Features Of Oral Lichen Planus Research Articles

Perturbed saliva microbiome is gender-specific in patients with oral lichen planus

ObjectiveTo understand the gender characteristics of oral lichen planus (OLP) by identifying the gender-specific salivary microbiome and its potential biomarkers. MethodsA gender-based study was undertaken, commencing with the collection of saliva samples, followed by 16S rRNA gene sequencing, to explore the differences in the composition of saliva microbiome in OLP patients (40 males and 56 females) and healthy controls (40 males and 56 females), respectively. ResultsBoth male and female OLP patients had significant differences in saliva microbiome composition from healthy controls, especially in female patients. Notably, Pseudomonas was only enriched in female patients. Rhodococcus (AUC: 0.91) and Pseudomonas (AUC: 0.97) had great potential as diagnostic biomarkers in male and female patients, respectively. The KEGG results showed metabolic dysfunction was more pronounced in female patients and a high level of microbial metabolism in diverse environments, ABC transporters, Quorum sensing and Two-component system. Capnocytophaga was negatively correlated with the erosion area in male patients. Neisseria was negatively correlated with the erosion area and Rothia was positively correlated with the pain level in female patients. ConclusionsOur study revealed gender-specific perturbation in salivary microbiome within OLP patients, suggesting that the male and female patients with OLP may have different pathogenesis.

Clinical Features and Histopathological Analysis of Oral Lichen Planus: An Analysis of 105 Chinese Patients.

To study the clinical and pathological characteristics of oral lichen planus (OLP) in a large sample. A comprehensive analysis was conducted on 105 patients with oral lichen planus (OLP), considering various factors including sex, age, disease site, lesion type, lesion area, morphological characteristics, self-reported symptoms, and history of systemic diseases. Histopathological examination was performed for each patient, and the pathology results were analysed according to sex and age group. 70.5% of the OLP patients were female, and OLP was most likely to occur in the cheek, followed by the tongue, lips, gums and palate. The patients with moderate pain according to the VAS score accounted for 60%. Thirty-nine percent of the OLP patients had a systemic disease, and the most common clinical type of OLP was nonerosive. Most of the pathological results showed liquefaction degeneration of basal cells and infiltration of lamina propria lymphocytes. There was no statistically significant difference in pathological manifestations between male and female patients, and there were statistically significant differences in pathological manifestations among different ages patients. This study analysed the sociodemographic data and clinical manifestations of 105 OLP patients to guide follow-up treatment planning and disease monitoring. Moreover, pathological manifestations should be analysed to avoid delayed treatment and to monitor for carcinogenesis. Furthermore, the correlation of pathological manifestations among OLP patients with different sexes and ages is conducive to further research on the specific differential manifestations and possible underlying mechanisms involved.

Human papillomavirus and its association with oral lichen planus

BACKGROUND: Oral lichen planus is a chronic disease with periods of exacerbations and remissions, requiring long-term symptomatic treatment and observation. Dermatosis can occur or worsen in the presence of different triggers, for example, due to the persistence of the human papillomavirus.
 AIM: to explore the effect human papillomavirus on the characteristics oral lichen planus.
 MATERIALS AND METHODS: 90 patients with oral lichen planus aged from 26 to 73 years (average age 55.61±1.00 years) were examined. Real-time polymerase chain reaction was used to detect human papillomavirus. The need for treatment of caries, Green–Vermillion and complex periodontal indices were used to analysis state of oral hygiene.
 RESULTS: Human papillomavirus DNA was detected in 53 (58.88%) cases. Patients of this group were 4 years younger than other study participants; the duration of dermatosis is 2 years longer with a predominance of atrophic/erythematous and erosive/ulcerative forms. It was noted that indexes of caries and the complex periodontal were significantly (p=0,007 and p=0,030 respectively) higher compared to patients without papillomavirus infection.
 CONCLUSION: It is found features of oral lichen planus in identifying human papillomavirus: early onset; severe of the disease with predominantly destructive forms; high prevalence of caries and periodontitis.

