/EOLP and Abs-/EOLP patients. We conclude that serum GPCA is the major factor causing vitamin B12 deficiency, macrocytosis and pernicious anemia in GPCA+/TGA/TMA/EOLP patients. ELOP itself but not TGA/TMA positivity plays a significant role in causing anemia and hematinic deficiencies in GPCA-/TGA/TMA/EOLP patients. Copyright © 2016. Published by Elsevier B.V.

  2. Prevalence of Oral, Skin, and Oral and Skin Lesions of Lichen Planus in Patients Visiting a Dental School in Southern India

    Science.gov (United States)

    Omal, PM; Jacob, Vimal; Prathap, Akhilesh; Thomas, Nebu George

    2012-01-01

    Background: Lichen planus (LP) is a mucocutaneous disease that is relatively common among adult population. LP can present as skin and oral lesions. This study highlights the prevalence of oral, skin, and oral and skin lesions of LP. Aims: The aim of this study was to evaluate the prevalence of oral, skin, and oral and skin lesions of LP from a population of patients attending the Department of Oral Medicine and Radiodiagnosis, Pushpagiri College of Dental Sciences, Tiruvalla, Kerala, India. Materials and Methods: A cross-sectional study was designed to evaluate the prevalence of oral, skin, and oral and skin lesions of LP. This is a ongoing prospective study with results of 2 years being reported. LP was diagnosed on the basis of clinical presentation and histopathological analysis of mucosal and skin biopsy done for all patients suspected of having LP. Statistical analysis was carried out using SPSS (Statistical package for social sciences) software version 14. To test the statistical significance, chi-square test was used. Results: Out of 18,306 patients screened, 8,040 were males and 10,266 females. LP was seen in 118 cases (0.64%). Increased prevalence of LP was observed in middle age adults (40–60 years age group) with lowest age of 12 years and highest age of 65 years. No statistically significant differences were observed between the genders in skin LP group (P=0.12) and in oral and skin LP groups (P=0.06); however, a strong female predilection was seen in oral LP group (P=0.000036). The prevalence of cutaneous LP in oral LP patients was 0.06%. Conclusion: This study showed an increased prevalence of oral LP than skin LP, and oral and skin LP with a female predominance. PMID:22615505

  3. Semaphorin4D Drives CD8+ T-Cell Lesional Trafficking in Oral Lichen Planus via CXCL9/CXCL10 Upregulations in Oral Keratinocytes.

    Science.gov (United States)

    Ke, Yao; Dang, Erle; Shen, Shengxian; Zhang, Tongmei; Qiao, Hongjiang; Chang, Yuqian; Liu, Qing; Wang, Gang

    2017-11-01

    Chemokine-mediated CD8+ T-cell recruitment is an essential but not well-established event for the persistence of oral lichen planus (OLP). Semaphorin 4D (Sema4D)/CD100 is implicated in immune dysfunction, chemokine modulation, and cell migration, which are critical aspects for OLP progression, but its implication in OLP pathogenesis has not been determined. In this study, we sought to explicate the effect of Sema4D on human oral keratinocytes and its capacity to drive CD8+ T-cell lesional trafficking via chemokine modulation. We found that upregulations of sSema4D in OLP tissues and blood were positively correlated with disease severity and activity. In vitro observation revealed that Sema4D induced C-X-C motif chemokine ligand 9/C-X-C motif chemokine ligand 10 production by binding to plexin-B1 via protein kinase B-NF-κB cascade in human oral keratinocytes, which elicited OLP CD8+ T-cell migration. We also confirmed using clinical samples that elevated C-X-C motif chemokine ligand 9/C-X-C motif chemokine ligand 10 levels were positively correlated with sSema4D levels in OLP lesions and serum. Notably, we determined matrix metalloproteinase-9 as a new proteolytic enzyme for the cleavage of sSema4D from the T-cell surface, which may contribute to the high levels of sSema4D in OLP lesions and serum. Our findings conclusively revealed an amplification feedback loop involving T cells, chemokines, and Sema4D-dependent signal that promotes OLP progression. Copyright © 2017 The Authors. Published by Elsevier Inc. All rights reserved.

  4. Psoriasis

    DEFF Research Database (Denmark)

    Linder, Michael Dennis; Piaserico, Stefano; Augustin, Matthias

    2016-01-01

    and patterns of risk. We argue that concepts from LCR and LCE could be widely applied in dermatology, in general, and, more precisely, in the study of chronic inflammatory skin diseases, e.g. atopic eczema and psoriasis. The life course approach can generally be applied in two different ways. It may be used...

  5. LIKEN PLANUS

    Directory of Open Access Journals (Sweden)

    Herman Cipto

    2015-08-01

    Full Text Available Lichen planus (LP is an inflammation skin and mucous membrane disease that has characteristic clinical and pathologic features. Typical lesion of LP are small, flat-topped, polygonal, violaceous papules on the skin or reticular, white patch or plaque on mucous membrane. Nail involvement is manifested by longitudinal ridging, thinning and distal splitting and hair involvement is atrophic cicatrical alopesia. There was an increased risk of developing squamous cell carcinoma in the leasion of mucous membrane of oral cavity. Pathology of LP is the prototype of lichenoid interface dermatitis, which shows damage to the basal cell layer and a band-like dental lymphocytic infiltrate in close approximation to the epidermis. Other pathologic findings are compact orthokeratosis, wedge-shape hypergranulosis and irregular acanthosis. The treatment of LP in the main is largely symptomatic like antipruritic for itching. Therapies to suppress immune responses are commonly effective in treating LP, such as corticosteroid and cyclosporine topical or systemic. Other treatment are psoralene ultra violet A (PUVA or steroids.

  6. Oral candidosis in lichen planus

    DEFF Research Database (Denmark)

    Kragelund, Camilla; Kieffer-Kristensen, L; Reibel, J

    2012-01-01

    mucosal lesion. METHODS: The genetic approach was validated on a reference panel of 60 well-defined unrelated fungal species. The study included 37 OLP patients. Oral candidosis (OC) was established based on clinical signs of OC and/or oral mucosal symptoms and at least one hypha in lesional cytosmear...

  7. Análise histopatológica comparativa entre líquen plano oral e cutâneo Comparative histopathological analysis between oral and cutaneous lichen planus

    Directory of Open Access Journals (Sweden)

    Silvia Elena Navas-Alfaro

    2003-01-01

    ência rara no LPO. Acantose em dente de serra é achado pouco freqüente no LPO, porém vacuolização basal está sempre presente associada a infiltrado linfocitário em faixa; plasmócitos podem acompanhar linfócitos no LPO, mas estão ausentes do LPC.BACKGROUND: Lichen planus is a relatively common chronic inflammatory disease affecting skin and mucous membranes, separately or together. It frequently involves the oral cavity, with or without concomitant cutaneous compromise. Microscopically, while skin presents well characteristic aspects, oral mucosa can present variations related to local characteristics of the mucosa in the oral cavity. OBJECTIVES: To compare histopathological alterations of oral lichen planus and cutaneous lichen planus with the study of the inflammatory infiltrate components. METHODS: 59 biopsies (29 of OLP and 30 of CLP, formalin-fixed, paraffin-embedded were studied. Semi-quantitative analysis of both epidermal and dermal alterations was performed using the hematoxylin-eosin and periodic acid-Schiff stains. RESULTS: For CLP the classic aspects of orthokeratosis, wedge shaped hypergranulosis and saw tooth rete ridges were observed. Such aspects differ from those of OLP in which orthokeratosis and thickened granular layer happen less frequently; instead, acquisition of those layers is observed in places where they are usually absent. Basal cell vacuolar alteration and effacement of the epithelium-conjunctive limit prevailed in both locations (skin and oral mucosa and lymphocytes and histiocytes were the inflammatory cells present in all cases. CONCLUSIONS: Classic alterations as compact orthokeratosis, wedge shaped hypergranulosis, saw tooth rete ridges acanthosis and basal cell vacuolar alteration associates to lymphocytes in superficial band-like pattern are diagnostic of CLP. However, for OLP, the particular own characteristics of oral mucosa in the biopsied place should be considered; also, subtler alterations of horny (light orthokeratosis and

  8. Off-label use of fumarate therapy for granulomatous and inflammatory skin diseases other than psoriasis vulgaris: a retrospective study.

    Science.gov (United States)

    Klein, A; Coras, B; Landthaler, M; Babilas, P

    2012-11-01

    Fumarates are approved for the systemic treatment of moderate and severe psoriasis vulgaris in Germany. However, a number of studies and case reports indicate their efficacy in the treatment of further inflammatory skin disorders or granulomatous skin diseases. To examine the efficacy and safety of fumarates for the treatment of granulomatous and inflammatory skin diseases other than psoriasis vulgaris. The therapeutic efficacy and side-effects of fumarate therapy were analysed retrospectively in patients with granuloma annulare (GA, n = 4), cutaneous sarcoidosis (SA, n = 1), lichen planus (LP, n = 3), pityriasis rubra pilaris (PRP, n = 1) or chronic discoid lupus erythematosus (CDLE, n = 1). Six patients (GA: 3/4; LP: 2/3; PRP: 1/1) showed complete clearance and two patients (GA: 1/3; SA: 1/1) had a partial response, and the CDLE patient showed stable disease under a combination therapy with hydroxychloroquine. Side-effects associated with fumarate therapy were seen in seven of ten patients and resolved spontaneously upon dose reduction or discontinuation of the therapy. According to this data, fumarates may represent a new approach in the treatment of granulomatous and inflammatory skin diseases other than psoriasis vulgaris. For the first time, the successful treatment of LP and CDLE with fumarates is reported. Side-effects are not limiting in most cases, but can hamper a dose escalation. © 2011 The Authors. Journal of the European Academy of Dermatology and Venereology © 2011 European Academy of Dermatology and Venereology.

  9. Efficacy of Dapsone in Lichen Planus

    Directory of Open Access Journals (Sweden)

    Bhushan Kumar

    1989-01-01

    Full Text Available Oral dapsone 200 mg daily for 16 weeks was tried on 52 adult patients, of whom 33 patients (males 17, femals 16 completed the study. No other topical or systemic medication was permitted. All the patients tolerated the drug very well. In 22 (66.5% patients there was complete healing with hyperpigmentaiion after 16 weeks of therapy. In 7 (21.5% patients partial respone was seen. There were 4 (12% treatment failures. In patients with hiucosal lesions, the response started early and was seen more often (80.0% No relapse was seen in any of the patients followed-up for a preiod of one year.

  10. Lichen planus pemphigoides in a child

    Directory of Open Access Journals (Sweden)

    Mariame Meziane

    2014-01-01

    Discussion: LPP is exceptional in children; just fifteen cases were reported in the literature. This condition seems to be idiopathic. However, in rare cases it has been associated with some drugs or after PUVA therapy. In our patient, it was probably induced by prolonged sun exposure.

  11. Cure of alopecia areata after eradication of Helicobacter pylori: A new association

    National Research Council Canada - National Science Library

    German Campuzano-Maya

    2011-01-01

    .... Alopecia areata is frequently associated with immune-medi- ated diseases with skin manifestations such as psoriasis and lichen planus, or without skin manifestations such as autoimmune thyroiditis...

  12. Psoriasis inversa

    DEFF Research Database (Denmark)

    Omland, Silje Haukali; Gniadecki, Robert

    2015-01-01

    Psoriasis is a chronic skin disorder affecting approximately 2% of the European and American population. The most common form of psoriasis is the chronic plaque type. Inverse psoriasis, also named flexural or intertriginous psoriasis, is not considered a separate disease entity but rather a special...... site of involvement of plaque psoriasis, characterized by its localization to inverse/intertriginous/flexural body sites. We review current evidence and establish whether inverse psoriasis is a separate disease entity based on characteristics in terms of epidemiology, pathogenesis, clinical...

  13. Antigen mimicry followed by epitope spreading: a pathogenetic trigger for the clinical morphology of lichen planus and its transition to Graham Lassueur Piccardi Little Syndrome and keratosis lichenoides chronica - Medical hypotheses or reality? Mimetismo antigênico seguido de espalhamento de epítopos: agente desencadeador patogênico da morfologia clínica do líquen plano e de sua transição para a Síndrome de Graham-Little-Piccardi-Lassueur e para a ceratose líquenóide crônica - Hipótese médica ou realidade?

    Directory of Open Access Journals (Sweden)

    Georgi Tchernev

    2009-12-01

    Full Text Available Literature data analysis, providing an exact explanation of the lichen planus pathogenesis, as well as its transition into other rare forms such as Keratosis lichenoides chronica or Graham Lassueur Piccardi Little Syndrome are scant, or totally missing. The chronological course of the disease, known in the literature as lichen planus, varies. Some patients develop Lichen planus or lichen nitidus and there is no logical explanation why. It is also not clear why single patients initially develop ulcerative lesions in the area of the mucosa and only in a few of them these lesions affect the skin. Antigen Mimicry and Epitope Spreading could be the possible pathogenic inductor in cases of lichenoid dermatoses, as well as the cause for their transition into ulcerative, exanthematous or other rare forms. The Epitope Spreading is probably not the leading pathogenetic factor in lichen planus but a phenomenon which occurs later. This manuscript analyzes some basic pathogenic aspects and presents some possible medical hypotheses regarding the heterogenic clinical picture and pathogenesis of lichen planus and lichenoid like pathologies of the skin which, in the near future should be analyzed in details in order to clarify several dilemmas the clinical dermatologist has to face.Análises das informações disponíveis na literatura que forneçam uma explicação precisa sobre a patogênese do Líquen Plano, assim como sobre sua transição para outras formas raras da doença, como Ceratose Liquenóide Crônica ou Síndrome de Graham-Little-Piccardi- Lassueur , são raras ou inexistentes. O curso cronológico da doença, conhecida na literatura como Líquen Plano, varia. Alguns pacientes desenvolvem Líquen Plano ou Líquen Nítido e não ha uma explicação lógica do por quê. Também não está claro por que alguns pacientes inicialmente desenvolvem lesões ulcerativas na área da mucosa e em apenas alguns deles essas lesões afetam a pele. Mimetismo Antig

  14. About Psoriasis

    Science.gov (United States)

    ... psoriasis covers more than 10 percent of your body, it is severe. Topical treatments, such as moisturizers, over-the-counter and prescriptions creams and shampoos, typically are used for mild psoriasis. ...

  15. Lichen Sclerosus

    Science.gov (United States)

    ... 71:84. Lichen sclerosus Symptoms & causes Diagnosis & treatment Advertisement Mayo Clinic does not endorse companies or products. ... a Job Site Map About This Site Twitter Facebook Google YouTube Pinterest Mayo Clinic is a not- ...

  16. Co-existence of Oral Lichen Planes & Chronic Liver Disease - A Coincidence?

    Directory of Open Access Journals (Sweden)

    Jyoti Gupta

    2003-01-01

    Full Text Available "Oral cavity is the reflection of an individual′s general health" .Many systemic diseases have manifestations in the oral cavity. Systemic influences,such as endocrinal, immtlnological, nutritional and psychological states have an important role in thebalance between oral health and disease. This also holds good for a well known mucocutaneous disorder - "Oral Lichen Planus". The present study is carried out to deteremine any co-relation between oral lichen planes and chronic liver diseases.

  17. Childhood psoriasis.

    Science.gov (United States)

    Mahé, Emmanuel

    2016-12-01

    Psoriasis is a common chronic inflammatory skin disease. Recently, few data have been published on epidemiology, comorbidity, or therapy in children with psoriasis. Psoriasis affects up to 2% of children in Europe, even during the first months of life. The link between psoriasis and metabolic comorbidities has been highlighted, notably in relation to excessive weight and obesity. The clinical picture of psoriasis in childhood resembles adult disease, however, some clinical features are noteworthy: neonatal diaper rash is relatively specific, face involvement and guttate psoriasis are more common, plaques are often smaller, and scales are finer and softer than in adults. Napkin, guttate and palmoplantar psoriasis appear to have specific features in childhood and prevalence depends on the age of the child. Although benign, the effect of psoriasis on social interaction can be major, especially in children. Topical therapies are the first line of treatment for skin-limited disease. For chronic cases and more severe cases, phototherapy or traditional biologic systemic treatments must be discussed. The great challenge will be to propose international guidelines to manage these children.

  18. Associação entre líquen plano e infecção pelo vírus da hepatite C: um estudo prospectivo envolvendo 66 pacientes da clínica de dermatologia da Santa Casa de Misericórdia de São Paulo Association between lichen planus and hepatitis C virus infection: a prospective study with 66 patients of the dermatology department of the hospital Santa Casa de Misericórdia de São Paulo

    Directory of Open Access Journals (Sweden)

    Thais Dias Tavares Guerreiro

    2005-10-01

    Full Text Available FUNDAMENTOS: O líquen plano é dermatose inflamatória crônica de etiologia desconhecida. Sua associação com doença hepática, particularmente a hepatite C, é tema de diversos trabalhos em todo o mundo, desde 1990, quando a sorologia para detecção do vírus da hepatite C (VHC se tornou disponível. OBJETIVOS: Este estudo visa avaliar uma possível relação causal entre a infecção pelo vírus C e o líquen plano. MÉTODOS: Tomaram-se por grupo de estudo 66 pacientes com líquen plano matriculados na Clínica de Dermatologia da Santa Casa de Misericórdia de São Paulo, no período de 2000 a 2003. O grupo comparativo foi constituído pelos doadores de sangue voluntários do Banco de Sangue da Santa Casa de Misericórdia de São Paulo, durante o período de outubro de 2001 a outubro de 2002. RESULTADOS: Dos 66 pacientes com líquen plano, cinco apresentaram sorologia positiva para VHC, representando 7,5% em comparação com 0,69% dos doadores de sangue. CONCLUSÕES: Esse resultado é compatível com muitos dados contidos na literatura médica mundial. Entretanto, são necessários novos estudos para o melhor conhecimento dessa controversa relação.BACKGROUND: Lichen planus is a chronic inflammatory dermatosis of unknown etiology. Its association with liver diseases, particularly hepatitis C, has been widely approached since 1990, when serology for the detection of hepatitis C virus became available. OBJECTIVES: The objective of this study was to evaluate a possible causal relation between virus C infection and lichen planus. METHODS: Sixty-six patients with lichen planus seen at the Dermatology Department of Santa Casa de Misericórida de Sao Paulo from 2000 to 2003 were included in the study group. The control group comprised volunteer blood donors of the Blood Bank of Santa Casa de Misericórida de Sao Paulo, from October 2001 to October 2002. RESULTS: Five out of the 66 patients with lichen planus had a positive serology for HCV

  19. [Psoriasis comorbidities].

