Uncommon oral manifestation of lichen sclerosus: critical analysis of cases reported from 1957 to 2016.

S Tomo,SA de Queiroz,GI Miyahara,IS Santos,LE Simonato,DG Bernabe

doi:10.4317/medoral.21606

Abstract

BackgroundLichen sclerosus is a mucocutaneous autoimmune disease which might be initiated by infectious pathogens as Borrelia Bugrdorferi and HPV. This disease shows destructive potential and is rarely diagnosed in oral mucosa. The purpose of this paper is to evaluate the characteristics of cases described in literature from 1957 to 2016, looking to provide valuable evidence about clinicopathologic features of this disease.Material and MethodsA MedLine search was performed aiming to find oral lichen sclerosus cases in literature and discuss its demographical and pathological characteristics as well as treatment methods performed for these cases.Results34 oral lichen sclerosus cases with histological confirmation and one clinicopathologic study linked with this disease were found in literature. Oral lichen sclerosus affected most commonly female patients, were asymptomatic and not associated to skin or genital lesions. Furthermore, affected patients in a range of 7 – 70-years old (Average age = 31.81).ConclusionsOral lichen sclerosus is a rare pathologic process with slight predilection for prepubertal girls, for which topical corticosterois have demonstrated satisfactory therapeutic value. Key words:Lichen sclerosus et atrophicous, skin diseases, mouth disease, autoimmune diseases, mouth.

Highlights

In 1887 Hallopeau (1) described ‘lichen planus atrophicus’ as a new pathologic process occurring in anogenital region
Anogenital skin and mucosa is the mostly affected region, in 15% to 20% of cases (4,7,8) patients might be committed by extragenital lesions, and the oral mucosa is an extremely rare site for Lichen sclerosus (LS) lesions occurrence (8-11), while only 6% of cases are represented by isolated extragenital lesions (6)
In only 33.33% of the cases, oral lesions were associated to skin lesions, and in only 16.12% of the cases oral LS lesions were associated to genital lesions

Summary

Introduction

In 1887 Hallopeau (1) described ‘lichen planus atrophicus’ as a new pathologic process occurring in anogenital region. Histopathologic features typically found for LS lesions include either variable epithelial atrophy or hyperplasia, focal hydropic degeneration of basal cells, a band of subepithelial hyalinization and a slightly diffuse band-like lymphocytic infiltrate beneath hyalinized collagen area (11,12). Both lichen planus and vitiligo lack the subepithelial hyalinized area, and melanocytes presence excludes vitiligo hypothesis (6). This disease shows destructive potential and is rarely diagnosed in oral mucosa. Conclusions: Oral lichen sclerosus is a rare pathologic process with slight predilection for prepubertal girls, for which topical corticosterois have demonstrated satisfactory therapeutic value

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