Humoral immune disorders affect clinical outcomes of oral lichen planus.

The molecular characteristics of oral lichen planus (OLP) are still unclear, and it is not possible to distinguish the clinical outcome of OLP patients in a short period of time for follow-up. Here, we investigate the molecular characteristics of lesions in patients with stable lichen planus (SOLP) and recalcitrant erosive oral lichen planus (REOLP). Our clinical follow-up cohort was split into SOLP and REOLP groups based on the follow-up clinical data. The core modules associated with the clinical information were identified by weighted gene co-expression network analysis (WGCNA). The OLP cohort samples were divided into two groups by molecular typing, and a prediction model for OLP was created by training neural networks with the neuralnet package. We screened 546 genes in five modules. After doing a molecular type of OLP, it was determined that B cells might have a significant impact on the clinical outcome of OLP. In addition, by means of machine learning, a prediction model was developed to predict the clinical regression of OLP with greater accuracy than the existing clinical diagnostic. Our study revealed humoral immune disorders may make an important contribution to the clinical outcome of OLP.

Oral lichen planus in children: An Italian case series.

Oral lichen planus usually occurs in adults; there are no clear data regarding the incidence and the clinical features of oral lichen planus in children. This paper reports clinical findings, treatments, and outcomes of 13 Italian patients with oral lichen planus in childhood diagnosed between 2001 and 2021. The most common finding was keratotic lesions with reticular or papular/plaque-like patterns, confined to the tongue in seven patients. Although oral lichen planus in childhood is rare and the malignant transformation index is unknown, specialists must be aware of its characteristics and oral mucosal lesions must be correctly diagnosed and managed.

Evaluation of the classification and clinical characteristics of oral lichen planus and its treatment effect in different clinical types: A retrospective study

PurposeOral lichen planus (OLP) is an intractable chronic inflammatory disease associated with dyskeratosis. This study aimed to investigate the clinical features of OLP at the initial diagnosis and classified it using the clinical visual examination type classification. Furthermore, we evaluated whether the clinical characteristics and effectiveness of symptomatic treatment differ between the typical reticular type and other types of OLP. MethodsWe evaluated the age, sex, chief complaints, clinical morphological forms, lesion sites, cytological and histopathological findings, therapeutic strategies, and therapeutic responsiveness of 132 patients with OLP. ResultsOf 132 patients, there were 42 men and 90 women (mean age, 66.4 ± 13.0 years). The buccal mucosa was the most affected site (n = 95). The reticular form was the most common clinical morphological form (n = 124). Biopsy was performed in 48 patients. The erosive form was the most common among the biopsied lesions. Regarding therapeutic strategies, topical steroids were prescribed to 85 patients, 47 of whom experienced symptomatic relief and 38 showed no changes in symptoms. The rates of symptomatic relief following topical steroid use were 70.4% and 15.9% for the reticular and erosive forms, respectively. In patients with erosive and plaque-like forms, symptomatic relief with topical steroid use was difficult to achieve, whereas in those with other forms, a moderate response was observed. ConclusionTopical steroids are often ineffective in patients with erosive or mixed forms, and these clinical morphological forms are associated with a higher risk of malignant transformation than the other forms. Therefore, early histological examination is important.

Clinical features of oral lichen planus and oral lichenoid lesions: an oral pathologist’s perspective

The clinicopathological features that precisely characterize oral lichen planus (OLP) and oral lichenoid lesions (OLL) still represent a challenge. The aim of the present study was to analyze, from an oral pathologist perspective, the clinical features from OLP and OLL. Specimens fullfilling the histological criteria for OLP and OLL, and also compatible with OLP (OLP-C), were selected and clinical information was retrieved from the laboratory forms. The final sample was composed by 221 cases, including 119 OLP (53.8%), 65 OLP-C (29.4%) and 37 OLL (16.7%). Females were more affected in the three groups, but the number of males was higher in OLL. Mean age was lower in OLP (52.3 years) in comparison with OLL (57.9 years) (p=0.020). Buccal mucosa and tongue involvement was more frequent in OLP; gingival involvement was uncommon in OLL. The reticular pattern was more frequently found in OLP, while the association of reticular and atrophic/erosive/ulcerated patterns was more common in OLP-C and OLL (p=0.025). In conclusion, gender and mean age of the patients, and anatomical location and clinical manifestation of OLL are different from OLP, and could help to better characterize this group of conditions. Specimens diagnosed as OLP-C showed clinical parameters close to OLP.