    Science.gov (United States)

    Gkalpakiotis, Spyridon

    2017-01-01

    Psoriasis is a chronic inflammatory skin disease affecting 2-4 % of Central European population. Nowadays, we know that psoriasis is not limited to the skin but is connected with several comorbidities like, psoriatic arthritis (around 25 %), Crohn's disease, ulcerative colitis, Bechterev, non-alcoholic liver steatosis, psychiatric disorders and mainly diseases of the so called metabolic syndrome, like diabetes mellitus type 2, arterial hypertension or dyslipidemia. In the last years, new information is arising which connect psoriasis with sleep apnoe and chronic obstructive pulmonary disease.

  20. Lichen explants and natural occurrence of lichens

    Energy Technology Data Exchange (ETDEWEB)

    Kirschbaum, A.; Klee, R.

    1971-01-01

    Studies with lichen explants and with naturally occurring lichens, conducted in the Lower Main region in West Germany within the framework of an air hydgienic and meteorologic model study of that region, are described. Parmelia physodes explants from oak trees growing in nonpolluted areas were exposed in polluted areas, such as in an industrial area, an airport, a petroleum refinery, and near a large chemical plant. The degree of air pollution in the exposure site was evaluated by the degree of the lichen damage in seven grades. The large-scale average distribution of air pollution in the survey area was studied by surveying the natural occurrence of lichen species on 10 apple trees in area units of 6.25 sq km each. The lichen explant and lichen survey methods compared by the study of naturally occurring lichens were near the exposure site of lichen explants.

  1. Lichen Sclerosus

    Directory of Open Access Journals (Sweden)

    Şeniz Ergin

    2012-06-01

    Full Text Available Lichen sclerosus is a progressive, inflammatory dermatosis characterized with porcelain white sclerotic plaques most commonly in the anogenital area of postmenopausal women. Children and men can also be affected. Extragenital involvement may occur. Even though the etiology is unknown; autoimmune, genetic, hormonal and infectious factors are suggested. Lichen sclerosus is associated with autoimmune diseases such as thyroid disease, alopecia areata, vitiligo, diabetes and pernicious anemia. An increased incidence of autoantibodies to the extracellular matrix protein 1 is shown in sera of patients with lichen sclerosus. Familial occurence and an association with HLA DQ7 supports the presence of genetic factors in its etiology. However, the role of estrogen and androgens could not be demonstrated as etiologic factors. Clinical similarity with acrodermatitis chronica atrophicans led researches to be held for the detection of Borrelia burgdorferi antibodies ended with conflicting results. Disease may be triggered with trauma in the presence of genetic predisposition. Pruritus is the main symptom. Pain, burning and dysesthesia may occur. Lichen sclerosus may be confused with sexual abuse in girls. Furthermore, it is more severe in the presence of sexual abuse. If not treated it leads to permanent anatomical disorders in the anogenital region. It is one of the most common cause of acquired phimosis in boys. Meatal stenosis and urinary obstruction may develop. Erectile dysfunction and dyspareunia due to introital stenosis may cause psychosexual problems in men and women. Perianal involvement causes constipation in women and girls. Long-standing anogenital lesions have the risk of developing squamous cell carcinoma. Verrucous carcinoma rarely occurs. Extragenital symptoms do not have similar risks. Ultra-potent topical corticosteroids are used as the first line therapy. In the case of unresponsiveness to corticosteroids the alternative approaches are

  2. Lichen Sclerosus

    Directory of Open Access Journals (Sweden)

    Şeniz Ergin

    2012-06-01

    Full Text Available Lichen sclerosus is a progressive, inflammatory dermatosis characterized with porcelain white sclerotic plaques most commonly in the anogenital area of postmenopausal women. Children and men can also be affected. Extragenital involvement may occur. Even though the etiology is unknown; autoimmune, genetic, hormonal and infectious factors are suggested. Lichen sclerosus is associated with autoimmune diseases such as thyroid disease, alopecia areata, vitiligo, diabetes and pernicious anemia. An increased incidence of autoantibodies to the extracellular matrix protein 1 is shown in sera of patients with lichen sclerosus. Familial occurence and an association with HLA DQ7 supports the presence of genetic factors in its etiology. However, the role of estrogen and androgens could not be demonstrated as etiologic factors. Clinical similarity with acrodermatitis chronica atrophicans led researches to be held for the detection of Borrelia burgdorferi antibodies ended with conflicting results. Disease may be triggered with trauma in the presence of genetic predisposition. Pruritus is the main symptom. Pain, burning and dysesthesia may occur. Lichen sclerosus may be confused with sexual abuse in girls. Furthermore, it is more severe in the presence of sexual abuse. If not treated it leads to permanent anatomical disorders in the anogenital region. It is one of the most common cause of acquired phimosis in boys. Meatal stenosis and urinary obstruction may develop. Erectile dysfunction and dyspareunia due to introital stenosis may cause psychosexual problems in men and women. Perianal involvement causes constipation in women and girls. Long-standing anogenital lesions have the risk of developing squamous cell carcinoma. Verrucous carcinoma rarely occurs. Extragenital symptoms do not have similar risks. Ultra-potent topical corticosteroids are used as the first line therapy. In the case of unresponsiveness to corticosteroids the alternative approaches are

  3. Lichen indicator [Section 4

    Science.gov (United States)

    Paul L. Patterson; Susan Will-Wolf; Marie T. Trest

    2009-01-01

    Lichens are very responsive to environmental stressors in forests, including changes in forest structure, air quality, and climate. Each lichen species on a plot is an indicator of how lichen communities respond to ecological conditions. Individual lichen species occur erratically and even common species are often absent from plots with suitable habitat. The combined...

  4. Scalp Psoriasis: Signs and Symptoms

    Science.gov (United States)

    ... Kids’ zone Video library Find a dermatologist Scalp psoriasis Overview Scalp psoriasis: When psoriasis forms on the scalp, it can creep beyond the scalp. Scalp psoriasis: Overview Psoriasis (sore-EYE-ah-sis) can appear ...

  5. Scalp Psoriasis: Diagnosis and Treatment

    Science.gov (United States)

    ... Kids’ zone Video library Find a dermatologist Scalp psoriasis Overview Scalp psoriasis: When psoriasis forms on the scalp, it can creep beyond the scalp. Scalp psoriasis: Overview Psoriasis (sore-EYE-ah-sis) can appear ...

  6. Hepatitis C virus infection in patients with oral lichen planus

    African Journals Online (AJOL)

    2011-02-20

    Feb 20, 2011 ... The study was conducted in the outpatient department of a dental college for a period of six months between. January and June ... Department of Oral Medicine and Radiology, Career Post Graduate Institute of Dental Sciences and Hospital, ... Erosive. Erosion or ulceration covered with fibrous plaque or.

  7. Hepatitis B virus in Nigerians with Lichen planus | Daramola | West ...

    African Journals Online (AJOL)

    West African Journal of Medicine. Journal Home · ABOUT · Advanced Search · Current Issue · Archives · Journal Home > Vol 23, No 2 (2004) >. Log in or Register to get access to full text downloads. Username, Password, Remember me, or Register · Download this PDF file. The PDF file you selected should load here if ...

  8. I Live with Psoriasis

    Science.gov (United States)

    ... turn Javascript on. Feature: Living with Psoriasis I Live with Psoriasis Past Issues / Fall 2013 Table of ... courtesy of Stephen Voss/ National Psoriasis Foundation "I live with the disease," she says, cautious about being ...

  9. What Is Psoriasis?

    Science.gov (United States)

    ... Kids Pages Breadcrumb Home Health Topics English Español Psoriasis Basics In-Depth Download Download EPUB Download PDF What is it? Points To Remember About Psoriasis Psoriasis is an autoimmune disease that causes red, ...

  10. Naevoid psoriasis

    Directory of Open Access Journals (Sweden)

    Mittal R

    1999-01-01

    Full Text Available A 6-year-old male child had linear scaly erythematous band on the penis, undersuface of penis, extending to the scrotum since birth. He was diagnosed clinically as well as histopathologically as a case of naevoid psoriasis.

  11. Lichen substances prevent lichens from nutrient deficiency.

    Science.gov (United States)

    Hauck, Markus; Willenbruch, Karen; Leuschner, Christoph

    2009-01-01

    The dibenzofuran usnic acid, a widespread cortical secondary metabolite produced by lichen-forming fungi, was shown to promote the intracellular uptake of Cu(2+) in two epiphytic lichens, Evernia mesomorpha and Ramalina menziesii, from acidic, nutrient-poor bark. Higher Cu(2+) uptake in the former, which produces the depside divaricatic acid in addition to usnic acid, suggests that this depside promotes Cu(2+) uptake. Since Cu(2+) is one of the rarest micronutrients, promotion of Cu(2+) uptake by lichen substances may be crucial for the studied lichens to survive in their nutrient-poor habitats. In contrast, study of the uptake of other metals in E. mesomorpha revealed that the intracellular uptake of Mn(2+), which regularly exceeds potentially toxic concentrations in leachates of acidic tree bark, was partially inhibited by the lichen substances produced by this species. Inhibition of Mn(2+) uptake by lichen substances previously has been demonstrated in lichens. The uptake of Fe(2+), Fe(3+), Mg(2+), and Zn(2+), which fail to reach toxic concentrations in acidic bark at unpolluted sites, although they are more common than Cu(2+), was not affected by lichen substances of E. mesomorpha.

  12. Lichen Endozoochory by Snails

    Science.gov (United States)

    Boch, Steffen; Prati, Daniel; Werth, Silke; Rüetschi, Jörg; Fischer, Markus

    2011-01-01

    Endozoochory plays a prominent role for the dispersal of seed plants. However, for most other plant taxa it is not known whether this mode of dispersal occurs at all. Among those other taxa, lichens as symbiotic associations of algae and fungi are peculiar as their successful dispersal requires movement of propagules that leaves the symbiosis functional. However, the potential for endozoochorous dispersal of lichen fragments has been completely overlooked. We fed sterile thalli of two foliose lichen species (Lobaria pulmonaria and Physcia adscendens) differing in habitat and air-quality requirements to nine snail species common in temperate Europe. We demonstrated morphologically that L. pulmonaria regenerated from 29.0% of all 379 fecal pellets, whereas P. adscendens regenerated from 40.9% of all 433 fecal pellets, showing that lichen fragments survived gut passage of all snail species. Moreover, molecular analysis of regenerated lichens confirmed the species identity for a subset of samples. Regeneration rates were higher for the generalist lichen species P. adscendens than for the specialist lichen species L. pulmonaria. Furthermore, lichen regeneration rates varied among snail species with higher rates after gut passage of heavier snail species. We suggest that gastropods generally grazing on lichen communities are important, but so far completely overlooked, as vectors for lichen dispersal. This opens new ecological perspectives and questions the traditional view of an entirely antagonistic relationship between gastropods and lichens. PMID:21533256

  13. Psoriasis and Obesity

    DEFF Research Database (Denmark)

    Jensen, Peter; Skov, Lone

    2017-01-01

    Psoriasis is a common chronic inflammatory skin disease with a complex pathogenesis consisting of a genetic component, immune dysfunction, and environmental factors. It is associated with numerous comorbidities including psoriatic arthritis, cardiovascular disease, metabolic syndrome, and obesity....... Evidence suggests that obesity is a risk factor for incident psoriasis, aggravates existing psoriasis, and that weight reduction may improve the severity of psoriasis in overweight individuals. Excess body weight may interfere with the medical treatment used in psoriasis and adds to the cardiovascular risk...... profile in these patients, which underscores the importance of effective weight control regimens. In this review we examine the current literature with regard to the association between obesity and psoriasis....

  14. PSORIASIS AS SYSTEM PATHOLOGY

    Directory of Open Access Journals (Sweden)

    I.V. Kozlova

    2008-03-01

    Full Text Available Psoriasis is one of the most widespread chronic dermatoses which 1-5% of the population of the planet suffers. They consider psoriasis as a systemic disease with not only lesions of skin, but also joints and visceral involvement, as «psoriasis disease». In the review there are discussed pathogenesis of psoriasis, submitted infectious-immunological, genetic, metabolic and neuroendocrine concepts. Changes of digestive, cardiovascular, nervous, hepatobiliary, urinary systems and suppoting-motive apparatus of patients with psoriasis are examined. Methods of treatment of psoriasis are presented. Immunosuppressive and anticytokine therapy is discussed.

  15. Overview of psoriasis

    NARCIS (Netherlands)

    de Rie, Menno A.; Goedkoop, Amber Y.; Bos, Jan D.

    2004-01-01

    Psoriasis is a chronic disease that affects the skin and joints. Clinical hallmarks comprise erythematous plaques covered by silvery scaling and a chronic recurrent course. Histologically, psoriasis is characterized by the hyperproliferation of the epidermis, elongated and prominent blood vessels

  16. Psoriasis og aterotrombotisk sygdom

    DEFF Research Database (Denmark)

    Ahlehoff, Ole; Gislason, Gunnar H; Skov, Lone

    2010-01-01

    Psoriasis and atherosclerosis share immunoinflammatory mechanisms and patients with psoriasis may carry an excess of cardiovascular risk factors (hypercholesterolemia, hypertension, obesity, metabolic syndrome, diabetes mellitus, smoking etc.) and increased risk of atherothrombotic disease...

  17. National Psoriasis Foundation

    Science.gov (United States)

    ... 723-9166 | Submit a Question | Learn More National Psoriasis Foundation provides you with the help you need to best manage your psoriasis or psoriatic arthritis, while promoting research to find ...

  18. Lichens in the Churchyard

    Science.gov (United States)

    Oldershaw, Cally; Hilton, Barbara; Rocca, Alis

    2010-01-01

    The late Tom Chester, in his role as the British Lichen Society churchyard coordinator, did a great deal to encourage the use of the churchyard as an educational tool. In his honour, the Society has created an award as part of its "Lichen Project". When the Society approached the Association for Science Education (ASE) for help in…

  19. Chloroquine

    Science.gov (United States)

    ... erythematosus, scleroderma, pemphigus, lichen planus, polymyositis, sarcoidosis, and porphyria cutanea tarda. Talk to your doctor about the ... liver disease, G-6-PD deficiency, hearing problems, porphyria or other blood disorders, psoriasis, vision changes, weakness ...

  20. Psoriasis og aterotrombotisk sygdom

    DEFF Research Database (Denmark)

    Ahlehoff, Ole; Gislason, Gunnar H; Skov, Lone

    2010-01-01

    Psoriasis and atherosclerosis share immunoinflammatory mechanisms and patients with psoriasis may carry an excess of cardiovascular risk factors (hypercholesterolemia, hypertension, obesity, metabolic syndrome, diabetes mellitus, smoking etc.) and increased risk of atherothrombotic disease....... The current review summarises the available evidence in this area of research and calls for increased awareness of cardiovascular risk assessment and treatment in patients with psoriasis....

  1. Treating Psoriasis During Pregnancy

    DEFF Research Database (Denmark)

    Bangsgaard, Nannie; Rørbye, Christina; Skov, Lone

    2015-01-01

    Psoriasis is a chronic inflammatory disease with a well-documented negative effect on the quality of life of affected patients. Psoriasis often occurs in the reproductive years, during which the issue of pregnancy needs to be addressed. The course of psoriasis during pregnancy is unpredictable......, and many patients face the challenge of needing treatment during pregnancy. In this review we provide an overview of the key considerations for managing psoriasis in pregnant women, covering the potential effects of active psoriasis and co-morbid conditions on the health of the mother and fetus, as well...

  2. Líquen estriado no adulto Lichen striatus on adult

    Directory of Open Access Journals (Sweden)

    Leticia Fogagnolo

    2011-02-01

    Full Text Available Líquen estriado é uma erupção inflamatória incomum, de etiologia desconhecida. Raramente acomete adultos, e é caracterizada pelo surgimento abrupto de pápulas coalescentes, em arranjo linear, usualmente em extremidades. A histopatologia mostra reação liquenóide envolvendo folículos e glândulas. Ocasionalmente há sobreposição com líquen plano linear e "blaschkitis", seus principais diagnósticos diferenciais. Relata-se um caso de mulher adulta com pápulas eritematovioláceas em região cervical e hemiface direitas, cuja correlação clínico-histopatológica permitiu o diagnóstico de líquen estriado. Os achados atípicos e a dificuldade diagnóstica são discutidos.Lichen Striatus is an uncommon inflammatory skin eruption of unknown etiology. It rarely affects adults, and it is characterized by abrupt onset of coalescent papules, in a linear disposition, usually on the extremities. Histopathology shows lichenoid reaction involving follicles and glands. Occasionally, there is overlap with linear lichen planus and "blaschkitis", the main differential diagnoses. It is reported here the case of an adult woman with erythematous violaceous papules on the right side of the neck and face, diagnosed with lichen striatus by clinical and histopathological correlation. The atypical findings and the diagnostic difficulty are discussed.

