Diagnosis Of Oral Lichen Planus Research Articles

Prevalence of Oral Lichen Planus in Patients with Hypothyroidism Versus Nonhypothyroidism

ABSTRACT Background: A chronic inflammatory illness known as oral lichen planus (OLP) affects approximately 1–2% of adults, with middle-aged women having a higher prevalence than men. One clinical endocrine condition that primary care doctors frequently see is hypothyroidism. Aim: To compare the prevalence of OLP among individuals with a previous diagnosis of hypothyroidism against those without hypothyroidism. Methods and Materials: A total of 1200 patients were included in this study. As per their medical reports, 600 patients included were found to have hypothyroidism. The rest 600 patients did not have hypothyroidism. All the patients underwent clinical examination and cases of OLP were identified according to the criteria of diagnosis of OLP. Results: Twenty (3.45%) study participants with hypothyroidism were found to have OLP. Eight (1.34%) study participants without hypothyroidism were found to have OLP of 2.37 (confidence interval: 0.91–6.23) and showed that the frequency of lichen planus in study participants with hypothyroidism was 2.37 times greater than that without hypothyroidism. Conclusion: Prevalence of lichen planus in persons with hypothyroidism was greater than that without hypothyroidism.

Immuno-histochemical evaluation of CD34 for OLP and OSMF

Immuno-histochemical evaluation of CD34 in oral lichen planus (OLP) and Oral Submucous Fibrosis (OSMF) is of interest to dentist.20 specimens of normal oral mucosa (buccal mucosa/gingiva tissue) from patients who had extractions performed as part of orthodontic treatment comprised Group I, the control group. Group II comprised 30 individuals with a diagnosis of oral lichen planus. 30 OSMF cases with diagnoses is Group III. These 80 specimens were all given consideration when choosing for CD34immuno-histochemical staining. The CD34 was greater in all categories of OLP and OSMF when compared to normal controls. Maximum CD34 expression was observed in erosive OLP (147.41ą17.60) followed by OSMF (116.01 ą11.72) and reticular OLP (105.01ą11.62). Data was statistically significant (p<0.001).Immunohistochemistry of CD34 evaluation is a potential diagnostic marker for OLP and OSMF.

Development of an immune-related diagnostic predictive model for oral lichen planus.

Oral lichen planus (OLP) was a chronic inflammatory disease of unknown etiology with a 1.4% chance of progressing to malignancy. However, it has been suggested in several studies that immune system disorders played a dominant role in the onset and progression of OLP. Therefore, this experiment aimed to develop a diagnostic prediction model for OLP based on immunopathogenesis to achieve early diagnosis and treatment and prevent cancer. In this study, 2 publicly available OLP datasets from the gene expression omnibus database were filtered. In the experimental group (GSE52130), the level of immune cell infiltration was assessed using MCPcounter and ssGSEA algorithms. Subsequently, differential expression analysis and gene set enrichment analysis were performed between the OLP and control groups. The resulting differentially expressed genes were intersected with immunologically relevant genes provided on the immunology database and analysis portal database (ImmPort) website to obtain differentially expressed immunologically relevant genes (DEIRGs). Furthermore, the gene ontology and kyoto encyclopedia of genes and genomes analyses were carried out. Finally, protein-protein interaction network and least absolute shrinkage and selection operator regression analyses constructed a model for OLP. Receiver operating characteristic curves for the experimental and validation datasets (GSE38616) were plotted separately to validate the model's credibility. In addition, real-time quantitative PCR experiment was performed to verify the expression level of the diagnostic genes. Immune cell infiltration analysis revealed a more significant degree of inflammatory infiltration in the OLP group compared to the control group. In addition, the gene set enrichment analysis results were mainly associated with keratinization, antibacterial and immune responses, etc. A total of 774 differentially expressed genes was obtained according to the screening criteria, of which 65 were differentially expressed immunologically relevant genes. Ultimately, an immune-related diagnostic prediction model for OLP, which was composed of 5 hub genes (BST2, RNASEL, PI3, DEFB4A, CX3CL1), was identified. The verification results showed that the model has good diagnostic ability. There was a significant correlation between the 5 hub diagnostic biomarkers and immune infiltrating cells. The development of this model gave a novel insight into the early diagnosis of OLP.