A Histomorphology Comparison of Saw-Tooth Shaped Rete Ridge Between Oral and Cutaneous Lichen Planus

Lichen planus is chronic and comparatively collective inflammatory mucocutaneous disease. The histopathological features of oral lichen planus were described as comparable to those of cutaneous lichen planus(CLP). Among those saw-toothed rete ridges are introduced as less important histopathologic features of idiopathic OLP in contrast to CLP. Accordingly, existing study aimed to estimate existence of saw tooth rete ridges in OLP in comparison to CLP.; In this retrospective cross-sectional study, 56; E stained slides with clinical and histopathological diagnoses of OLP were randomly collected from the archive of the oral pathology laboratory. CLP cases were selected randomly from a private pathology laboratory and were evaluated for the presence of saw-toothed rete ridges. Collected data were evaluated using Chi-square; Fishers exact test in SPSS 24 at an error level of 0.05%. Chi-square test did not show a substantial difference between oral; cutaneous groups in terms of the shape of the rete ridges (p = 0.511). Outcomes of existing study showed that saw tooth rete ridge was seen in OLP similar to CLP. Future studies concerning clinical subtype and type of keratosis are recommended.

Metabolomics and Transcriptomics Analysis on Metabolic Characteristics of Oral Lichen Planus.

ObjectiveTo explore metabolic biomarkers related to erosive and reticulated oral lichen planus (OLP) by non-targeted metabolomics methods and correlate metabolites with gene expression, and to investigate the pathological network pathways of OLP from the perspective of metabolism.MethodsA total of 153 individuals were enrolled in this study, including 50 patients with erosive oral lichen planus (EOLP), 51 patients with reticulated oral lichen planus (ROLP), and 52 healthy controls (HC). The ultra-high-performance liquid chromatography quadrupole-Orbitrap high-resolution accurate mass spectrometry (UHPLC/Q-Orbitrap HRMS) was used to analyze the metabolites of 40 EOLP, 40 ROLP, and 40 HC samples, and the differential metabolic biomarkers were screened and identified. The regulatory genes were further screened through the shared metabolites between EOLP and ROLP, and cross-correlated with the OLP-related differential genes in the network database. A “gene-metabolite” network was constructed after finding the key differential genes. Finally, the diagnostic efficiency of the biomarkers was verified in the validation set and a diagnostic model was constructed.ResultCompared with HC group, a total of 19 and 25 differential metabolites were identified in the EOLP group and the ROLP group, respectively. A total of 14 different metabolites were identified between EOLP and ROLP. Two diagnostic models were constructed based on these differential metabolites. There are 14 differential metabolites shared by EOLP and ROLP. The transcriptomics data showed 756 differentially expressed genes, and the final crossover network showed that 19 differential genes were associated with 12 metabolites. Enrichment analysis showed that alanine, aspartate and glutamate metabolism were closely associated with the pathogenesis of OLP.ConclusionThe metabolic change of different types of OLP were clarified. The potential gene perturbation of OLP was provided. This study provided a strong support for further exploration of the pathogenic mechanism of OLP.

Histopathologic evaluation of oral lichen planus and oral lichenoid reaction: A comparative analysis based on basement membrane thickness and the distribution of mast cells.