  3. Lichen simplex chronicus

    Science.gov (United States)

    ... occur in people who have: Skin allergies Eczema (atopic dermatitis) Psoriasis Nervousness, anxiety, depression, and other emotional problems The problem is common in children, who cannot stop scratching insect bites and other ...

  4. NK Cells and Psoriasis

    Directory of Open Access Journals (Sweden)

    Sinéad Dunphy

    2011-01-01

    Full Text Available Psoriasis is a chronic condition of the skin characterised by distinctive scaly plaques. The immune system is now thought to play a major role in the development and pathogenesis of psoriasis with immune cells and cytokines influencing keratinocyte function. Keratinocytes in turn, can activate and recruit immune cells leading to a positive feedback loop in disease. Natural Killer (NK cells are lymphocytes that are best known for killing virally infected and cancer cells. However, evidence is emerging to support a role for NK cells in psoriasis. NK cells are found in the inflammatory infiltrate in psoriatic skin lesions. They can produce a range of inflammatory cytokines, many of which are important in the pathogenesis of psoriasis. Recent genetic studies have identified a range of potential molecules relating to NK cell biology that are known to be important in psoriasis. This paper will discuss the evidence, both cellular and genetic, for NK cell involvement in psoriasis.

  5. Laserbehandeling bij psoriasis

    NARCIS (Netherlands)

    Sewbaransingh. A., [No Value

    2000-01-01

    Aan de Wetenschapswinkel Geneeskunde en Volksgezondheid werd een vraag voorgelegd van de Nederlandse Bond van Psoriasis Patiënten Verenigingen (NBPV) betreffende een folder genaamd 'de behandeling van psoriasis met laser' (zie Bijlage I). De vraag van de NBPV was om na te gaan in hoeverre de in de

  6. Psoriasis: Comorbidity and Treatment

    NARCIS (Netherlands)

    M. Wakkee (Marlies)

    2010-01-01

    textabstractPsoriasis is universal in occurrence, although the worldwide prevalence varies between 0.6% and 4.8%.The prevalence of psoriasis in people of Caucasian descend is approximately 2%. In the Netherlands it is therefore estimated that approximately 300,000 people are diagnosed as having

  7. Psoriasis in Monozygotic Twins

    Directory of Open Access Journals (Sweden)

    Pranesh Nigam

    1985-01-01

    Full Text Available A pair of monozygotic developed a similar pattern of psoriatic lesions in of the distribution of lesions and the time of onset of the disease, in spite of living in different living conditions. This suggests a strong influence of genetic factors. Clinically, one had guttate psoriasis and the other, the nummular psoriasis. The - possible mode of inheritance is autosomal recessive trait.

  8. Interventions for nail psoriasis

    NARCIS (Netherlands)

    de Vries, Anna Christa Q.; Bogaards, Nathalie A.; Hooft, Lotty; Velema, Marieke; Pasch, Marcel; Lebwohl, Mark; Spuls, Phyllis I.

    2013-01-01

    Psoriasis is a common skin disease that can also involve the nails. All parts of the nail and surrounding structures can become affected. The incidence of nail involvement increases with duration of psoriasis. Although it is difficult to treat psoriatic nails, the condition may respond to therapy.

  9. Interventions for nail psoriasis

    NARCIS (Netherlands)

    Vries, A.C. de; Bogaards, N.A.; Hooft, L.; Velema, M.; Pasch, M.C.; Lebwohl, M.; Spuls, P.I.

    2013-01-01

    BACKGROUND: Psoriasis is a common skin disease that can also involve the nails. All parts of the nail and surrounding structures can become affected. The incidence of nail involvement increases with duration of psoriasis. Although it is difficult to treat psoriatic nails, the condition may respond

  10. Psoriasis and Obesity

    Directory of Open Access Journals (Sweden)

    Mehmet Ali Gürer

    2012-03-01

    Full Text Available In recent years, it has been thought that a strong association exists between metabolic syndrome, specifically obesity, and psoriasis. Obesity is a multifactorial disease affected by both genetic and environmental factors. Adipokines (e.g. leptin secreted by the adipose tissue are believed to play a role in the pathogenesis of psoriasis. The main role of leptin is to adjust metabolism by controlling appetite. Serum leptin levels in patients with severe and moderate psoriasis were found to be higher than in normal control groups. In many similar studies, leptin secretion has been found to stimulate keratinocyte proliferation, which is one of the characteristics of psoriasis. Although many studies showed increased prevalence of obesity in psoriasis patients, few others reported development of obesity in psoriasis patients. Additionally, obesity was found to affect treatment responses not only in classical systemic/topical treatment approaches in psoriasis, but also in newer biological treatments. Overall, increasing epidemiological evidence suggests strong association between obesity and psoriasis, increase in serum leptin levels is thought to have a major role, and weight loss may have significant impact on response to treatment.

  11. Future Therapies of Psoriasis

    Directory of Open Access Journals (Sweden)

    Nilgün Atakan

    2008-12-01

    Full Text Available For many years psoriasis was thought to be an epidermal disorder resulting from uncontrolled hyperproliferation of keratinocytes. After the discovery of T cell targeted immunosuppressive agents improving psoriasis, it has been considered as a T cell mediated autoimmune disease. Systemic agents including methotrexate, tretinoin, cyclosporin have been used to treat psoriasis for over 30 years. The understanding of psoriasis as a T-cell.mediated disease has led to the development of biologic agents which target key molecules in the pathologic process.These new agents named biologicals appear to be safer than the agents in traditional therapies. Because they are so new and their long term safety is not established well; scientists are exploring several new therapeutic targets. Several new molecules such as angiogenesis inhibitors, immunomodulatory compounds, intracellular messenger targets, anti-inflammatory molecules, anti-integrins can be possible future treatment agent of psoriasis.

  12. Mousses and lichens

    African Journals Online (AJOL)

    User

    2011-05-02

    May 2, 2011 ... The effect of the dust rejected by the steel complex of El Hadjar (SIDER) studies was by subjecting the mousses and lichens under a treatment by various concentrations of dust. Previously, the chemical composition of this dust was to analyze and show as well the quantitative and qualitative composition of ...

  13. Study of Some Lichens of Qatar

    Directory of Open Access Journals (Sweden)

    Roda F. Al-Thani

    2011-01-01

    Full Text Available The desert regions of North and central Qatar were surveyed for lichens. Twelve species were reported. The most common lichens are of the crustose type and all fungi of the lichens collected are Ascomycete.

  14. Dimethyl fumarate for psoriasis.

    Science.gov (United States)

    2017-12-01

    Dimethyl fumarate (Skilarence - Almirall) was licensed by the European Medicines Agency in June 2017 for the treatment of moderate to severe plaque psoriasis in adults in need of systemic therapy. 1 An unlicensed formulation of dimethyl fumarate has been used in the UK for the management of psoriasis for several years. Here, we consider the evidence for the new product and how it fits with current strategies for the management of adults with psoriasis. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

  15. Therapeutic development in psoriasis.

    Science.gov (United States)

    Sobell, Jeffrey M; Leonardi, Craig L

    2014-06-01

    Advances in molecular biology have provided the basis for development of new therapeutic approaches to psoriasis. New, more effective therapies target specific molecules in the inflammatory cascade involved in the pathogenesis of psoriasis.The biologic era of psoriasis therapy began with inhibitors of T-cell activation, tumor necrosis factor-α, and interleukin (IL)-12/23. Continued investigation has led to therapies and therapeutic candidates that target IL-17, IL-23, phosphodiesterase-4, and isomers of Janus kinase. 2014 by Frontline Medical Communications Inc.

  16. Management of Psoriasis

    Directory of Open Access Journals (Sweden)

    Tülin Ergun

    2015-09-01

    Full Text Available Current data has led to better understanding of impact of psoriasis on quality of life as well as its physical and psychosocial co-morbidities. Consequently, holistic approach is mandatory in appropriate management of patients with psoriasis. Dermatologists should not only treat dermatological findings and symptoms but also screen patients regularly for co-morbidities and be active in coordinating the treatment if co-morbidities exist. Current review highlights main steps in management of psoriasis with a special emphasis on important practical points.

  17. Living with psoriasis

    DEFF Research Database (Denmark)

    Bak, Kirsten Tarri

    2004-01-01

    Living with psoriasis is a considerable burden and quality of life in patients is deeply affected, yet compliance with therapy is a major problem. The literature is abundant in quantitative studies stating the incidence of decrease in quality of life and related, measurable terms, and in efforts...... directed at the improvement of therapies. However, it is sparse concerning the experiences of patients. This study aims to promote an understanding of the daily life of patients with psoriasis with particular regard to how they manage the disease, ultimately to improve nursing care to these patients....... A qualitative, collective case study design was applied. The participants were 4 adult patients with a long and complicated psoriasis history. They were interviewed in depth focusing on their experiences related to psoriasis and its treatment. The patients suffered physically from itch and pain. However...

  18. THE HISTOPATHOLOGY OF PSORIASIS

    Directory of Open Access Journals (Sweden)

    C. Mignogna

    2011-09-01

    Full Text Available Psoriasis is a common, chronic, relapsing, papulo-squamous dermatitis, with overlying silvery scales. The scalp, sacral region, and extensor surfaces of extremity are commonly involved, even if flexural and intertriginous areas may be affected in the so-called “inverse psoriasis”. Involvement of nails is frequent. Oral lesions (geographic stomatitis and/or glossitis are commonly described. 5-8% of psoriatic patients develop arthritis. Interphalangeal joints are characteristically involved, but large joints are also affected. From a histological point of view, psoriasis is a dynamic dermatosis that changes during the evolution of an individual lesion; we can classify it in an early stage, advanced stage, and later lesions. Lesions are usually diagnostic only in early stages or near the margin of advancing plaques. Munro microabscesses and Kogoj micropustoles are diagnostic clues of psoriasis, but they aren’t always present. All other features can be found in numerous eczematous dermatitis. Key words: Psoriasis, histopathology, immunohistochemistry

  19. Advances in treating psoriasis

    Science.gov (United States)

    Belge, Katharina; Brück, Jürgen

    2014-01-01

    Psoriasis is a T helper (Th)17/Th1-mediated autoimmune disease affecting the skin and joints. So far, distinct traditional oral compounds and modern biologics have been approved in most countries for the treatment of patients with moderate to severe psoriasis or psoriatic arthritis. Yet, the anti-psoriatic therapeutic spectrum is to be extended by a number of novel targeted therapies including biologics and modern oral compounds. The next set of anti-psoriatic biologics targets mainly Th17-associated cytokines such as IL-17 or IL-23. In contrast, modern oral anti-psoriatics, such as dimethyl fumarate (DMF), apremilast or Janus kinase (JAK) inhibitors interfere with intracellular proteins and affect signaling pathways. Here we summarize the current systemic therapies for psoriasis and their immunological mechanism. The recent advances in psoriasis therapy will help treat our patients efficiently and complete our understanding of disease pathogenesis. PMID:24592316

  20. Biomonitoring with lichens on twigs

    DEFF Research Database (Denmark)

    Vilsholm, René Larsen; Wolseley, Pat; Søchting, Ulrik

    2009-01-01

    Two surveys of the lichen and bryophyte flora growing on oak twigs from a Welsh and a Danish locality were compared with additional data on bark pH and % nitrogen in thalli of Hypogymnia physodes. Despite differences in climate and lichen flora, both sites showed a shift in the lichen communities...... showing a loss of nitrophobes in all sites and the appearance of nitrophiles in pasture sites in 2003. This study demonstrates that lichens on twigs can be used as an early warning system to detect a response to changes in land management and nitrogen deposition....

  1. Lichenized Ascomycetes (Lichenes of the Choszczno Lake District

    Directory of Open Access Journals (Sweden)

    Ludwik Lipnicki

    2014-08-01

    Full Text Available The paper includes the list of 184 species of Lichens stated in the area of Choszczno Lake District. It gives the ecological conditions of their occurrence and the number of sites. Theendangered lichens growing in the forest-bereft regions which were under the strong influence of factors included by intensive agriculture were presented.

  2. Psoriasis: classical and emerging comorbidities*

    Science.gov (United States)

    de Oliveira, Maria de Fátima Santos Paim; Rocha, Bruno de Oliveira; Duarte, Gleison Vieira

    2015-01-01

    Psoriasis is a chronic inflammatory systemic disease. Evidence shows an association of psoriasis with arthritis, depression, inflammatory bowel disease and cardiovascular diseases. Recently, several other comorbid conditions have been proposed as related to the chronic inflammatory status of psoriasis. The understanding of these conditions and their treatments will certainly lead to better management of the disease. The present article aims to synthesize the knowledge in the literature about the classical and emerging comorbidities related to psoriasis. PMID:25672294

  3. LICHEN STRIATUS – CASE REPORTS

    Directory of Open Access Journals (Sweden)

    Caius Solovan

    2013-07-01

    Full Text Available Lichen striatus is an acquired linear inflammatory dermatosis, not frequently reported, with a peculiar clinical aspect, most often described in adults, with a poor response to treatment. We described 4 cases of lichen striatus diagnosed over an 8-month period of time.

  4. Koebner phenomenon of the ear canal skin.

    LENUS (Irish Health Repository)

    Young, O

    2009-02-01

    The Koebner phenomenon originally described the appearance of psoriatic lesions in the uninvolved skin of patients with psoriasis as a consequence of trauma. We describe a case of concurrent lichen planus and sarcoidosis in the auditory canal, which represents an unusual manifestation of the Koebner phenomenon. This is the first case of concurrent lichen planus and sarcoidosis in the head and neck region and highlights the need for biopsy to allow accurate histopathological diagnosis and treatment.

  5. Koebner phenomenon of the ear canal skin.

    LENUS (Irish Health Repository)

    Young, O

    2012-02-01

    The Koebner phenomenon originally described the appearance of psoriatic lesions in the uninvolved skin of patients with psoriasis as a consequence of trauma. We describe a case of concurrent lichen planus and sarcoidosis in the auditory canal, which represents an unusual manifestation of the Koebner phenomenon. This is the first case of concurrent lichen planus and sarcoidosis in the head and neck region and highlights the need for biopsy to allow accurate histopathological diagnosis and treatment.

  6. Bone scintigraphy in psoriasis

    Energy Technology Data Exchange (ETDEWEB)

    Hahn, K.; Thiers, G.; Eissner, D.; Holzmann, H.

    1980-08-01

    Since 1973 bone scintigraphy using sup(99m)Tc-phosphate-complexes was carried out in 382 patients with psoriasis. For comparison with the results of nuclear medicine, roentgenologic and clinical findings a group af 121 patients with psoriasis aged between 11 and 74 years was compared to a group of 42 patients aged between 20 and 49 years without roentgenologic and clinical signs of psoriasis arthritis. We found by means of isotope investigation that an essentially greater part of the bones adjacent to the joints was involved than was expected according to X-ray and clinical findings. In addition, in 205 patients with psoriasis whole-body scintigraphy, using sup(99m)Tc-MDP, was carried out since 1977/78. In 17 patients we found an increased accumulation of activity in the region of extraarticular structures of the skull as well as of the skeletal thorax. According to these results we conclude that in addition to the clinically and roentgenologically defined psoriatic arthritis in patients with psoriasis an osteopathy may exist, which can only be demonstrated by skeletal scintigraphy and which is localized in bones adjacent to the joints but can also be demonstrated in the region of extraarticular bones.

  7. Psoriasis and Nutrition Interactions

    Directory of Open Access Journals (Sweden)

    Leyla Tevfikoğlu Alceylan

    2015-06-01

    Full Text Available Psoriasis is a chronic complex inflammatory disease affected by both genetic and environmental factors. Nutrition and diet has been suggested to play a role in the etiology and pathogenesis of psoriasis. Diets poor in energy and saturated fatty acids and rich in polyunsaturated fatty acids have positive effects on the treatment of psoriasis. Vitamin A and D modulate immune system and their receptors shows an anti-inflammatory effect by inhibiting the proliferation of keratinocytes. Patients with psoriasis are often Vitamin D deficient, they should be therefore evaluated considering their vitamin D levels. If they take a vitamin D supplementation, they should be monitored for side effects. Consumption levels of minerals such as copper, zinc and iron, and antioxidant compounds, including carotenoids and flavonoids involve in antioxidant reactions should be followed-up. A diet including a variety of vegetables and fruit can help reduce the risk of oxidative stress. Selenium levels are lower in patients, and selenium is effective in the prognosis of the disease when combined with antioxidant treatment. Alcohol consumption has a negative impact on the nutrition of the patients and the prognosis of the disease and should be avoided. The follow-up of the disease at an early stage, adequate and balanced nutrition are important in the treatment of psoriasis. Weight controls should be provided and diets with individual specific nutrition variety should be set.

  8. Psoriasis and Sleep Apnea

    DEFF Research Database (Denmark)

    Egeberg, Alexander; Khalid, Usman; Gislason, Gunnar Hilmar

    2016-01-01

    and sleep apnea. METHODS: All Danish citizens age 18 y or older between January 1, 1997 and December 31, 2011 (n = 5,522,190) were linked at individual level in nationwide registries. Incidence rates (IRs) per 10,000 person-years were calculated and incidence rate ratios (IRRs) adjusted for age, sex......, socioeconomic status, smoking history, alcohol abuse, medication, and comorbidity were estimated by Poisson regression. RESULTS: There were 53,290, 6,885, 6,348, and 39,908 incident cases of mild psoriasis, severe psoriasis, psoriatic arthritis, and sleep apnea, respectively. IRRs (95% confidence interval...