Studying the relationship between oral lichen planus and periodontal disease: Value on periodontal pathogens and oral hygiene

BACKGROUND: Oral lichen planus is a chronic inflammatory condition of the oral mucosa characterized by white, lacy lesions. The etiology of oral lichen planus is complex and remains unclear, but it is thought to be a T-cell mediated autoimmune disease. Several factors have been implicated in the pathogenesis of oral lichen planus, including genetic predisposition, dental materials, iatrogenic factors, infections, autoimmunity, and bowel disease. The microflora of the oral cavity plays an important role in maintaining oral health and preventing disease. However, its role in the development and progression of oral lichen planus is not yet totally understood. Some studies have shown that there are differences in the microflora of oral lichen planus patients compared to healthy controls. These differences may be related to the inflammatory process in oral lichen planus, or they may be a contributing factor to the disease.
 AIM: Identify the prevalence of the detection of periodontopathogenic microorganisms in oral lichen planus patients and compare their prevalence in healthy non-oral lichen planus patients.
 MATERIALS AND METHODS: A cross-sectional, single-center study was conducted. A total of 75 patients were recruited, 45 with oral lichen planus and 30 healthy controls. The groups were formed by simple random sampling. The diagnosis of oral lichen planus was confirmed histologically in the main group. The forms and localization of oral lichen planus were determined in the main group based on clinical examination. In the control group, patients were divided into two subgroups depending on the presence of chronic periodontitis or gingivitis. The prevalence of periodontal pathogens was assessed based on the analysis of culture results. Among the 48 bacteria isolated from the oral mucosa of the affected site in the main and control groups, we focused on the microbiota of only periodontal bacteria to study their role and assess their impact on disease progression.
 RESULTS: Among the 45 patients with a clinical diagnosis of oral lichen planus, there were 10 (22.22%) men and 35 (77.78%) women, with a mean age of 55.3±13.4 years. The control group included 30 healthy volunteers, 8 (26.67%) men and 22 (73.33%) women, with a mean age of 54.8±12.7 years. In patients with oral lichen planus regardless of their periodontal status the percentage of seropositivity for A. actinomycetemcomitans, V. parvula, P. gingivalis, T. denticola is higher compared to their healthy counterparts with gingivitis and periodontitis.
 CONCLUSION: The study found an increased frequency of detection of pathogenic microorganisms, such as A. actinomycetemcomitans, V. parvula, P. gingivalis, and T. denticola, in patients with oral lichen planus, regardless of the presence of periodontitis. These periodontopathogens may be associated with oral lichen planus. However, further studies are needed to clarify their role in the pathogenesis of the disease.

Evaluation of clinical and demographical finding in patients with oral lichen planus: A retrospective cross sectional study.

Aim: To learn more about Oral Lichen Planus Iraqi patients, including their background information, symptoms, and prognosis. Materials and Methods: From the Oral and Maxillofacial Pathology Department, College of Dentistry, Baghdad University, we retrospectively reviewed the medical records of 68 patients with a histologically confirmed clinical diagnosis of oral lichen planus and subsequently contacted the patients by phone to evaluate their prognosis. Results: Females were more likely than males to experience severe pain; the reticular form of Oral Lichen Planus was the most prevalent at 38.2%, but the erosive type was more prevalent among females. Only 53 of 68 patients responded to phone calls. More than 37% of those respondents reported involvement at a second location intra-orally following the first oral manifestation, and 20% had extraoral Lichen Planus, and approximately 22.6% of them observed changes in the morphology and behavior of the lesion after a brief period of time, while 26.4% experienced complete remission. Conclusions: Females were more likely to have oral lichen planus. Females and elderly persons were more likely to have severe pain than other. The lesion must be monitored for symptomatic flare-ups over time.

The impact of COVID-19 pandemic in patients with a diagnosis of Oral Lichen Planus: Pain perception and psychological profile analysis.

To assess the impact of COVID-19 in patients affected by OLP, in terms of level of pain, stress, depression and anxiety and their impact on the clinical manifestation of the disease. A longitudinal design was employed. Psychometric evaluations of anxiety, stress, and depression were conducted using the DASS21 scale, while pain levels were measured using the VAS scale. Clinical diagnosis and phenotype evaluation were performed. The study included 24 patients with an average age of 62.9years, with 70.8% presenting erosive OLP. Results revealed a significant worsening of anxiety, stress, and depression scores during the pandemic. Pain level (1.5 ± 1.2 pre-pandemic VS 3.8 ± 1.1 during the pandemic, p < 0.0001) was also negatively affected. These findings highlight the potential interplay between psychological stress and oral health conditions, emphasizing the need for a comprehensive understanding of OLP's complex etiology and its response to external stressors. Multidisciplinary care strategies to address both physical and psychological aspects of OLP patients is recommended following the present findings. Further research is warranted to confirm these observations in larger multicenter studies and to guide tailored guidance approaches for OLP patients during challenging times.