Background:Lichen planus is a chronic mucocutaneous disease of unknown etiology with well-established clinical and microscopic features. Oral lichenoid reactions are a family of lesions triggered by contact with specific agents such as metallic restorative materials, resins and drugs. Oral lichenoid reactions share clinical and histological features of oral lichen planus (OLP) but has varied management options. Hence, the discrimination between these two lesions is a major challenge for clinicians as well as pathologists.Aim:Histopathologic categorization of OLP and oral lichenoid reaction by comparing the thickness of basement membrane and the distribution of mast cells using special stains.Materials and Methods:The test group consists of formalin-fixed paraffin-embedded blocks of OLP (n = 15), and oral lichenoid reactions (n = 15) obtained from the archives of the Department of Oral Pathology, Amrita School of Dentistry. Three serial sections of 4 μm thickness were cut from each block. The sections were stained with H & E, periodic acid-Schiff (PAS) and toluidine blue, respectively.Results:A significant increase in the maximum basement membrane thickness (BMT) was noticed in OLP when compared to oral lichenoid reaction. A definite increase was also noticed in the number of mast cells in OLP and oral lichenoid reaction when compared to normal oral mucosa. There was a statistically significant increase in the number of degranulated mast cells in the deeper connective tissue in oral lichenoid reaction when compared to OLP.Conclusion:OLP and oral lichenoid reactions are two different entities showing similar clinical and microscopic presentation. The histochemical analysis of basement membrane and mast cells in these lesions might provide a more authentic method for differentiating these two lesions and might be of utmost value in deciding the treatment options.

Lichenoid dysplasia is not a distinct pathological entity

ObjectivesOral Lichenoid Dysplasia (OLD) is a controversial histological term applied to lesions that display features of oral lichen planus (OLP) and oral epithelial dysplasia (OED). In this study we investigated the molecular profiles of OLD, OLP and OED to determine whether OLD exists as a distinct pathological entity. Materials and MethodsSamples from patients presenting with lesions diagnosed histologically as OLP, OLD or OED underwent RNA sequencing followed by differential gene expression, functional enrichment and network analysis, sparse partial least squares discriminant analysis, and immune cell phenotypic estimation. ResultsUnsupervised clustering demonstrated a group of genes with high expression in OLP and OLD, and low expression in OED, predominantly involved in inflammatory processes. Many genes were significantly differentially expressed between either OLD or OLP and OED, but few between OLD and OLP. Functional enrichment showed significant pathways and ontologies related to inflammatory signalling and immune response between OLD or OLP and OED. Broad commonality was found between OLP and OLD in upregulation of specific immune system pathways. Classifying models discriminated histologically diagnosed OLD from OED based upon molecular data alone. Bioinformatic profiling showed that immune cell populations in OLP and OLD were consistent, and distinct from OED. ConclusionMolecular data shows that OLD is not a distinct pathological entity. Its transcriptomic and immunophenotypic profile is similar to OLP and distinct from OED. We recommend that oral lichenoid dysplasia not be used as a distinct pathological entity. Our data further supports exclusion of dysplasia in diagnosis of OLP.

Clinical characteristics of oral lichen planus and its causal context with dental restorative materials and oral health-related quality of life

BackgroundThe aim of this study was to investigate the influence of clinical characteristics and dental restorative materials on oral health-related quality of life in patients with oral lichen planus. In particular, the influences of amalgam and metals were investigated.MethodsA total of 112 patients with clinical and histological features of oral lichen planus from the Department of Cranio-Maxillofacial Surgery at the University Hospital of Münster participated in this prospective study. Clinical parameters of oral lichen planus and the dental restorative materials used were evaluated. Oral health-related quality of life was investigated by using the short form of the German version of the Oral Health Impact Profile (OHIP-14). In addition, physical pain was rated on a visual analogue scale.ResultsThe average OHIP-14 score was 13.54. A high correlation was seen between OHIP and pain. Likewise, higher OHIP-values were seen for male patients, and such as for those patients with non-reticular forms of oral lichen planus (OLP). A local form of OLP is more often seen on female patients, such as with the presence of reticular lichen. In regard to the restorations, the presence of composite restorations is correlated with a local lichen, whereas the presence of gold restorations is often seen with a generalized lichen. Furthermore, the grading of strength of association between mucosal lesion and amalgam/metal was tested. No significant differences revealed the analysis of the relationship between gender, clinical form of OLP, age, and presentation form between the 4 gradings of Thornhill.ConclusionsThe oral health-related quality of life is significantly limited in patients with oral lichen planus. But these OHIP scores are not influenced by the restorative materials. Here, pain severity is the most important aspect. We found no statistical differences in the clinical parameters between patients with amalgam or metal restoration and patients without these restorations. It is not necessary to replace amalgam fillings that are not in direct contact with mucosal surfaces.