  9. Psoriasis and Sleep Apnea

    DEFF Research Database (Denmark)

    Egeberg, Alexander; Khalid, Usman; Gislason, Gunnar Hilmar

    2015-01-01

    and sleep apnea. METHODS: All Danish citizens age 18 y or older between January 1, 1997 and December 31, 2011 (n = 5,522,190) were linked at individual level in nationwide registries. Incidence rates (IRs) per 10,000 person-years were calculated and incidence rate ratios (IRRs) adjusted for age, sex......, socioeconomic status, smoking history, alcohol abuse, medication, and comorbidity were estimated by Poisson regression. RESULTS: There were 53,290, 6,885, 6,348, and 39,908 incident cases of mild psoriasis, severe psoriasis, psoriatic arthritis, and sleep apnea, respectively. IRRs (95% confidence interval...

  10. Effect of weight loss on the severity of psoriasis

    DEFF Research Database (Denmark)

    Jensen, P; Zachariae, Claus; Christensen, R

    2013-01-01

    Psoriasis is associated with adiposity and weight gain increases the severity of psoriasis and the risk of incident psoriasis. Therefore, we aimed to measure the effect of weight reduction on the severity of psoriasis in obese patients with psoriasis.......Psoriasis is associated with adiposity and weight gain increases the severity of psoriasis and the risk of incident psoriasis. Therefore, we aimed to measure the effect of weight reduction on the severity of psoriasis in obese patients with psoriasis....

  11. Physiotherapy approaches aimed at management of talipes planus. Subtitle: Diagnosis and Therapy

    OpenAIRE

    Koukalová, Aneta

    2017-01-01

    Title: Physiotherapy approaches aimed at management of talipes planus, subtitle: diagnosis and therapy Abstract: Bachelor thesis is aimed on the diagnosis of talipes planus and physiotherypy methods suitable for patients with the untreated talipes planus. Talipes planus causes a lot of musculoskeletal problems so is important to start with diagnosis and therapy early. The theoretical part contains anatomy of the foot, differential diagnosis of the talipes planus and its causes, symptoms and c...

  12. Scoring nail psoriasis

    NARCIS (Netherlands)

    Klaassen, K.M.G.; Kerkhof, P.C.M. van de; Bastiaens, M.T.; Plusje, L.G.; Baran, R.L.; Pasch, M.C.

    2014-01-01

    BACKGROUND: Scoring systems are indispensable in evaluating the severity of disease and monitoring treatment response. OBJECTIVE: We sought to evaluate the competence of various nail psoriasis severity scoring systems and to develop a new scoring system. METHODS: The authors conducted a prospective,

  13. Immunology of Psoriasis

    Science.gov (United States)

    Lowes, Michelle A.; Suárez-Fariñas, Mayte; Krueger, James G.

    2014-01-01

    The skin is the front line of defense against insult and injury and contains many epidermal and immune elements that comprise the skin-associated lymphoid tissue (SALT). The reaction of these components to injury allows an effective cutaneous response to restore homeostasis. Psoriasis vulgaris is the best-understood and most accessible human disease that is mediated by T cells and dendritic cells. Inflammatory myeloid dendritic cells release IL-23 and IL-12 to activate IL-17-producing T cells, Th1 cells, and Th22 cells to produce abundant psoriatic cytokines IL-17, IFN-γ, TNF, and IL-22. These cytokines mediate effects on keratinocytes to amplify psoriatic inflammation. Therapeutic studies with anticytokine antibodies have shown the importance of the key cytokines IL-23, TNF, and IL-17 in this process. We discuss the genetic background of psoriasis and its relationship to immune function, specifically genetic mutations, key PSORS loci, single nucleotide polymorphisms, and the skin transcriptome. The association between comorbidities and psoriasis is reviewed by correlating the skin transcriptome and serum proteins. Psoriasis-related cytokine-response pathways are considered in the context of the transcriptome of different mouse models. This approach offers a model for other inflammatory skin and autoimmune diseases. PMID:24655295

  14. Psoriasis y nuevas terapias

    Directory of Open Access Journals (Sweden)

    Edgardo N. Chouela R., Dr.

    2011-11-01

    Esta reseña de las nuevas terapias disponibles de la psoriasis y de las que están en camino de ser aprobadas por las autoridades sanitarias, permitirá al lector tener una idea del estado actual del tratamiento de esta enfermedad.

  15. Delayed Hypersensitivity in Psoriasis

    Directory of Open Access Journals (Sweden)

    Bhushan Kumar

    1981-01-01

    Full Text Available Twenty two adult male patients of psoriasis and 100 normal Volunteers Were skin-tested ′ with DNC-B, mumps skin antigen, candidin coccidiodin, PPD, croton Oil and histamine hate Except for ′decreased mine phosphate sensitization seen: with DNCB, the response of psoriabics to, skin testing was comparable with the normals.

  16. Psoriasis and Contact Sensitivitiy

    Directory of Open Access Journals (Sweden)

    Deniz Arlı

    2013-03-01

    Full Text Available Objective: The aim of this study was to investigate the frequency of contact sensitivity in patients with psoriasis, whether there was an association between clinical types and contact sensitivity, whether patch test is a factor that causes Koebner reaction and frequency of contact sensitivity against commonly used topical corticosteroids. Methods: Fifty patients with psoriasis and 50 healthy volunteers were included in this study and ‘European standard series' and test units of active ingredients of some corticosteroids were performed on their upper back. The patches were read on hours 24, 48 and on day 7 in order to detect delayed allergic reactions and also Koebner reaction. The results of both groups were compared by using chi-square test. Results: At the end of the patch test allergic reaction was observed in 7 of 50 (14% patients with psoriasis and 12 of 50 (24% healthy volunteers. There was no statistically significant difference between allergic reaction of study group and healthy volunteers. There was no statistically significant difference between the clinical types of psoriasis and allergic contact sensitivity. The frequency of reaction increased in individuals having a positive sensitivity history to any substance in both patient and control groups. Reaction to topical steroids was not seen in any patients. Koebner phenomenon due to patch test was also not seen in any patients. Conclusion: We did not show any association between psoriasis and contact sensitivity in this study. We believe that contact allergens should be determined by using patch test in psoriatic patients with a positive history to any substance.

  17. Psoriasis (chronic plaque).

    Science.gov (United States)

    Naldi, Luigi; Rzany, Berthold

    2009-01-09

    Psoriasis affects 1-3% of the population, in some people causing changes to the nails and joints in addition to skin lesions. We conducted a systematic review and aimed to answer the following clinical questions: What are the effects of systemic drug treatments, topical drug treatments, and non-drug treatments (other than ultraviolet light) for chronic plaque psoriasis? What are the effects of ultraviolet light treatments for chronic plaque psoriasis? What are the effects of combined treatment with drugs plus ultraviolet light on chronic plaque psoriasis? What are the effects of combined systemic plus topical drug treatments for chronic plaque psoriasis? We searched: Medline, Embase, The Cochrane Library, and other important databases up to August 2007 (Clinical Evidence reviews are updated periodically; please check our website for the most up-to-date version of this review). We included harms alerts from relevant organisations such as the US Food and Drug Administration (FDA) and the UK Medicines and Healthcare products Regulatory Agency (MHRA). We found 122 systematic reviews, RCTs, or observational studies that met our inclusion criteria. We performed a GRADE evaluation of the quality of evidence for interventions. In this systematic review we present information relating to the effectiveness and safety of the following interventions: acupuncture, adding calcipotriol (topical) to psoralen plus ultraviolet light A or ultraviolet light B, adding oral retinoids to psoralen plus ultraviolet A (PUVA), alefacept, balneotherapy, ciclosporin, dithranol, T cell-targeted therapies, cytokine blocking agents, emollients (alone or plus ultraviolet light B), etanercept, fish oil supplementation, fumaric acid derivatives, Goeckerman treatment, heliotherapy, infliximab, Ingram regimen, keratolytics (salicylic acid, urea), leflunomide, methotrexate, oral pimecrolimus, phototherapy plus balneotherapy, psoralen plus ultraviolet A, psychotherapy, oral retinoids (alone or with

  18. Psoriasis y dermatomicosis Psoriasis ad dermatomycosis

    Directory of Open Access Journals (Sweden)

    Maria E. Vargas

    1994-01-01

    Full Text Available

    Se realizó estudio micológico a 52 pacientes que tenían diagnóstico clínico e histopatológico de psoriasis, pertenecientes al servicio de dermatología del Hospital Universitario San Vicente de Paúl, de Medellín, entre agosto de 1991 y febrero de 1993. Se tomaron 109 muestras a partir de las placas psoriáticas y de las lesiones sospechosas de dermatomicosis. En 10 casos (19.2% se corroboró el diagnóstico de dermatomicosis; en 5 de ellos se encontró onicomicosis por Candida albicans sin asociación con la edad, el sexo, el oficio O el tratamiento de los pacientes. En 4 hombres se aisló E. floccosum de diferentes localizaciones y en una mujer 7: tonsurans de lesiones interdigitales en los pies. Se demostró una asociación estadísticamente significativa entre la Infección por dermatofitos y el uso de esteroides sistémlcos (p = 0.021 . No se obtuvo crecimiento de dermatofitos a partir de las placas psoriáticas ni se vieron cambios histológicos típicos de la enfermedad en las lesiones producidas por los hongos. En conclusión, es baja la frecuencia de dermatomicosis en personas con psoriasis; usualmente la piel comprometida por los hongos está libre de cambios psoriáticos y el riesgo de contraer la dermatofitomicosis se incrementa en unas 30 veces en los pacientes tratados con esteroides sistémicos.

    Mycological study was performed on 52 patients with clinical and histopathological diagnosis of psoriasis; they were attending the Dermatology Service at Hospital Universitario San Vicente de Paúl, Medellín, Colombia, between August 1991 and February 1993. One hundred and nine specimens were obtained from either psoriatic plaques or lesions suggestive of dermatomycosis. The diagnosis of dermatomycosis  was established in 10 patients (19.2%; 5 of them had Candida albicans

  19. Turkey Psoriasis Treatment Guide-2016

    Directory of Open Access Journals (Sweden)

    Melih Akyol

    2016-08-01

    Full Text Available Psoriasis is a common, chronic, recurrent, inflammatory disease of the skin with unknown etiology. In addition to skin involvement, joint involvement is often seen in psoriasis; however as comorbidities including metabolic syndrome, cardiovascular diseases, psychological/psychiatric disorders and inflammatory bowel disease accompany psoriasis, the inflammatory process underlying has been shown to damage several organs. It is also known that the risk of mortality is increased in patients with severe psoriasis. What’s more, psoriasis significantly affects the patients quality of life. According to physical/psychological examinations, the quality of life is affected from psoriasis as much as other chronic diseases like cancer or diabetes. Psoriasis leads to massive performance loss because of time and work loss at business and daily life as a result of either disease itself or its treatment. Psoriasis has several treatment modalities either topical or systemic. Topical treatment is sufficient and successful for mild psoriasis but early systemic therapy is recommended for moderate and severe psoriasis to prevent comorbidites due to increased inflammatory effect and to manage psoriatic arthritis. Topical treatment is usually applied alone for mild cases and in combination with systemic therapy or phototherapy for moderate or severe cases. Indications for the systemic therapy includes erythrodermic psoriasis, generalized pustular psoriasis, psoriatic arthritis and moderate-severe plaque psoriasis that causes serious decrease at quality of life which is irresponsive-incompatible to topical modalities or phototherapy. As the role of the immunology in pathophysiology of psoriasis is better understood, new generation of biological therapies affecting molecular mechanisms which take role at onset of psoriasis have been developed. Today, cyclosporine, methotrexate, and acitretin are used systemically; etanercept, infliximab, adalimumab or ustekinumab are

  20. Psoriasis and comorbid diseases: Epidemiology.

    Science.gov (United States)

    Takeshita, Junko; Grewal, Sungat; Langan, Sinéad M; Mehta, Nehal N; Ogdie, Alexis; Van Voorhees, Abby S; Gelfand, Joel M

    2017-03-01

    Psoriasis is a common chronic inflammatory disease of the skin that is increasingly being recognized as a systemic inflammatory disorder. Psoriatic arthritis is a well-known comorbidity of psoriasis. A rapidly expanding body of literature in various populations and settings supports additional associations between psoriasis and cardiometabolic diseases, gastrointestinal diseases, kidney disease, malignancy, infection, and mood disorders. The pathogenesis of comorbid disease in patients with psoriasis remains unknown; however, shared inflammatory pathways, cellular mediators, genetic susceptibility, and common risk factors are hypothesized to be contributing elements. As additional psoriasis comorbidities continue to emerge, education of health care providers is essential to ensuring comprehensive medical care for patients with psoriasis. Copyright © 2016 American Academy of Dermatology, Inc. All rights reserved.

  1. Exploring symbiont management in lichens.

    Science.gov (United States)

    Grube, Martin; Spribille, Toby

    2012-07-01

    Lichens are unique among fungal symbioses in that their mycelial structures are compact and exposed to the light as thallus structures. The myriad intersections of unique fungal species with photosynthetic partner organisms (green algae in 90% of lichens) produce a wide variety of diverse shapes and colours of the fully synthesized lichen thallus when growing in nature. This characteristic complex morphology is, however, not achieved in the fungal axenic state. Even under ideal environmental conditions, the lichen life cycle faces considerable odds: first, meiotic spores are only produced on well-established thalli and often only after achieving considerable age in a stable environment, and second, even then in vivo resynthesis requires the presence of compatible algal strains where fungal spores germinate. Many lichen species have evolved a way around the resynthesis bottleneck by producing asexual propagules for joint propagation of symbionts. These different dispersal strategies ostensibly shape the population genetic structure of lichen symbioses, but the relative contributions of vertical (joint) and horizontal (independent) symbiont transmission have long eluded lichen evolutionary biologists. In this issue of Molecular Ecology, Dal Grande et al. (2012) close in on this question with the lung lichen, Lobaria pulmonaria, a flagship species in the conservation of old growth forests. By capitalizing on available microsatellite markers for both fungal and algal symbionts, they show that while vertical transmission is the predominant mode of reproduction, horizontal transmission is demonstrable and actively shapes population genetic structure. The resulting mixed propagation system is a highly successful balance of safe recruitment of symbiotic clones and endless possibilities for fungal recombination and symbiont shuffling.

  2. Male genital lichen sclerosus

    Directory of Open Access Journals (Sweden)

    Christopher Barry Bunker

    2015-01-01

    Full Text Available Male genital lichen sclerosus (MGLSc is a chronic inflammatory skin disease responsible for male sexual dyspareunia and urological morbidity. An afeared complication is squamous cell carcinoma (SCC of the penis. The precise etiopathogenesis of MGLSc remains controversial although genetic, autoimmune and infective (such as human papillomavirus (HPV hepatitis C (HCV, Epstein-Barr virus (EBV and Borrelia factors have been implicated: Consideration of all the evidence suggests that chronic exposure of susceptible epithelium to urinary occlusion by the foreskin seems the most likely pathomechanism. The mainstay of treatment is topical ultrapotent corticosteroid therapy. Surgery is indicated for cases unresponsive to topical corticosteroid therapy, phimosis, meatal stenosis, urethral stricture, carcinoma in situ (CIS and squamous cell carcinoma.

  3. Psoriasis and comorbidities. Epidemiological studies

    DEFF Research Database (Denmark)

    Egeberg, Alexander

    2016-01-01

    , the relationship between psoriasis and uveitis, and the risk of incident multiple sclerosis (MS) following the onset of psoriasis, respectively. The main results were a significantly increased risk of myocardial infarction, stroke, and CVD death in patients with psoriasis during stages of acute depression...... was significantly associated with certain CNS diseases, and the risk of CVD was strongly associated with acute depression in these patients. These novel findings suggest an important link between psoriasis and CNS diseases, and high-light the necessity for a holistic approach to the diagnosis and treatment...

  4. Psoriasis y dermatomicosis Psoriasis ad dermatomycosis

    OpenAIRE

    Maria E. Vargas; Fernando Montoya; Lucía Santamaría de Uribe; Herta Vélez; Carlos Valencia

    1994-01-01

    Se realizó estudio micológico a 52 pacientes que tenían diagnóstico clínico e histopatológico de psoriasis, pertenecientes al servicio de dermatología del Hospital Universitario San Vicente de Paúl, de Medellín, entre agosto de 1991 y febrero de 1993. Se tomaron 109 muestras a partir de las placas psoriáticas y de las lesiones sospechosas de dermatomicosis. En 10 casos (19.2%) se corroboró el diagnóstico de derm...

  5. Biological therapy of psoriasis

    Directory of Open Access Journals (Sweden)

    Sivamani Raja

    2010-01-01

    Full Text Available The treatment of psoriasis has undergone a revolution with the advent of biologic therapies, including infliximab, etanercept, adalimumab, efalizumab, and alefacept. These medications are designed to target specific components of the immune system and are a major technological advancement over traditional immunosuppressive medications. These usually being well tolerated are being found useful in a growing number of immune-mediated diseases, psoriasis being just one example. The newest biologic, ustekinumab, is directed against the p40 subunit of the IL-12 and IL-23 cytokines. It has provided a new avenue of therapy for an array of T-cell-mediated diseases. Biologics are generally safe; however, there has been concern over the risk of lymphoma with use of these agents. All anti-TNF-α agents have been associated with a variety of serious and "routine" opportunistic infections.