Oral Cavity Squamous Cell Carcinomas in Patients with a History of Oral Lichen Planus: Frequency and Outcomes

Oral lichen planus (OLP) is an inflammatory condition which affects the mucous membranes of the oral cavity. While previous studies have described the association between OLP and development of oral cavity cancer, there is currently a paucity of literature examining the impact of this disease on treatment response and prognosis. As such, we present a retrospective cohort study of Oral cavity squamous cell carcinoma (OCSCC) patients with a history of OLP to explore the course of their disease. Using an IRB approved tertiary care registry of head and neck cancer patients, we identified patients with OCSCC who had a prior diagnosis of OLP. The number of new primary tumors, rates of local (LF), regional (RF) and distant failure (DF), as well as overall survival (OS) were assessed using Cox proportional hazards and Kaplan Meier analysis for actuarial survival estimates. Fifty-four patients with OCSCC and OLP were identified with 109 individual OCSCC diagnoses. Patients had a median age of 67 years, were predominantly female (n = 42, 77.8%) and never smokers (n = 29, 53.7%) with a median follow up after diagnosis of OCSCC of 46.5 months. Nine patients (16.7%) had a history of immunosuppression of whom 6 (11.1%) had chronic steroid use for treatment of OLP. Within the cohort, 33 (61.1%) of OLP patients had a single OCSCC, 11 (20.4%) had 2, and 10 (18.5%) had >3 separate tumors develop. The most common oral cavity subsites were oral tongue (n = 42, 38.5%), followed by alveolar ridge (n = 14, 12.8%) and gingiva (n = 13, 11.9%). Papillary SCC subtype was identified in 10.1%. 92.7% of tumors (n = 101) were treated with primary surgery, with 23 (21.1%) receiving adjuvant RT and 10 of those patients receiving concurrent chemotherapy. Among resected patients, pathologic stages were predominantly T1-2 (84.1%) and N0 (50% vs N1 15.6% and N2a-3 34.4%). The mean RT dose was 62 Gy in 32 fractions. Locoregional failure occurred in 24.8% of cancers (n = 27), with local and regional failure occurring in 13.8% (n = 15) and 11% (n = 12) of lesions, respectively. Recurrence free survival at 3 and 5 years was 75% and 70.3%, respectively, with overall survival at 3 and 5 years of 71.1% and 67%, respectively. Patients with OCSCC and a history of OLP are predominantly female and never smokers. The tumors that develop in such patients are often early stage but a proportion of patients appear to be at higher risk of developing multiple malignancies and surveillance of this patient population to identify new tumors is crucial.

A retrospective cohort study of the efficacy of metronidazole in oral lichen planus.

Lichen planus (LP)is an inflammatory dermatosis with mucosal variants, including oral LP (OLP). OLP has a relapsing chronic course and may significantly affect a patient's quality of life. We analysed the efficacy of metronidazole as a treatment for OLP via a retrospective chart review of patients with a diagnosis of OLP seen at our institution over 10 years. Thirty patients with OLP were treated with metronidazole 500 mg twice daily. Most patients (n = 18; 60%) showed improvement with metronidazole, including 10 (33%) who experienced complete resolution of symptoms. Our results were limited by the retrospective nature of the review and the relatively small cohort size. Given the efficacy, mild side-effect profile and the less immunosuppressive nature of metronidazole vs. alternative systemic treatment options, metronidazole is a reasonable option to try in patients with symptomatic OLP who have failed topical treatment options.

COVID-19 and Oral Lichen Planus: Between an "Intriguing Plot" and the "Fata Morgana Effect".

The COVID-19 pandemic, caused by the SARS-CoV-2 virus, has led to significant morbidity and mortality worldwide since its declaration as a global pandemic in March 2020. Alongside the typical respiratory symptoms, unusual clinical manifestations such as oral lichen planus (OLP) have been observed. OLP is a chronic inflammatory mucocutaneous dermatosis that results from a cell-mediated reaction, and its pathogenesis involves the loss of immunological tolerance. OLP has been associated with several triggering factors, such as certain drugs, stress, smoking, and even some viruses. Exposure to the spike protein antigen of SARS-CoV-2 during an infection can trigger autoimmune reactions and lead to the onset or flare of OLP. The E3 protein ligase TRIM21, which is identified in the lamina propria of OLP lesions, is overexpressed in COVID-19 patients and plays a critical role in autoimmune pathologies. Furthermore, the psychological stress of the lockdown and quarantine can be a trigger for the onset or exacerbation of OLP. However, the diagnosis of OLP is complex and requires a biopsy in order to confirm a clinical diagnosis, rule out other pathologies, and establish the most appropriate therapeutic procedure. Further research is needed to understand the potential link between Co-19 and OLP.