Clinical Characteristics of Oral Lichen Planus in Patients Visiting A Private Dental Institution - A Retrospective Study.

Clinical Characteristics of Oral Lichen Planus in Patients Visiting A Private Dental Institution - A Retrospective Study.

Clinical and Demographic Characteristics of Oral Lichen Planus - A Retrospective Study

Clinical and Demographic Characteristics of Oral Lichen Planus - A Retrospective Study

Reflectance confocal microscopy characteristics of oral lichen planus: An analysis of 47 cases in a Chinese cohort.

Reflectance confocal microscopy (RCM) is a non-invasive tool that provides real-time microscopic images and relatively high-resolution tissue images. This technique provides a link between clinical examination and histopathology. RCM has been used to detect skin diseases and has also recently been applied to diseases of the oral mucosa. The present study aimed to explore the features of oral lichen planus (OLP) using RCM. A total of 47 patients with OLP exhibiting a reticular pattern, were included in the present study. The lesion sites and healthy adjacent sites were examined using in vivo RCM, with the lesion being histopathologically confirmed after RCM examination. The confocal images were reviewed, and the features were described. Sensitivity and specificity analysis of the RCM features was also performed. RCM examination presented parakeratosis, acanthosis and connective tissue papillae disappearance, with the presence of large melanocytes and roundish inflammatory cell infiltration, as well as dilated vessels in the lesion tissue. The sensitivity and specificity of OLP for dorsal tongue lesions were not as satisfactory as those on other sites. The results implied that RCM may be a promising technique to detect OLP non-invasively in vivo.

Characterization of oral lichen planus in a subset of patients: A single-center experience

Introduction: Lichen planus (LP) is a common chronic, mucocutaneous inflammatory disorder with unclear pathophysiology. The aim was to describe the epidemiology and clinicopathological characteristics of oral lichen planus (OLP) patients at King Abdulaziz University Dental Hospital (KAUDH) in Jeddah. Materials and Methods: This was a retrospective, chart-review study which included OLP patients previously seen at KAUDH from June 2012 to June 2018. Demographic data, clinical features, management, and outcome were collected and analyzed. Diagnosis of LP was done using clinical criteria with or without histopathologic diagnosis, and the scoring system by Escudier et al. was used. Results: Fifty patients with a mean age of 48 years (range: 21–71) and 2.5:1 female-to-male ratio were included in this study. The most concomitant systemic diseases were diabetes mellitus (30%) and hypertension (26%). Reticular OLP was the most common form (98%), followed by erythematous (66%), ulcerative (26%), and plaque-like type (8%). More than half of the patients were asymptomatic (64%), whereas twenty-two symptomatic patients were managed with either topical steroids, a combination of topical and systemic steroids, and/or intralesional steroid injections with 68% improvement. Conclusion: Based on the current data, clinical features at KAUDH matched what has been previously reported in the literature. In addition, the response to different treatment modalities varied between patients which could be linked to factors such as disease extension and severity.

Research trends and characteristics of oral lichen planus: A bibliometric study of the top-100 cited articles.