  6. Poliosis overlying psoriasis

    Directory of Open Access Journals (Sweden)

    Sevgi Akarsu

    2013-03-01

    Full Text Available Poliosis is the term used to describe a localized area of hypopigmented or depigmented hairs. It is believed that this condition is a result of the destruction of follicular melanocytes by an inflammatory or autoimmune mechanism. Poliosis can occur in several hereditary syndromes or is acquired after inflammation, irradiation or infection and some medications. Additionally, it has also been reported that it can overlie some benign and malignant lesions, including some nevi, melanoma and neurofibroma. On the other hand, there has been no prior data of an association between psoriasis, which is a T-cell-mediated autoimmune inflammatory disease, and poliosis in the literature. Here, we describe an 11-year-old female with poliosis of the scalp overlying a plaque of psoriasis.

  7. Psoriasis y nuevas terapias

    OpenAIRE

    Chouela R., Edgardo N.

    2011-01-01

    La psoriasis es una enfermedad compleja, sistémica y crónica, que compromete la calidad de vida de los pacientes desde muy temprana edad y que requiere del compromiso del médico tratante para su manejo terapéutico. El mejor conocimiento de la fisiopatología de la enfermedad ha permitido el desarrollo de nuevas terapéuticas, algunas ya disponibles y otras en vías de serlo en los próximos años. Esta reseña de las nuevas terapias disponibles de la psoriasis y de las que están en camino de ...

  8. Biosimilars for psoriasis

    DEFF Research Database (Denmark)

    Cohen, A D; Wu, J J; Puig, L

    2017-01-01

    , different regulatory agencies use highly variable methods for definition, production, approval, marketing and postmarketing surveillance. Due to potential interchangeability between biologics and biosimilars, traceability and pharmacovigilance are required to collect accurate data about adverse events......The introduction of biological drugs for the treatment of patients with psoriasis has revolutionized treatment paradigms and enabled numerous patients to achieve disease control with an acceptable safety profile. However, the high cost of biologics limits access to these medications...... for the majority of patients worldwide. In recent years, the introduction of biosimilars for inflammatory diseases has become a fast evolving field. The future use of biosimilars offers the potential for decreased cost and increased access to biologics for patients with psoriasis. For approval of biosimilars...

  9. Lichens survive in space: results from the 2005 LICHENS experiment.

    Science.gov (United States)

    Sancho, Leopoldo G; de la Torre, Rosa; Horneck, Gerda; Ascaso, Carmen; de Los Rios, Asunción; Pintado, Ana; Wierzchos, J; Schuster, M

    2007-06-01

    This experiment was aimed at establishing, for the first time, the survival capability of lichens exposed to space conditions. In particular, the damaging effect of various wavelengths of extraterrestrial solar UV radiation was studied. The lichens used were the bipolar species Rhizocarpon geographicum and Xanthoria elegans, which were collected above 2000 m in the mountains of central Spain and as endolithic communities inhabiting granites in the Antarctic Dry Valleys. Lichens were exposed to space in the BIOPAN-5 facility of the European Space Agency; BIOPAN-5 is located on the outer shell of the Earth-orbiting FOTON-M2 Russian satellite. The lichen samples were launched from Baikonur by a Soyuz rocket on May 31, 2005, and were returned to Earth after 16 days in space, at which time they were tested for survival. Chlorophyll fluorescence was used for the measurement of photosynthetic parameters. Scanning electron microscopy in back-scattered mode, low temperature scanning electron microscopy, and transmission electron microscopy were used to study the organization and composition of both symbionts. Confocal laser scanning microscopy, in combination with the use of specific fluorescent probes, allowed for the assessment of the physiological state of the cells. All exposed lichens, regardless of the optical filters used, showed nearly the same photosynthetic activity after the flight as measured before the flight. Likewise, the multimicroscopy approach revealed no detectable ultrastructural changes in most of the algal and fungal cells of the lichen thalli, though a greater proportion of cells in the flight samples had compromised membranes, as revealed by the LIVE/DEAD BacLight Bacterial Viability Kit. These findings indicate that most lichenized fungal and algal cells can survive in space after full exposure to massive UV and cosmic radiation, conditions proven to be lethal to bacteria and other microorganisms. The lichen upper cortex seems to provide adequate

  10. Lichens Survive in Space: Results from the 2005 LICHENS Experiment

    Science.gov (United States)

    Sancho, Leopoldo G.; de la Torre, Rosa; Horneck, Gerda; Ascaso, Carmen; de los Rios, Asunción; Pintado, Ana; Wierzchos, J.; Schuster, M.

    2007-06-01

    This experiment was aimed at establishing, for the first time, the survival capability of lichens exposed to space conditions. In particular, the damaging effect of various wavelengths of extraterrestrial solar UV radiation was studied. The lichens used were the bipolar species Rhizocarpon geographicum and Xanthoria elegans, which were collected above 2000 m in the mountains of central Spain and as endolithic communities inhabiting granites in the Antarctic Dry Valleys. Lichens were exposed to space in the BIOPAN-5 facility of the European Space Agency; BIOPAN-5 is located on the outer shell of the Earth-orbiting FOTON-M2 Russian satellite. The lichen samples were launched from Baikonur by a Soyuz rocket on May 31, 2005, and were returned to Earth after 16 days in space, at which time they were tested for survival. Chlorophyll fluorescence was used for the measurement of photosynthetic parameters. Scanning electron microscopy in back-scattered mode, low temperature scanning electron microscopy, and transmission electron microscopy were used to study the organization and composition of both symbionts. Confocal laser scanning microscopy, in combination with the use of specific fluorescent probes, allowed for the assessment of the physiological state of the cells. All exposed lichens, regardless of the optical filters used, showed nearly the same photosynthetic activity after the flight as measured before the flight. Likewise, the multimicroscopy approach revealed no detectable ultrastructural changes in most of the algal and fungal cells of the lichen thalli, though a greater proportion of cells in the flight samples had compromised membranes, as revealed by the LIVE/DEAD BacLight Bacterial Viability Kit. These findings indicate that most lichenized fungal and algal cells can survive in space after full exposure to massive UV and cosmic radiation, conditions proven to be lethal to bacteria and other microorganisms. The lichen upper cortex seems to provide adequate

  11. Etiopathogenesis of Psoriasis

    Directory of Open Access Journals (Sweden)

    Tülin Ergun

    2008-12-01

    Full Text Available Psoriasis is a common chronic inflammatory disease affecting the skin, joints and also having association with metabolic syndrome and coronary artery disease. Although recent progress has helped in elucidating the immunologic pathways and genetic basis of the disease, the etiology remains unknown. This review focuses on the role of cells involved in pathogenesis; T-lymphocytes, dendritic cell subgroups, macrophages, neutrophils, mast cells and keratinocytes and summarizes the immunopathogenesis.

  12. EPR Spectroscopy in Environmental Lichen-Indication

    Science.gov (United States)

    Bondarenko, P. V.; Nguyet, Le Thi Bich; Zhuravleva, S. E.; Trukhan, E. M.

    2017-09-01

    The paramagnetic properties of lichens were investigated using EPR spectroscopy and Xanthoria parietina (L.) Th. Fr. as a case study. It was found that the concentration of paramagnetic centers in lichen thalli increased as the air-pollution level increased. Possible formation mechanisms of the paramagnetic centers in lichens were discussed. The efficiency of using EPR spectroscopy to study lichens as environmental quality indicators was demonstrated.

  13. Nystatin in Psoriasis

    Directory of Open Access Journals (Sweden)

    Bhushan Kumar

    1989-01-01

    Full Text Available The hypothesis of the role of Candida in the gut for provoking psoriasis was tested by treating 9 males and 6 females having stable psoriasis with 200,000 units of nystatin orally 4 times a day for a minimum of 6 weeks. Intradermal candidin test and throat swab and stool samples for culture of Candida were taken before and twice after (between 4 and 8 weeks institution of the therapy. Various Candida species isolated before therapy in 11 patients, disappeared after the therapy in 6. In the other 5 the colony counts came down. Only scaling became less in 4 patients. More than 50% clearance was noted in 2 patients. No improvement occurred in 9 patients. No obivous correlation between isolation and disappearance of Candida and persistence or clearance of lesions was observed. Immediate (Type-1 hypersensitivity response to candidin was positive in only 3 patients. Immediate hypersensitivity to Candida antigens -or its metabolic products does not appear to have any role in the pathogenesis of psoriasis.

  14. Balneotherapy of Psoriasis

    Directory of Open Access Journals (Sweden)

    Golušin Zoran

    2014-09-01

    Full Text Available Application of different kinds of mineral waters and peloids on the skin exerts mechanical, thermal and chemical effects. Significant reduction of inflammation and increased differentiation of keratinocytes may explain why balneotherapy has positive clinical effects in psoriatic patients. In vitro models have shown that thermal water stimulates interleukin-2 production after cell stimulation by staphylococcal enterotoxin B, and reduces interleukin-4 secretion. After balneotherapy, a significant decrease in Psoriasis Area Severity Index (PASI, associated with a significant reduction of interleukin-8, Staphylococcus aureus colonization and enterotoxin N, have been reported in patients with psoriasis. Mineral water was found to have inhibitory in vitro effects on substance P, TNF-α release and antigen-induced cell degranulation. Immunomodulatory effects of water depend on its content. Sulfur waters have beneficial anti-inflammatory, keratolytic, and antipruriginous effects and also possess antibacterial and antifungal properties. The effectiveness of balneotherapy in the treatment of psoriasis has been reported in many studies conducted all over the world. The majority of studies were conducted at the Dead Sea coast. Investigations showed that balneotherapy factors are important therapeutic factors in the treatment of psoriatic patients. The first and only comparable study of this kind in Serbia, was conducted in Prolom Spa with satisfactory therapeutic results.

  15. Psoriasis and cardiovascular events

    DEFF Research Database (Denmark)

    Raaby, Line; Ahlehoff, Ole; de Thurah, Annette

    2017-01-01

    So far, systematic reviews have suggested an increased risk of cardiovascular diseases (CVD) in psoriatic patients, though some results have been conflicting. The aim of this study was to update the current level of evidence through a systematic search in MEDLINE, EMBASE and Cochrane Central...... Register databases. In total, 13 high-quality observational studies estimating the incidence of CVD were included. Patients with mild psoriasis had an increased risk of stroke [Hazard ratio (HR) = 1.10, 95% CI: 1.0-1.19] and myocardial infarction (MI) (HR = 1.20, 95% CI: 1.06-1.35), but not cardiovascular...... death. The risks of both stroke (HR = 1.38, 95% CI: 1.20-1.60), MI (HR = 1.70, 95% CI: 1.18-2.43) and cardiovascular death (HR = 1.37, 95% CI: 1.13-1.67) were increased in patients with severe psoriasis. In conclusion, this updated meta-analysis confirmed that patients with psoriasis have an increased...

  16. Bacterial communities associated with the lichen symbiosis.

    Science.gov (United States)

    Bates, Scott T; Cropsey, Garrett W G; Caporaso, J Gregory; Knight, Rob; Fierer, Noah

    2011-02-01

    Lichens are commonly described as a mutualistic symbiosis between fungi and "algae" (Chlorophyta or Cyanobacteria); however, they also have internal bacterial communities. Recent research suggests that lichen-associated microbes are an integral component of lichen thalli and that the classical view of this symbiotic relationship should be expanded to include bacteria. However, we still have a limited understanding of the phylogenetic structure of these communities and their variability across lichen species. To address these knowledge gaps, we used bar-coded pyrosequencing to survey the bacterial communities associated with lichens. Bacterial sequences obtained from four lichen species at multiple locations on rock outcrops suggested that each lichen species harbored a distinct community and that all communities were dominated by Alphaproteobacteria. Across all samples, we recovered numerous bacterial phylotypes that were closely related to sequences isolated from lichens in prior investigations, including those from a lichen-associated Rhizobiales lineage (LAR1; putative N(2) fixers). LAR1-related phylotypes were relatively abundant and were found in all four lichen species, and many sequences closely related to other known N(2) fixers (e.g., Azospirillum, Bradyrhizobium, and Frankia) were recovered. Our findings confirm the presence of highly structured bacterial communities within lichens and provide additional evidence that these bacteria may serve distinct functional roles within lichen symbioses.

  17. Lycopene in the management of oral lichen planus: A placebo-controlled study

    Directory of Open Access Journals (Sweden)

    Nisheeth Saawarn

    2011-01-01

    Settings and Design: This prospective, randomized, double-blind, placebo-controlled study was done in the Oral Medicine Department of a postgraduate teaching dental hospital in India. Materials and Methods: Thirty symptomatic OLP patients, randomly divided into two groups of 15 each, were administered lycopene 8 mg/day and an identical placebo, respectively, for 8 consecutive weeks. Burning sensation using visual analogue scale and overall treatment response using Tel Aviv-San Francisco scale were recorded at every visit. The data obtained were analyzed statistically using Wilcoxon Rank test, Mann-Whitney and Fischer′s Exact test. Results: A higher (84% reduction in burning sensation was seen in lycopene than in the placebo group (67%. All 15 (100% patients in the lycopene group showed 50% or more benefit and 11 (73.3% patients showed 70-100% benefit, while this number was only 10 and 4 (26.7%, respectively, in the placebo group. Conclusion: Lycopene was very effective in the management of OLP, and oxidative stress may have a role in disease pathogenesis.

  18. Subgrouping of patients with oral lichen planus according to cytochrome P450 enzyme phenotype and genotype

    DEFF Research Database (Denmark)

    Kragelund, Camilla; Jensen, Siri Beier; Hansen, Claus

    2014-01-01

    . A total of 111 patients with OLP were categorized according to normal, low, or high CYP1A2 activity and CYP2D6*4 genotype. Lifestyle parameters influencing the CYP1A2 activity and symptoms and manifestations of OLP were recorded. Results. Of the 111 patients, 21% had low, 65% normal, and 14% high CYP1A2...... activity. The high-CYP1A2-activity group was more exposed to CYP1A2 inducers than the low-CYP1A2-activity group. In the normal-CYP1A2-activity group, more patients had a CYP2D6*4 genotype (58%) (P = .02), and they presented more symptoms (P = .003) and gingival lesions (P = .03). More patients in the low...

  19. Maxillary sinus carcinoma in a patient with oral lichen planus: A case report

    OpenAIRE

    Grando, L. J.; Fabro, S. M.; Da Silva Rath, Inês Beatriz; Meurer, M. I.; Daniel, F. I.; Teixeira, G. V.; Somacarrera Pérez, María Luisa

    2013-01-01

    Mujer de 55 años de edad, fumadora, depresiva, con Liquen Plano Oral (LPO) de control clínico difícil, de más de 10 años de evolución. La paciente ha presentado períodos de remisión y exacerbación de las lesiones, de forma paralela presentó aumento de volumen intraoral en región maxilar izquierda, la superficie de la nueva lesión estaba ulcerada, y desprendía olor fétido en región alveolar sometida a exodoncias previas. El diagnóstico clínico inicial fue de una probable transforma...

  20. Atypical dermoscopic findings in patients diagnosed with lichen planus by histological examination

    Directory of Open Access Journals (Sweden)

    Jiyun Jung

    2017-03-01

    Conclusion: In this study, we emphasize the role of dermoscopy for identification of the clinical status of LP and its correlation to the results of histopathologic examinations. In addition to the typical dermoscopic patterns, dermoscopic recognition of variation in the morphology of LP could aid in the diagnosis of LP prior to histopathologic evaluation.

  1. Is grandma like a lichen planus? The problem of image perception and knowledge retention in pathology

    Science.gov (United States)

    Mello-Thoms, Claudia; Legowski, Elizabeth; Tseytlin, Eugene

    2013-03-01

    Medicine is the science of acquiring a lot of obscure knowledge and the art of knowing when to apply it, even if only once in a physician's lifetime. Although medical experts seem to have it all figured out, being significantly better and faster than trainees, many studies have suggested that it is not only the amount of knowledge - which comes with experience - that differentiates the experts, but it is also how the knowledge is structured in memory. To acquire new knowledge, trainees will first encode both `surface' (i.e., irrelevant) and `structural' (relevant) features, and repeated presentations of the material will allow for dismissal of the unimportant elements from memory. However, just because knowledge has been encoded it does not mean that it is safely guarded in the physician's memory; as with any information, if it is not tended to, it will slowly decay, and eventually it may be completely forgotten. In this study we investigated knowledge retention in a specific sub-domain of Pathology which is rarely, if ever, used by trainees. We wanted to determine the relationship between the way long-term memory is accessed (i.e., through recognition or free recall) and trainee performance. We also sought to determine whether access to long-term memory through either mechanism led to better transfer of newly acquired knowledge to never before seen cases.

  2. Increased cyclooxygenase 2 expression in association with oral lichen planus severity

    Directory of Open Access Journals (Sweden)

    Thaneeya Chankong

    2016-09-01

    Conclusion: Enhanced COX-2 expression in both OLP epithelium and inflammatory infiltrates correlates well with the clinical severity. An association between VAS score and COX-2 expression in OLP inflammatory infiltrates suggests an important role of additional COX-2 expression from inflammation in causing pain in OLP patients.

  3. Serum cytokine profile and clinicopathological findings in oral lichen planus, oral lichenoid lesions and stomatitis

    DEFF Research Database (Denmark)

    Larsen, Kristine Røn; Johansen, Jeanne Duus; Reibel, Jesper

    2017-01-01

    -nine patients and 29 healthy age- and gender-matched subjects were included. Demographic and clinical data immunohistochemical findings in mucosal specimens, results of contact allergy testing, and serum levels of tumor necrosis factor-α, interferon-γ, interleukin (IL)-6, IL-10, IL-12p40, and IL-12p70 were...