Bibliometric analysis highlights the key topics and research trends which have shaped the understanding and management of a concerned disease. The objective of this study was to identify and characterize the most-cited articles on oral lichen planus (OLP), and highlight the analysis of key topics and research trends. A comprehensive search was performed and identified in the Scopus database from 1907 to 5 March 2019 for the top-100 most-cited articles on OLP. The number of citations of the 100 selected articles varied from 101 to 570, with a mean of 178.7 citations per article. Malignant potential, immunopathogenesis, and topical drug therapy were the top-3 study topics, and the majority of high-quality articles were the research of the 3 topics. Journal of Oral Pathology and Medicine (n = 19) and Oral Surgery Oral Medicine Oral Pathology Oral Radiology (n = 14) were 2 journals with the most articles published. Both van der Waal I. and Scully C. were the most frequently contributing authors (n = 9). United States (n = 27) and Academic Centre for Dentistry Amsterdam (n = 7) was the most contributing country and institution, respectively. Systematic reviews (n = 2), randomized controlled trial (n = 1), cohort studies (n = 17) were study designs with higher evidence level, but the large majority (n = 80) were considered lower level. The results of this first citation analysis of the 100 most cited articles on OLP provide a historical perspective on scientific evolution, and suggest further research trends and clinical practice in the field of OLP.

An unusual presentation of oral lichen planus with desquamative gingivitis

Lichen planus (LP) is a chronic, autoimmune, mucocutaneous disease affecting the skin and mucosa. Oral LP (OLP) usually presents as a bilateral symmetrical lesion that affects approximately 1%–2% of the population. OLP exhibits a wide variety of clinical presentations. This case report deals with a 52-year-old female patient with OLP lesion isolated to the left buccal mucosa and desquamative gingivitis in relation to marginal gingiva of maxillary left premolars with white lacy striae extending from the left- to right-side central incisor region and a brownish-black-pigmented papule to the left angle of lip. Incisional biopsy was performed which revealed typical features of OLP. The patient was advised topical corticosteroids and antioxidants. She was subjected to oral prophylaxis to eliminate local irritating factors and was encouraged to follow meticulous oral hygiene measures to maintain periodontal health following which there was a resolution of the lesion and the symptoms.

Histopathological features of oral lichen planus and its response to corticosteroid therapy: A retrospective study.

Oral lichen planus (OLP) exhibits variations in severity and response to corticosteroid therapy. This study aims to assess the histopathological features of OLP at the time of diagnosis and their relationship in response to corticosteroid therapy.In this retrospective study, OLP patients were selected if a histopathological report was available. Data were collected regarding patients’ demographics and medical history. Clinical and histological data were also obtained. The outcomes were histopathological findings, clinical form of OLP, number of exacerbations per year, and the response to corticosteroid therapy.In this study, 100 OLP patients were enrolled. Basal layer hydropic degeneration and band-like subepithelial lymphocytes infiltrate were observed in all patients. Plasma cells, identified in 62% of OLP patients, were significantly associated with fewer disease exacerbations and better response to corticosteroid treatment.Identifying histopathological features that may affect the clinical course would be clinically helpful in tailoring patient management.

Oral lichen planus and thyroid gland diseases: possible associations

BackgroundLichen planus (LP) is a chronic inflammatory mucocutaneous disease that commonly affects the oral cavity. Previous reports have suggested a possible association between LP and thyroid gland diseases (TGDs). The purpose of this study was to investigate possible associations between oral lichen planus (OLP) and TGDs.MethodsPatients diagnosed with OLP, both clinically and histopathologically (N = 102), were classified according to clinical course (symptomatic/asymptomatic), type (reticular/plaque, atrophic and erosive) and location of lesions. Data on TGDs was compared to age- and gender-matched controls (N = 102) without OLP. Diagnosis of any type of TGD and related medication for study and control groups was recorded from the medical files provided by patients’ physicians. Statistical analysis used Student’s t-test and Fisher’s exact test; significance was set at p < 0.05.ResultsTGDs (all), hypothyroidism and related medications were found in 16.6, 12.7 and 12.7% of patients with OLP, respectively. These findings were similar to the control group: TGDs (all) -15.7%, hypothyroidism - 9.8% and thyroid gland disease-related medication - 9.8% (p > 0.05). No significant associations were found between different characteristics of OLP and hypothyroidism or other TGD (p > 0.05).ConclusionsWe found no significant associations between the co-existence of OLP and TGD or related-medications. Our findings are in agreement with some of the previously published similar studies but in controversy with others. Further well-designed, multicenter studies with large groups of patients and controls may help to establish the nature of the associations between OLP and TGDs.