  4. Prevalence of Candida spp., xerostomia, and hyposalivation in oral lichen planus--a controlled study.

    Science.gov (United States)

    Artico, G; Freitas, R S; Santos Filho, A M; Benard, G; Romiti, R; Migliari, D A

    2014-04-01

    To determine the frequency of Candida spp., xerostomia, and salivary flow rate (SFR) in three different groups: patients with OLP (OLP group), patients with oral mucosal lesions other than OLP (non-OLP group), and subjects without oral mucosal lesions (control group). Xerostomia as well as SFR was investigated in the three groups. Samples for isolation of Candida spp. were collected from OLP lesions (38 patients), non-OLP lesions (28 patients), and healthy subjects (32 subjects). There was no statistically significant difference regarding the frequency of xerostomia and hyposalivation among the three groups (P > 0.05). A higher prevalence for colonization by Candida spp. was found in the healthy subject as compared to that of patients with OLP (P = 0.03) and non-OLP (P = 0.02) groups. Low SFR was not a factor for colonization by Candida spp. Xerostomia and hyposalivation occur with similar frequency in subjects with and without oral lesions; also, the presence of oral lesions does not increase the susceptibility to colonization by Candida spp. It seems that any study implicating Candida spp. in the malignant transformation of oral lesions should be carried out mostly on a biochemical basis, that is, by testing the capability of Candida spp. to produce carcinogenic enzyme. © 2013 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  5. Asthma in patients with psoriasis

    DEFF Research Database (Denmark)

    Lønnberg, A S; Skov, L; Skytthe, A

    2015-01-01

    We read with interest the report by Fang and colleagues of the relationship between psoriasis and asthma in a large retrospective case-control study from Taiwan [1]. The study found a 1.38-fold increased risk of asthma among patients with psoriasis, and with an increasing risk according to higher...

  6. [Psoriasis and cardiovascular risk factors].

    Science.gov (United States)

    Tal, Roy; Pavlovsky, Lev; David, Michael

    2012-10-01

    Psoriasis is a common inflammatory skin disease which may dramatically affect patients' lives. This chronic disease is characterized by a protracted course of alternating remissions and relapses. In recent years, the attention of researchers has focused on the association between psoriasis and cardiovascular disease risk factors. This review summarizes the literature on this topic with an emphasis on research conducted in Israel.

  7. Promising New Treatments for Psoriasis

    Directory of Open Access Journals (Sweden)

    Sarah Dubois Declercq

    2013-01-01

    Full Text Available Psoriasis is a chronic, proliferative, and inflammatory skin disease affecting 2-3% of the population and is characterized by red plaques with white scales. Psoriasis is a disease that can affect many aspects of professional and social life. Currently, several treatments are available to help control psoriasis such as methotrexate, ciclosporin, and oral retinoids. However, the available treatments are only able to relieve the symptoms and lives of individuals. The discovery of new immunological factors and a better understanding of psoriasis have turned to the use of immunological pathways and could develop new biological drugs against specific immunological elements that cause psoriasis. Biological drugs are less toxic to the body and more effective than traditional therapies. Thus, they should improve the quality of life of patients with psoriasis. This review describes new psoriasis treatments, which are on the market or currently in clinical trials that are being used to treat moderate-to-severe plaque psoriasis. In addition, this paper describes the characteristics and mechanisms in detail. In general, biological drugs are well tolerated and appear to be an effective alternative to conventional therapies. However, their effectiveness and long-term side effects need to be further researched.

  8. Lichens as environmental risk detectors

    Science.gov (United States)

    Caridi, F.; D'Agostino, M.; Messina, M.; Marcianò, G.; Grioli, L.; Belvedere, A.; Marguccio, S.; Belmusto, G.

    2017-04-01

    Several studies carried out after the Chernobyl nuclear accident in 1986 showed that lichens are suitable biomonitors of the fall-out, given their long life expectancy. 137Cs activity concentrations were measured through HPGe gamma spectrometry in different epiphytic lichens ( Usnea SPP, Platismatia glauca, Pseudevernia furfuracea, Ramalina SPP), collected from three sampling sites in the Calabria region, south of Italy. Data on variations in the contents of airborne particulates heavy metals, As, Be, Cd, Cu, Hg, Pb and Zn, measured in the thalli of the investigated lichens through inductively coupled plasma mass spectrometry (ICP-MS), were reported in accordance with a lichen thalli naturalness/alteration scale. Energy-dispersive X-ray microanalysis in a scanning electron microscope (SEM-EDX), with an electron beam of 20keV, that interacts with the sample leading to the emission of characteristic X-rays as secondary radiation, was also employed to investigate about the chemistry of the adherent particles to the surface of investigated lichens and about the possible interaction between them and the surrounding environment. Data obtained in this article provide useful information on the environmental risk of the studied area and can be further used for a radiological and chemical mapping.

  9. Smoking and risk for psoriasis

    DEFF Research Database (Denmark)

    Lønnberg, Ann Sophie; Skov, Lone; Skytthe, Axel

    2016-01-01

    BACKGROUND: Smoking is a potential risk factor for psoriasis. Both psoriasis and smoking habits are partly explained by genetic factors. However, twin studies investigating the association between these traits are limited. METHODS: Questionnaire-based data on smoking habits and psoriasis were...... collected for 34,781 twins, aged 20-71 years, from the Danish Twin Registry. A co-twin control analysis was performed on 1700 twin pairs discordant for lifetime history of smoking. Genetic and environmental correlations between smoking and psoriasis were estimated using classical twin modeling. RESULTS......: After multivariable adjustment, age group (50-71 vs. 20-49 years) and childhood exposure to environmental tobacco smoke (ETS) were significantly associated with psoriasis in the whole population (odds ratio [OR] 1.15, 95% confidence interval [CI] 1.02-1.29 [P = 0.021] and OR 1.28, 95% CI 1.10-1.49 [P...

  10. Association between psoriasis and inflammatory bowel disease

    DEFF Research Database (Denmark)

    Egeberg, Alexander; Mallbris, L; Warren, R B

    2016-01-01

    BACKGROUND: Psoriasis, Crohn disease (CD) and ulcerative colitis (UC) are chronic inflammatory disorders with overlapping genetic architecture. However, data on the frequency and risk of CD and UC in psoriasis are scarce and poorly understood. OBJECTIVES: To investigate the association between CD......-associated increased risk of CD and UC, which was higher in severe psoriasis, and an increased risk of psoriasis in patients with inflammatory bowel disease. Increased focus on gastrointestinal symptoms in patients with psoriasis may be warranted....

  11. Xanthones of Lichen Source: A 2016 Update.

    Science.gov (United States)

    Le Pogam, Pierre; Boustie, Joël

    2016-03-02

    An update of xanthones encountered in lichens is proposed as more than 20 new xanthones have been described since the publication of the compendium of lichen metabolites by Huneck and Yoshimura in 1996. The last decades witnessed major advances regarding the elucidation of biosynthetic schemes leading to these fascinating compounds, accounting for the unique substitution patterns of a very vast majority of lichen xanthones. Besides a comprehensive analysis of the structures of xanthones described in lichens, their bioactivities and the emerging analytical strategies used to pinpoint them within lichens are presented here together with physico-chemical properties (including NMR data) as reported since 1996.

  12. What is Psoriasis? | NIH MedlinePlus the Magazine

    Science.gov (United States)

    ... page please turn Javascript on. Feature: Living with Psoriasis What is Psoriasis? Past Issues / Fall 2013 Table of Contents What Is Psoriasis? There are several forms of psoriasis. The typical ...

  13. Extragenital lichen sclerosus et atrophicus

    Directory of Open Access Journals (Sweden)

    Leelavathy Ganesan

    2015-01-01

    Full Text Available Lichen sclerosus et atrophicus (LSA is a chronic inflammatory dermatosis with anogenital and extragenital presentations. Extragenital lichen sclerosus is most common on the neck, shoulders and upper trunk. Linear lesions are uncommon in LSA. We report a case of linear extragenital LSA involving forehead and scalp, along with grouped white papules of LSA in the right side of the back in a postmenopausal woman. The patient showed atypical clinical presentation of LSA in face which clinically mimicked ′en coup de sabre′ as seen in morphea, but other clinical features suggested the diagnosis of LSA and the histopathological findings confirmed it.

  14. Deciphering psoriasis. A bioinformatic approach.

    Science.gov (United States)

    Melero, Juan L; Andrades, Sergi; Arola, Lluís; Romeu, Antoni

    2018-02-01

    Psoriasis is an immune-mediated, inflammatory and hyperproliferative disease of the skin and joints. The cause of psoriasis is still unknown. The fundamental feature of the disease is the hyperproliferation of keratinocytes and the recruitment of cells from the immune system in the region of the affected skin, which leads to deregulation of many well-known gene expressions. Based on data mining and bioinformatic scripting, here we show a new dimension of the effect of psoriasis at the genomic level. Using our own pipeline of scripts in Perl and MySql and based on the freely available NCBI Gene Expression Omnibus (GEO) database: DataSet Record GDS4602 (Series GSE13355), we explore the extent of the effect of psoriasis on gene expression in the affected tissue. We give greater insight into the effects of psoriasis on the up-regulation of some genes in the cell cycle (CCNB1, CCNA2, CCNE2, CDK1) or the dynamin system (GBPs, MXs, MFN1), as well as the down-regulation of typical antioxidant genes (catalase, CAT; superoxide dismutases, SOD1-3; and glutathione reductase, GSR). We also provide a complete list of the human genes and how they respond in a state of psoriasis. Our results show that psoriasis affects all chromosomes and many biological functions. If we further consider the stable and mitotically inheritable character of the psoriasis phenotype, and the influence of environmental factors, then it seems that psoriasis has an epigenetic origin. This fit well with the strong hereditary character of the disease as well as its complex genetic background. Copyright © 2017 Japanese Society for Investigative Dermatology. Published by Elsevier B.V. All rights reserved.

  15. Natural killer cells in psoriasis.

    LENUS (Irish Health Repository)

    Tobin, A M

    2012-02-01

    Psoriasis is one of the most common immune-mediated disorders. There is evidence that it is mediated by Th1 and, more recently, Th17 cells. The cytokine pattern, particularly the dominance of TNF-alpha, implicates the innate immune system in psoriasis pathogenesis. Of the many components of the innate immune system known to be involved in psoriatic lesions, natural killer and natural killer T cells appear to have a unique role. We review the evidence supporting a role for natural killer cells in psoriasis.

  16. Implementing Best Practice in Psoriasis

    DEFF Research Database (Denmark)

    Kragballe, Knud; Gniadecki, Robert; Mørk, Nils-Jørgen

    2014-01-01

    In the absence of Nordic-wide guidelines on the best practice management of psoriasis, this paper aims to provide Nordic recommendations for treatment goals, evaluation of quality of life impact and assessment/management of co-morbidities. This Delphi approach consisted of telephone interviews...... of psoriasis patients with cardio-metabolic risk factors to their general practitioner. In order to achieve the best practice management of psoriasis, Nordic dermatologists should be trained and adhere to these recommendations in conjunction with available treatment guidelines....

  17. Highlighting Interleukin-36 Signalling in Plaque Psoriasis and Pustular Psoriasis.

    Science.gov (United States)

    Furue, Kazuhisa; Yamamura, Kazuhiko; Tsuji, Gaku; Mitoma, Chikage; Uchi, Hiroshi; Nakahara, Takeshi; Kido-Nakahara, Makiko; Kadono, Takafumi; Furue, Masutaka

    2018-01-12

    Plaque psoriasis and pustular psoriasis are overlapping, but distinct, disorders. The therapeutic response to biologics supports the pivotal role of the tumour necrosis alpha (TNF-?)/ interleukin (IL)-23/IL-17/IL-22 axis in the pathogenesis of these disorders. Recently, functional activation of the IL-36 receptor (IL-36R) was discovered to be another driving force in the pathogenesis of psoriasis. This was first highlighted by the discovery that a loss-of-function mutation of the IL-36R antagonist (IL-36Ra) causes pustular psoriasis. Although the TNF-?/IL-23/IL-17/IL-22 axis and the functional activation of IL-36R are fundamentally involved in plaque psoriasis and pustular psoriasis, respectively, the 2 pathways are closely related and mutually reinforced, resulting in full-blown clinical manifestations. This review summarizes current topics on how IL-36 agonists (IL-36?, IL-36?, IL-36?) signal IL-36R, the pathological expression of IL-36 agonists and IL-36Ra in plaque and pustular psoriatic lesions, and the cross-talk between the TNF-?/IL-23/IL-17/IL-22 axis and the functional activation of IL-36R in the epidermal milieu.

  18. Sarcoidosis in Patients with Psoriasis

    DEFF Research Database (Denmark)

    Khalid, Usman; Gislason, Gunnar Hilmar; Hansen, Peter Riis

    2014-01-01

    PURPOSE: Psoriasis is a chronic inflammatory disease characterized by a systemic immunological response which is mainly driven by activated T helper (Th) 1 and Th17 lymphocytes. Like psoriasis, sarcoidosis is a chronic inflammatory disorder with Th1/Th17-driven inflammation. Therefore, we...... investigated the risk of sarcoidosis in patients with psoriasis compared to the background population in a nationwide cohort. METHODS: The study included the entire Danish population aged ≥10 years followed from 1st January 1997 until diagnosis of sarcoidosis, death or 31st December 2011. Patients...... with a history of psoriasis and/or sarcoidosis at baseline were excluded. Information on comorbidity and concomitant medication was identified by individual-level linkage of administrative registers. Incidence rates of sarcoidosis were calculated and adjusted hazard ratios (HRs) were estimated by multivariable...

  19. Co-morbidity in psoriasis

    DEFF Research Database (Denmark)

    Lønnberg, Ann Sophie; Skov, Lone

    2017-01-01

    INTRODUCTION: Psoriasis is a common, chronic, immune-mediated inflammatory disorder. The disease is associated with several co-morbidities including cardiovascular disease, metabolic syndrome, and psychiatric disorders. It is important to identify and treat these co-morbidities because they have...... a strongly negative effect on the overall health of patients with psoriasis. Unfortunately, these co-morbidities are often overlooked and/or left untreated. Therefore, the aim of this review is to discuss the mechanisms of how co-morbidities are associated with psoriasis as well as implications...... for the clinic to be able to recognize such co-morbidities. Areas covered: This is a review of studies investigating and discussing co-morbidities of psoriasis and screening. Literature was retrieved by searching on the PubMed database using individual and combined search terms related to relevant co...

  20. Treatment of psoriasis with cyclosporin

    African Journals Online (AJOL)

    Treatment of psoriasis with cyclosporin. Experience at Johannesburg Hospital. R. J. Nevin, E. J. Schulz. Ten patients with moderate to severe plaque psoriasis were treated with cyclosporin A (CyA) for 2 - 19 months. (mean 12 months). Initial dosages were 2,5 mg/kg/d in 6 patients and 5,0 mg/kg/d in 4. At 3 months the ...

  1. Coexistencia de psoriasis y vitiligo.

    OpenAIRE

    María Isabel Moreno; Luis Hernando Moreno

    2009-01-01

    Se presenta el caso de un paciente de 53 años de edad, con historia de 10 años de evolución de vitiligo y quien posteriormente, sobre estas lesiones, desarrollo psoriasis en placas, manifestándose como un fenómeno isomórfico de Koebner. En la actual recibe tratamiento con fototerapia, luz ultravioleta B de banda estrecha, con resultados satisfactorios especialmente en la psoriasis.

  2. Psoriasis, mental disorders and stress.

    Science.gov (United States)

    Biljan, Darko; Laufer, Davor; Filaković, Pave; Situm, Mirna; Brataljenović, Tomo

    2009-09-01

    Etiology of psoriasis is still not known and comprises a range of assumptions and very complex etiological and pathogenetic mechanisms. Along with genetical predisposition, mental disorders and stresses might have a key role in the occurrence of this disease. Total number of 70 patients suffering from psoriasis were included in the investigation. Generally accepted structured clinical interview (SCID - The Structured Clinical Interview for DSM-IV) was applied in diagnostics of mental disorders. Various mental disorders were found in as many as 90% of patients suffering from psoriasis. The most frequent mental disorders were depressive disorder (19.2%), the posttraumatic stress disorder (17.8%), alcoholism (16.4%), adaptation disorder (15.1%), anxiety - depressive disorders (13.7%) and generalized anxious disorder (9.6%). The authors have concluded that in patients with psoriasis both various mental disorders and various stress events are frequent. The results have implied that there is a link between psoriasis on the one hand and various mental disorders and various stressors on the other. The investigation implies that there is a need to improve multidisciplinary approach in diagnostics and treatment of psoriasis and multi disciplinary team should consist of dermatologist, psychiatrist and psychologist.

  3. Fluorine content in epiphtic lichens and mosses

    Energy Technology Data Exchange (ETDEWEB)

    Olech, M.; Kajfosz, J.; Szymczyk, S.; Wodniecki, P.

    1981-01-01

    The fluorine content in epiphytic lichens (Physcia adscendens, Physconia grisea, Parmelia sulcata and Evernia prunastri) and the moss Orthotrichum obtusifolium growing near an aluminum plant is presented. Analyses of lichen samples show the correlation between the distribution of the emitted fluorine and the distance from the source of emission; the most visible effects are in the direction of the prevailing winds. The more resistant lichen species accumulate greater amounts of fluorine than the less resistant ones.

  4. Psoriasis and New-Onset Diabetes

    DEFF Research Database (Denmark)

    Khalid, Usman; Hansen, Peter Riis; Gislason, Gunnar Hilmar

    2013-01-01

    OBJECTIVE Psoriasis is associated with increased risk of cardiovascular events and increased prevalence of cardiovascular risk factors. Diabetes mellitus (DM) is a major contributor to cardiovascular morbidity and mortality that may be associated with psoriasis, but conflicting results have been...

  5. Patients with psoriasis are insulin resistant

    DEFF Research Database (Denmark)

    Gyldenløve, Mette; Storgaard, Heidi; Holst, Jens Juul

    2015-01-01

    BACKGROUND: Patients with psoriasis have increased risk of type 2 diabetes. The pathophysiology is largely unknown, but it is hypothesized that systemic inflammation causes insulin resistance. Insulin sensitivity has only been sparsely investigated in patients with psoriasis, and previous studies...

  6. LYMPHOCYTE APOPTOSIS IN PSORIASIS

    Directory of Open Access Journals (Sweden)

    О. M. Kapuler

    2006-01-01

    Full Text Available Abstract. Forty-two patients with progressive vulgar psoriasis (PASI = 19.7 ± 1.5 and 40 healthy volunteers were under investigation. Psoriatic patients were characterized by increased number of CD4+ CD95+ peripheral blood T lymphocytes, which correlates with clinical psoriatic score, and by increased levels of soluble Fas (sFas in serum, as compared to controls (resp., 1868.1 ± 186.8 pg/ml vs. 1281.4 ± 142.5 pg/ml, PLSD = 0.019. The levels of spontaneous lymphocyte apoptosis and anti-Fas (Mab-induced apoptosis in psoriatic patients did not differ from the controls. However, apoptosis induced by “oxidative stress” (50 M Н202, 4 hrs was depressed in the patients. Moreover, a simultaneous assessment of cell cycle structure (metachromatic staining with Acridine Orange, apoptosis and Fas receptor expression (AnnV-FITC/antiFas mAbs-PE staining following a short-term mitogenic stimulation (PHA-P, 5 µg/ml, 24 hrs were performed. We found no marked differences in mitogenic reactivity, activation-induced apoptosis, and activation-induced Fas receptor expression when studying lymphocytes from healthy donors and psoriatic patients. However, PHA-activated lymphocytes from psoriatic patients displayed a significantly decreased ratio of AnnV+CD95+ to the total AnnV+ subpopulation, thus suggesting a decreased role of Fas-dependent mechanisms of apoptosis during the cell activation. The data obtained confirm a view, that an abnormal lymphocyte “apoptotic reactivity”, which plays a crucial role in the mechanisms of autoimmunity, may also of importance in the pathogenesis of psoriasis.

  7. Lichens: unexpected anti-prion agents?

    Science.gov (United States)

    Rodriguez, Cynthia M.; Bennett, James P.; Johnson, Christopher J.

    2012-01-01

    The prion diseases sheep scrapie and cervid chronic wasting disease are transmitted, in part, via an environmental reservoir of infectivity; prions released from infected animals persist in the environment and can cause disease years later. Central to controlling disease transmission is the identification of methods capable of inactivating these agents on the landscape. We have found that certain lichens, common, ubiquitous, symbiotic organisms, possess a serine protease capable of degrading prion protein (PrP) from prion-infected animals. The protease functions against a range of prion strains from various hosts and reduces levels of abnormal PrP by at least two logs. We have now tested more than 20 lichen species from several geographical locations and from various taxa and found that approximately half of these species degrade PrP. Critical next steps include examining the effect of lichens on prion infectivity and cloning the protease responsible for PrP degradation. The impact of lichens on prions in the environment remains unknown. We speculate that lichens could have the potential to degrade prions when they are shed from infected animals onto lichens or into environments where lichens are abundant. In addition, lichens are frequently consumed by cervids and many other animals and the effect of dietary lichens on prion disease transmission should also be considered.

  8. Lichens: unexpected anti-prion agents?

    Science.gov (United States)

    Rodriguez, Cynthia M; Bennett, James P; Johnson, Christopher J

    2012-01-01

    The prion diseases sheep scrapie and cervid chronic wasting disease are transmitted, in part, via an environmental reservoir of infectivity; prions released from infected animals persist in the environment and can cause disease years later. Central to controlling disease transmission is the identification of methods capable of inactivating these agents on the landscape. We have found that certain lichens, common, ubiquitous, symbiotic organisms, possess a serine protease capable of degrading prion protein (PrP) from prion-infected animals. The protease functions against a range of prion strains from various hosts and reduces levels of abnormal PrP by at least two logs. We have now tested more than twenty lichen species from several geographical locations and from various taxa and found that approximately half of these species degrade PrP. Critical next steps include examining the effect of lichens on prion infectivity and cloning the protease responsible for PrP degradation. The impact of lichens on prions in the environment remains unknown. We speculate that lichens could have the potential to degrade prions when they are shed from infected animals onto lichens or into environments where lichens are abundant. In addition, lichens are frequently consumed by cervids and many other animals and the effect of dietary lichens on prion disease transmission should also be considered.

  9. Dramatic Response of Nail Psoriasis to Infliximab

    Directory of Open Access Journals (Sweden)

    Gilles Safa

    2011-01-01

    Full Text Available Nail psoriasis, affecting up to 50% of psoriatic patients, is an important cause of serious psychological and physical distress. Traditional treatments for nail psoriasis, which include topical or intralesional corticosteroids, topical vitamin D analogues, photochemotherapy, oral retinoids, methotrexate, and cyclosporin, can be time-consuming, painful, or limited by significant toxicities. Biological agents may have the potential to revolutionize the management of patients with disabling nail psoriasis. We present another case of disabling nail psoriasis that responded dramatically to infliximab.

  10. Scalp psoriasis, clinical presentations and therapeutic management

    NARCIS (Netherlands)

    van de Kerkhof, P. C.; de Hoop, D.; de Korte, J.; Kuipers, M. V.

    1998-01-01

    The scalp is a well-known predilection site for psoriasis. Many patients indicate that scalp psoriasis is both psychologically and socially distressing. The aim of the present investigation is to provide epidemiological data on the various manifestations of scalp psoriasis, as well as on its

  11. [Bullous lichen sclerosus after radiotherapy].

    Science.gov (United States)

    Tournillac, I; Dandurand, M; Guillot, B

    1998-02-01

    Bullous lichen sclerosus is an uncommon observation after radiotherapy and can be misdiagnosed as a radiodermitis or recurrence of the neoplasia. Two women developed bullous lichen sclerosus after radiotherapy. The delay after radiotherapy was 4 months and 10 years respectively. Irradiation dose was 60 and 64 grays. The lesions covered more than the irradiated zone in one case. Stabilization or regression of the lesions was obtained with cases I topical corticosteroids, with acitretine in one case. These cases, and similar cases reported in the literature, underline the fact that the condition has only been reported in women. This is probably because of the nature of the neoplasias treated (breast cancer in 20 cases and cervical cancer in 1). The delay to onset of the skin lesions are quite variable. Lichen sclerosus or morphea may be observed in the irradiated zone but may also appear at a distance. These lesions are not associated with recurrence of the initial cancer. As no association between breast cancer and localized sclerodermia has been found, the causal role is probably played by radiotherapy, producing a Koebner phenomena in predisposed tissue.

  12. Psychological parameters of psoriasis.

    Science.gov (United States)

    Kouris, A; Platsidaki, E; Kouskoukis, C; Christodoulou, C

    2017-01-01

    Psoriasis is a chronic, inflammatory scaling dermatosis. The marked visible appearance of the lesions have a negative impact on body image that leads to decreased self-esteem, hence seriously compromising the patient's quality of life. The clinical picture critically affects the social well-being of the patient since the disease is commonly misunderstood and feared by the social environment as being contagious. The patient feels stigmatized and this further intensifies their lack of self-confidence and self-esteem. Feelings of shame and guilt increase the tendency toward suicidal ideation. The poor quality of life of psoriatic patients has been associated with excessive alcohol consumption, increased smoking and greater use of tranquilizers, sedatives and antidepressants. As far as mental impairment is concerned, a correlation has been found between psychological stress and the clinical severity of symptoms: the more mentally affected the patient, the more severe the dermatologic lesions. Similarly, stressful life events constitute a major risk for the occurrence and recurrence, exacerbating the severity and duration of the symptoms. Depression and anxiety can worsen the disease or cause resistance to treatment or patient's indifference, which in turn can lead to expensive and prolonged treatment. Not least, the disease itself contributes to anxiety, depression and psychological stress, thus creating a "vicious circle" that is difficult to manage. Given that women seem to invest more in their personal appearance than men, it is hardly surprising that female psoriatic patients report higher levels of depression. Similarly, the risk of mental disorders is also higher in younger patients for whom body image plays an equally significant role. The severity of the disease, side effects of therapy and mental disorders are among the causes that have been attributed to sexual dysfunction reported by some psoriatic patients. At the social level, stigma, social rejection

  13. Psoriasis and comorbid diseases: Implications for management.

    Science.gov (United States)

    Takeshita, Junko; Grewal, Sungat; Langan, Sinéad M; Mehta, Nehal N; Ogdie, Alexis; Van Voorhees, Abby S; Gelfand, Joel M

    2017-03-01

    As summarized in the first article in this continuing medical education series, the currently available epidemiologic data suggest that psoriasis may be a risk factor for cardiometabolic disease. Emerging data also suggest associations between psoriasis and other comorbidities beyond psoriatic arthritis, including chronic kidney disease, inflammatory bowel disease, hepatic disease, certain malignancies, infections, and mood disorders. Recognizing the comorbid disease burden of psoriasis is essential for ensuring comprehensive care of patients with psoriasis. The clinical implications of the comorbid diseases that are associated with psoriasis and recommendations for clinical management are reviewed in this article. Copyright © 2016 American Academy of Dermatology, Inc. All rights reserved.

  14. Skin-infiltrating, interleukin-22-producing T cells differentiate pediatric psoriasis from adult psoriasis.

    Science.gov (United States)

    Cordoro, Kelly M; Hitraya-Low, Maria; Taravati, Keyon; Sandoval, Priscila Munoz; Kim, Esther; Sugarman, Jeffrey; Pauli, Mariela L; Liao, Wilson; Rosenblum, Michael D

    2017-09-01

    Evidence from adult psoriasis studies implicates an imbalance between regulatory and effector T cells, particularly TH-17-producing T cells, in the pathogenesis of psoriasis. Little is known about the immunopathology of psoriasis in children. We sought to functionally characterize the inflammatory cell profiles of psoriatic plaques from pediatric patients and compare them with healthy, age-matched controls and adult psoriasis patients. Skin samples from pediatric psoriasis patients and healthy controls were analyzed by multiparameter flow cytometry to determine the dominant immune cell subsets present and cytokines produced. Lesional tissue from pediatric psoriasis patients had significantly increased interleukin (IL) 22 derived from CD4+ and CD8+ cells compared with the tissues from healthy pediatric controls and adult psoriasis patients. Tissue from pediatric psoriasis patients had significantly less elevation of IL-17 derived from CD4+ and CD8+ cells compared with the tissue from adult psoriasis patients. In contrast with the lesions from adult patients, lesional skin in pediatric patients with psoriasis did not have increases in regulatory T cells. This is a pilot study, thus the sample size is small. Significant differences in IL-17 and IL-22 expression were observed in the pediatric psoriasis patients compared with pediatric healthy controls and adult psoriasis patients. IL-22 might be relevant in the pathogenesis of pediatric psoriasis and represents a potential treatment target unique to pediatric psoriasis. Copyright © 2017 American Academy of Dermatology, Inc. Published by Elsevier Inc. All rights reserved.

  15. The "Ride for Russia" Tree Lichen Survey

    Science.gov (United States)

    Young, Simon

    2013-01-01

    The prevalence of nine indicator lichens found on trees in Northern Europe and Western Russia was used for monitoring air quality. The 4200 mile route of the survey went through eight countries. Surveys were carried out in cities, towns, countryside and forests, and along motorways. The author has conducted tree lichen surveys with pupils from…

  16. Development of lichen-rich communities

    NARCIS (Netherlands)

    Ketner-Oostra, R.; Sparrius, L.B.; Sýkora, K.V.; Fanta, J.; Siepel, H.

    2010-01-01

    The pioneer vegetation of inland dunes is known for its lichen diversity. The development of lichen-rich vegetation may take several decades after the first pioneer stage with Corynephorus canescens and Polytrichum piliferum. The neophytic moss Campylopus introflexus and atmospheric nitrogen

  17. Morphological changes and damages of indicator lichens from Sakhalin Island

    Directory of Open Access Journals (Sweden)

    Alexander K. Ezhkin

    2013-04-01

    Full Text Available Lichen morphological changes, abnormalities and damages are very important parameters that define the general vitality of lichen communities. Correct detecting of lichen abnormalities helps to make an accurate assessment of the disturbance level of ecosystems. Main morphological changes and damages of indicator lichens of the Sakhalin Island are discussed.

  18. Reindeer lichen productivity: Problems and possibilities

    Directory of Open Access Journals (Sweden)

    Bjartmar Sveinbjörnsson

    1990-09-01

    Full Text Available Reindeer lichens are important in the structure and function of tundra and taiga ecosystems, as exemplified by cover values, biomass, mineral content, and effect on other ecosystem components. They are particularly important for winter ecology of reindeer and caribou which largely relay on them. Growth measurement is difficult due to the very slow rate and the methods that have been used are not sufficiently documented, precise, or appropriate. Use of carbon dioxide exchange models, coupled with models of lichen microclimate and water relations, based on microclimatic data are suggested as alternatives for land managers. The assumptions of such models are discussed and the performance of mixed species lichen mats and of the lichen CO2 environment and its effect on lichen CO2 exchange.

  19. Newer targeted therapies in psoriasis

    Directory of Open Access Journals (Sweden)

    Sujay Khandpur

    2013-01-01

    Full Text Available Psoriasis is a common, chronic, inflammatory skin disease that can have a significant impact on the quality of life of those who are afflicted due to chronicity of the disease and frequent remissions and relapses. Many available systemic therapies, however, are unsuitable for chronic administration due to the risk of cumulative toxicity. Recent advances in the understanding of the pathophysiology of psoriasis have led to the development of new, genetically engineered, targeted therapies for this disease. These include approaches targeting antigen presentation and co-stimulation, T-cell activation and leukocyte adhesion, action on pro-inflammatory mediators, and modulating the cytokine balance. Although only preliminary data are available so far and there is limited data supporting their use, these trials contribute to a further understanding of the disease and will eventually lead to new therapeutic options for psoriasis.

  20. Ixekizumab for treatment of psoriasis

    DEFF Research Database (Denmark)

    Dyring-Andersen, Beatrice; Skov, Lone; Zachariae, Claus

    2015-01-01

    Psoriasis is a prevalent chronic inflammatory skin disease of unknown etiology. Recent advances in understanding the pathogenesis of psoriasis suggest that IL-17 is a key proinflammatory mediator present in the skin. Several agents targeting IL-17 or its receptor are in clinical trials...... for the treatment of psoriasis. This review focuses on the biological rationale and the results of clinical trials with ixekizumab, a humanized IgG4 monoclonal antibody. Ixekizumab binds the IL-17A homodimer, thereby blocking the binding of IL-17A to the IL-17 receptor. The currently available Phase I-III data...... indicate that ixekizumab is a promising drug, although long-term data of efficacy and safety are needed before ixekizumab and other IL-17 targeting therapeutics can find their place in clinical practice....

  1. Psoriasis and New-onset Depression

    DEFF Research Database (Denmark)

    Jensen, Peter; Ahlehoff, Ole; Egeberg, Alexander

    2016-01-01

    Psoriasis is associated with an increased risk of depression, but results are inconsistent. This study examined the risk of new-onset depression in patients with psoriasis in a nationwide Danish cohort including some 5 million people in the period 2001-2011. A total of 35,001 patients with mild...... psoriasis and 7,510 with severe psoriasis were identified. Incidence rates per 1,000 person-years and incidence rate ratios (IRRs) were calculated. Incidence rates for depression were 20.0 (95% confidence interval 19.9-20.0), 23.9 (23.1-24.7) and 31.6 (29.5-33.8) for the reference population, mild......, the risk of new-onset depression in psoriasis is mediated primarily by comorbidities, except in younger individuals with severe psoriasis, in whom psoriasis itself may be a risk factor....

  2. Pustular psoriasis: pathophysiology and current treatment perspectives

    Directory of Open Access Journals (Sweden)

    Benjegerdes KE

    2016-09-01

    Full Text Available Katie E Benjegerdes,1 Kimberly Hyde,2 Dario Kivelevitch,3 Bobbak Mansouri1,4 1Texas A&M Health Science Center College of Medicine, Temple, 2Texas A&M Health Science Center College of Medicine, Round Rock, 3Division of Dermatology, Baylor University Medical Center, Dallas, 4Department of Dermatology, Scott and White Hospital, Texas A&M Health Science Center College of Medicine, Temple, TX, USA Abstract: Psoriasis vulgaris is a chronic inflammatory disease that classically affects skin and joints and is associated with numerous comorbidities. There are several clinical subtypes of psoriasis including the uncommon pustular variants, which are subdivided into generalized and localized forms. Generalized forms of pustular psoriasis include acute generalized pustular psoriasis, pustular psoriasis of pregnancy, and infantile and juvenile pustular psoriasis. Localized forms include acrodermatitis continua of Hallopeau and palmoplantar pustular psoriasis. These subtypes vary in their presentations, but all have similar histopathologic characteristics. The immunopathogenesis of each entity remains to be fully elucidated and some debate exists as to whether these inflammatory pustular dermatoses should be classified as entities distinct from psoriasis vulgaris. Due to the rarity of these conditions and the questionable link to the common, plaque-type psoriasis, numerous therapies have shown variable results and most entities remain difficult to treat. With increasing knowledge of the pathogenesis of these variants of pustular psoriasis, the development and use of biologic and other immunomodulatory therapies holds promise for the future of successfully treating pustular variants of psoriasis. Keywords: psoriasis, pustular psoriasis, generalized pustular psoriasis, von Zumbusch, impetigo herpetiformis, acrodermatitis continua of Hallopeau, palmoplantar pustulosis, biologic

  3. Strict Anatomical Colocalization of Vitiligo and Elastolytic Granulomas

    Directory of Open Access Journals (Sweden)

    N. Merino de Paz

    2010-02-01

    Full Text Available Vitiligo is the most common depigmenting disorder, with a worldwide occurrence of 0.1–2% in the general population. Multiple conditions have been described colocalized in vitiligo patches, like psoriasis or lichen planus. However, actinic granuloma has not been described in association with vitiligo lesions so far.

  4. Acanthosis nigricans: a flag for insulin resistance

    African Journals Online (AJOL)

    2013-11-04

    Nov 4, 2013 ... as alopecia areata, dermatophyte infections, lichen planus, psoriasis, polymorphous light eruptions, pityriasis versicolor, traumatic fissures, vitiligo and warts were not significantly associated. Discussion. Higher grades of acanthosis nigricans on the neck and axilla are sensitive markers for IR. In our study ...

  5. Phenomenon of isomorphic provoking responses in cases of limited scleroderma

    Directory of Open Access Journals (Sweden)

    Talnikova Е.Е.

    2015-09-01

    Full Text Available The article presents the historical origin of the term "Koebner phenomenon". The literature data reflect the etiology, pathogenesis and epidemiology of isomorphic mechanisms provoking responses in lichen planus, psoriasis, scleroder-ma, syphilis. Variants of the Koebner phenomenon's classifications are given. The clinical cases of limited scleroderma after mechanical injury are described.

  6. Microbiome change by symbiotic invasion in lichens

    Science.gov (United States)

    Maier, Stefanie; Wedin, Mats; Fernandez-Brime, Samantha; Cronholm, Bodil; Westberg, Martin; Weber, Bettina; Grube, Martin

    2016-04-01

    Biological soil crusts (BSC) seal the soil surface from erosive forces in many habitats where plants cannot compete. Lichens symbioses of fungi and algae often form significant fraction of these microbial assemblages. In addition to the fungal symbiont, many species of other fungi can inhabit the lichenic structures and interact with their hosts in different ways, ranging from commensalism to parasitism. More than 1800 species of lichenicolous (lichen-inhabiting) fungi are known to science. One example is Diploschistes muscorum, a common species in lichen-dominated BSC that infects lichens of the genus Cladonia. D. muscorum starts as a lichenicolous fungus, invading the lichen Cladonia symphycarpa and gradually develops an independent Diploschistes lichen thallus. Furthermore, bacterial groups, such as Alphaproteobacteria and Acidobacteria, have been consistently recovered from lichen thalli and evidence is rapidly accumulating that these microbes may generally play integral roles in the lichen symbiosis. Here we describe lichen microbiome dynamics as the parasitic lichen D. muscorum takes over C. symphycarpa. We used high-throughput 16S rRNA gene and photobiont-specific ITS rDNA sequencing to track bacterial and algal transitions during the infection process, and employed fluorescence in situ hybridization to localize bacteria in the Cladonia and Diploschistes lichen thalli. We sampled four transitional stages, at sites in Sweden and Germany: A) Cladonia with no visible infection, B) early infection stage defined by the first visible Diploschistes thallus, C) late-stage infection with parts of the Cladonia thallus still identifiable, and D) final stage with a fully developed Diploschistes thallus, A gradual microbiome shift occurred during the transition, but fractions of Cladonia-associated bacteria were retained during the process of symbiotic reorganization. Consistent changes observed across sites included a notable decrease in the relative abundance of

  7. Risk of aortic aneurysm in patients with psoriasis

    DEFF Research Database (Denmark)

    No, D J; Amin, Faisal Mohammad; Egeberg, A

    2017-01-01

    Psoriasis has been associated with cardiovascular disease and major adverse cardiovascular events. Studies suggests that the overexpression of inflammatory mediators contribute to the shared pathogenesis of psoriasis and atherosclerotic changes. Moreover, the aberrant inflammation in psoriasis may...

  8. Treatment of inflammatory nail disorders.

    Science.gov (United States)

    Dehesa, Luis; Tosti, Antonella

    2012-01-01

    This article provides an updated review on diagnosis and treatment of inflammatory nail disorders including psoriasis, lichen planus, trachyonychia, and autoimmune bullous disorders. Despite the significant negative repercussion of the nail psoriasis in the quality of life of patients, treatment is often not sufficiently effective. The efficacy of topical therapies is limited to nail bed psoriasis. Intralesional corticosteroid injections are extensively utilized in nail matrix psoriasis. Systemic immunosuppressant drugs such as methotrexate and cyclosporine have shown efficacy. Biologics, particularly infliximab and etanercept, have also demonstrated high efficacy in the treatment of severe nail disease. Nail matrix lichen planus can cause nail atrophy and irreversible nail scarring and requires prompt treatment with systemic steroids. There is not gold standard therapy for trachyonychia, but in most cases the nail signs improve spontaneously and treatment is not necessary. Nail changes in pemphigus and other autoimmune disorders respond promptly to systemic therapy with steroids and immunosuppressants. © 2012 Wiley Periodicals, Inc.

  9. The prevalence of psoriasis in Trabzon

    Directory of Open Access Journals (Sweden)

    Savaş Yaylı

    2016-12-01

    Full Text Available Background and Design: Psoriasis is a chronic inflammatory skin disease affecting nearly 2% of the population. In Turkey, the only data about the prevalence of psoriasis from a population-based study is the data of the prevalence of 0.5% in a small district in a rural area. We aimed to provide the first large-scale data in Turkey by determining the prevalence of psoriasis in a large area, in the central and outlying districts of the province of Trabzon. Materials and Methods: A random sample of 7885 (4057 male and 3828 female adults was collected by using the stratified sampling technique. The study was performed with face-to-face questionnaire administration with participants selected according to the place of residence, gender and age groups. Psoriasis was diagnosed based on the questionnaires filled by patients during these interviews. Crude psoriasis prevalence ratios and age-adjusted psoriasis prevalence ratios according to the Segi population were calculated and presented with 95% confidence interval (CI. Results: Of 7885 people, 87 were diagnosed with psoriasis, of which 45 were female and 42 were male. The prevalence of psoriasis was found to be 1.1% (95% CI: 0.9-1.3 in the general population. The prevalence of psoriasis in females (1.2% was higher than that in men (1.0%. Age-adjusted prevalence was 3.9% (95% CI: 3.5-4.3 and 1.0% (95% CI: 0.8-1.2 for females and males, respectively. The presence of a family history of psoriasis increased the psoriasis risk by eight-fold (p<0.001. Conclusion: We found that the prevalence of psoriasis was 1.1% in a large area, in the central and outlying districts of the province of Trabzon. Our study reveals that the prevalence of psoriasis in our country may be lower than that in Northern Europe and North America.

  10. Psoriasis: dysregulation of innate immunity

    NARCIS (Netherlands)

    Bos, J. D.; de Rie, M. A.; Teunissen, M. B. M.; Piskin, G.

    2005-01-01

    The current understanding of the function of natural killer (NK) T cells in innate immunity and their potential to control acquired specific immunity, as well as the remarkable efficacy of antitumour necrosis factor-alpha biological treatments in psoriasis, forces us to refine the current T-cell

  11. Psoriasis & Comorbidities: Unraveling the Maze

    NARCIS (Netherlands)

    E.A. Dowlatshahi (Emmilia)

    2014-01-01

    markdownabstract__Abstract__ In this thesis we used a multifaceted approach to analyzing depression in psoriasis, by investigating Health Related Quality of Life (HRQoL), depressive symptoms, clinical depression and antidepressant use, using various data sources and statistical methods. These

  12. Innovative Approaches Using Lichen Enriched Media to Improve Isolation and Culturability of Lichen Associated Bacteria.

    Science.gov (United States)

    Biosca, Elena G; Flores, Raquel; Santander, Ricardo D; Díez-Gil, José Luis; Barreno, Eva

    2016-01-01

    Lichens, self-supporting mutualistic associations between a fungal partner and one or more photosynthetic partners, also harbor non-photosynthetic bacteria. The diversity and contribution of these bacteria to the functioning of lichen symbiosis have recently begun to be studied, often by culture-independent techniques due to difficulties in their isolation and culture. However, culturing as yet unculturable lichenic bacteria is critical to unravel their potential functional roles in lichen symbiogenesis, to explore and exploit their biotechnological potential and for the description of new taxa. Our objective was to improve the recovery of lichen associated bacteria by developing novel isolation and culture approaches, initially using the lichen Pseudevernia furfuracea. We evaluated the effect of newly developed media enriched with novel lichen extracts, as well as the influence of thalli washing time and different disinfection and processing protocols of thalli. The developed methodology included: i) the use of lichen enriched media to mimic lichen nutrients, supplemented with the fungicide natamycin; ii) an extended washing of thalli to increase the recovery of ectolichenic bacteria, thus allowing the disinfection of thalli to be discarded, hence enhancing endolichenic bacteria recovery; and iii) the use of an antioxidant buffer to prevent or reduce oxidative stress during thalli disruption. The optimized methodology allowed significant increases in the number and diversity of culturable bacteria associated with P. furfuracea, and it was also successfully applied to the lichens Ramalina farinacea and Parmotrema pseudotinctorum. Furthermore, we provide, for the first time, data on the abundance of culturable ecto- and endolichenic bacteria that naturally colonize P. furfuracea, R. farinacea and P. pseudotinctorum, some of which were only able to grow on lichen enriched media. This innovative methodology is also applicable to other microorganisms inhabiting these

  13. Innovative Approaches Using Lichen Enriched Media to Improve Isolation and Culturability of Lichen Associated Bacteria

    Science.gov (United States)

    Biosca, Elena G.; Flores, Raquel; Santander, Ricardo D.; Díez-Gil, José Luis; Barreno, Eva

    2016-01-01

    Lichens, self-supporting mutualistic associations between a fungal partner and one or more photosynthetic partners, also harbor non-photosynthetic bacteria. The diversity and contribution of these bacteria to the functioning of lichen symbiosis have recently begun to be studied, often by culture-independent techniques due to difficulties in their isolation and culture. However, culturing as yet unculturable lichenic bacteria is critical to unravel their potential functional roles in lichen symbiogenesis, to explore and exploit their biotechnological potential and for the description of new taxa. Our objective was to improve the recovery of lichen associated bacteria by developing novel isolation and culture approaches, initially using the lichen Pseudevernia furfuracea. We evaluated the effect of newly developed media enriched with novel lichen extracts, as well as the influence of thalli washing time and different disinfection and processing protocols of thalli. The developed methodology included: i) the use of lichen enriched media to mimic lichen nutrients, supplemented with the fungicide natamycin; ii) an extended washing of thalli to increase the recovery of ectolichenic bacteria, thus allowing the disinfection of thalli to be discarded, hence enhancing endolichenic bacteria recovery; and iii) the use of an antioxidant buffer to prevent or reduce oxidative stress during thalli disruption. The optimized methodology allowed significant increases in the number and diversity of culturable bacteria associated with P. furfuracea, and it was also successfully applied to the lichens Ramalina farinacea and Parmotrema pseudotinctorum. Furthermore, we provide, for the first time, data on the abundance of culturable ecto- and endolichenic bacteria that naturally colonize P. furfuracea, R. farinacea and P. pseudotinctorum, some of which were only able to grow on lichen enriched media. This innovative methodology is also applicable to other microorganisms inhabiting these

  14. Long-term management of scalp psoriasis: perspectives from the International Psoriasis Council

    NARCIS (Netherlands)

    Kragballe, K.; Menter, A.; Lebwohl, M.; Tebbey, P.W.; Kerkhof, P.C.M. van de

    2013-01-01

    The scalp is a well-known predilection site for psoriasis. Epidemiological data on the various manifestations of scalp psoriasis as well as on its therapeutic management are sparse. The understanding of the natural course of scalp psoriasis is relevant for its therapeutic management. In over 25% of

  15. How much of the productivity losses among psoriasis patients are due to psoriasis.

    Science.gov (United States)

    Mustonen, Anssi; Mattila, Kalle; Leino, Mauri; Koulu, Leena; Tuominen, Risto

    2015-03-04

    In previous studies, productivity losses have been measured specifically due to psoriasis or generally due to health problems in psoriasis patients. There is no information on the proportion of health related productivity losses that are due to psoriasis. The aim of this study was to estimate the proportion of productivity losses due to psoriasis and due to other medical problems among employed psoriasis patients. Patients visiting a tertiary level dermatological clinic during a one-year period due to psoriasis or psoriasis arthritis, who were employed, were selected to the study. A questionnaire was used to assess productivity losses during the previous month. Psoriasis accounted for 38% of the total lost productivity costs. One fifth of patients had been on sick leave (absenteeism) due to psoriasis and a third of patients worked despite being sick with psoriasis (presenteeism). Men had higher costs of presenteeism, but the costs of absenteeism due to psoriasis were lower for men than for women. Productivity losses should be assessed disease specifically to avoid overestimations of the role of the disease on indirect costs. Our study shows that about a third of the lost productivity costs are due to psoriasis.

  16. Certolizumab pegol for the treatment of psoriasis.

    Science.gov (United States)

    Campanati, A; Benfaremo, D; Luchetti, M M; Ganzetti, G; Gabrielli, A; Offidani, A

    2017-03-01

    Psoriasis is a chronic immunomediated and inflammatory disease involving mainly skin and joints, often associated with several metabolic and non-metabolic comorbidities. TNF-alpha inhibitors have shown long-term efficacy and safety/tolerability in psoriasis, and preliminary data support the use of certolizumab pegol (CZP) as well. Areas covered: The authors review the pharmacological properties of CZP, as well as its safety data and efficacy profile. They also review the quality of life outcomes related to CZP in psoriasis. The authors also provide their expert opinion on the subject. Expert opinion: CZP is a promising treatment for psoriasis owing to its rapid reduction of disease activity, long-term therapeutic efficacy - both in bio-naive and non-bio-naive patients, long term safety and low rate of site injection reactions. CZP seems to be a promising therapeutic option for psoriasis patients, although further evidence supporting the continuing clinical program for development of CZP in psoriasis is needed.

  17. Psoriasis and comorbidities: links and risks

    Directory of Open Access Journals (Sweden)

    Ni C

    2014-04-01

    Full Text Available Catherine Ni, Melvin W Chiu Division of Dermatology, Department of Medicine, David Geffen School of Medicine at the University of California, Los Angeles, CA, USA Abstract: Psoriasis is a chronic inflammatory skin disease affecting approximately 2% of the population worldwide. In the past decade, many studies have drawn attention to comorbid conditions in psoriasis. This literature review examines the epidemiological evidence, pathophysiological commonalities, and therapeutic implications for different comorbidities of psoriasis. Cardiovascular disease, obesity, diabetes, hypertension, dyslipidemia, metabolic syndrome, nonalcoholic fatty liver disease, cancer, anxiety and depression, and inflammatory bowel disease have been found at a higher prevalence in psoriasis patients compared to the general population. Because of the wide range of comorbid conditions associated with psoriasis, comprehensive screening and treatment must be implemented to most effectively manage psoriasis patients. Keywords: cardiovascular, metabolic syndrome

  18. Incidence and Prevalence of Psoriasis in Denmark

    DEFF Research Database (Denmark)

    Egeberg, Alexander; Skov, Lone; Gislason, Gunnar H

    2017-01-01

    The incidence and temporal trends of psoriasis in Denmark between 2003 and 2012 were examined. There was a female predominance ranging between 50.0% (2007) and 55.4% (2009), and the mean age at time of diagnosis was 47.7-58.7 years. A total of 126,055 patients with psoriasis (prevalence 2.2%) were....... The relationship between psoriasis incidence and age appeared to be relatively linear, and disease prevalence was comparable to that in other European countries....

  19. Lichens of abandoned zinc-lead mines

    Directory of Open Access Journals (Sweden)

    Urszula Bielczyk

    2013-12-01

    Full Text Available A list of lichens from areas of zinc-lead ores in Southern Poland and a review of the characteristic lichen biota of these sites is provided. In spite of the devastated and heavy metal contaminated environment, a highly diverse epigeic and epilithic lichen biota was found, including species characteristic of various anthropogenic habitats, particularly zinc and lead enriched substrates (Diploschistes muscorum, Steinia geophana, Sarcosagium campestre, Vezdaea aestivalis and V. leprosa. Also, the high-mountain species Leucocarpia biatorella, as well as very rare in Europe Thelocarpon imperceptum, and several species categorized as very rare, endangered and protected in Poland were recorded. Crustose lichens are the most abundant; among fruticose forms Cladonia spp. predominate and Stereocaulon incrustatum is common.

  20. Psoriasis er associeret med type 2-diabetes

    DEFF Research Database (Denmark)

    Gyldenløve, Mette; Knop, Filip Krag; Vilsbøll, Tina

    2013-01-01

    Psoriasis is a chronic inflammatory skin disease with a global prevalence of 2-3%. In recent years it has been established that patients with psoriasis carry an increased risk of type 2 diabetes, but the underlying pathophysiological mechanisms remain unclear. The association is most likely due...... to a combination of shared genes, immunoinflammatory mechanisms and a number of diabetes risk factors in patients with psoriasis. The current review summarises the evidence in the field and calls for attention on diabetes risk assessment, preventive measures and treatment in patients with psoriasis....