ORAL LICHEN PLANUS AND ORAL LICHENOID LESION: A CLINICOPATHOLOGICAL STUDY

Objective To reassess the cases diagnosed as oral lichen planus (OLP) and oral lichenoid lesion (OLL) and compare their sociodemographic and clinicopathological characteristics. Study Design Records and slides of 72 cases with diagnosis of OLP and OLL were evaluated and submitted to bivariate analysis. Results OLP prevailed (52.8%). Middle-aged, non-smoking white women with white lesions at multiple oral sites without symptomatology, were, clinically, the most affected for both lesions. In LPO, bilateral lesions showing intense lymphocytic infiltrate (IL) in band, well-defined and in the superficial portion of the connective tissue, with a hydropic degeneration of the basal layer, colloid bodies, parakeratin, hyperplastic epithelial crest, and absence of epithelial dysplasia, predominated. In OLL, isolated lesions presenting moderate to intense focal IL, with basal degeneration colloid bodies, hyperplastic epithelial crest, and epithelial dysplasia, were observed. OLP was associated with lesions that appeared bilaterally (p=0.001), well-defined IL, in band, and in the superficial portion of the connective tissue (p≤0.0001). OLL was associated with the presence of epithelial dysplasia and mild dysplasia (p≤0.0001). Conclusion Histopathology of the lichenoid IL and the presence of dysplasia alone are not sufficient for the differential diagnosis LPO and LLO; the association of clinical and follow-up data is essential. To reassess the cases diagnosed as oral lichen planus (OLP) and oral lichenoid lesion (OLL) and compare their sociodemographic and clinicopathological characteristics. Records and slides of 72 cases with diagnosis of OLP and OLL were evaluated and submitted to bivariate analysis. OLP prevailed (52.8%). Middle-aged, non-smoking white women with white lesions at multiple oral sites without symptomatology, were, clinically, the most affected for both lesions. In LPO, bilateral lesions showing intense lymphocytic infiltrate (IL) in band, well-defined and in the superficial portion of the connective tissue, with a hydropic degeneration of the basal layer, colloid bodies, parakeratin, hyperplastic epithelial crest, and absence of epithelial dysplasia, predominated. In OLL, isolated lesions presenting moderate to intense focal IL, with basal degeneration colloid bodies, hyperplastic epithelial crest, and epithelial dysplasia, were observed. OLP was associated with lesions that appeared bilaterally (p=0.001), well-defined IL, in band, and in the superficial portion of the connective tissue (p≤0.0001). OLL was associated with the presence of epithelial dysplasia and mild dysplasia (p≤0.0001). Histopathology of the lichenoid IL and the presence of dysplasia alone are not sufficient for the differential diagnosis LPO and LLO; the association of clinical and follow-up data is essential.

Risk of Oral Squamous Cell Carcinoma in One Hundred Patients with Oral Lichen Planus: A Follow-Up Study of Umberto I University Hospital of Rome.

This study aims to retrospectively assess the potential risk of malignant transformation in patients with diagnosed oral lichen planus (OLP) between 2015 and 2022, and to evaluate the influence of different risk factors. The department's database and medical records from 2015 to 2022 were searched for patients with a confirmed diagnosis of OLP based on both clinical and histological parameters. A total of 100 patients (59 females and 41 males) were found with a mean age of 64.03 years. In the considered period, the percentage of diagnosed OLP patients was 1.6%, while the percentage of diagnosed OLP patients with transformation to oral squamous cell carcinoma (OSCC) was 0.18%. A statistically significant difference was found with age (p = 0.038), tobacco status (p = 0.022), and radiotherapy (p = 0.041). The analysis revealed the presence of significant risk in ex-smokers (>20 pack-years), with an odds ratio (OR) of 10.0000 (95% confidence interval (95% CI) 1.5793-63.3186); in alcohol-drinker patients, with an OR of 4.0519 (95% CI 1.0182-16.1253); in ex-smoker and alcohol-drinker patients, with OR of 17.6250 (95% CI 2.2464-138.2808); and in patients who had undergone radiotherapy, with OR of 6.3000 (95% CI 1.2661-31.3484). The malignant transformation of oral lichen planus was slightly higher than thought, and the results revealed a possible association with age, tobacco and alcohol status, and history of radiotherapy. An elevated risk of malignant transformation was observed in heavy ex-smoker patients, alcohol-drinker patients, and alcohol-drinker patients with a history of smoking (ex-smokers). Persuading the patient to quit tobacco and alcohol consumption and periodic follow-ups are recommended in general, but particularly in the presence of these risk factors.

Coexistence of oral lichen planus and vulvar lichen sclerosus

Oral lichen planus (OLP) is a mucosal variant of lichen planus. Lichen sclerosus (LS) is an inflammatory disorder with a predilection for genital skin. We aimed to identify the characteristics of patients with both mucosal diagnoses. This retrospective study included 86 women with both OLP and vulvar LS diagnosed from June 1, 1991 through November 30, 2020 at a Mayo Clinic campus in Rochester, Minnesota; Scottsdale, Arizona; or Jacksonville, Florida. Data included treatments, other cutaneous diagnoses, comorbidities, and information on patch testing and malignant transformation. The median patient age at diagnosis was 64.5 years for OLP and 65.6 years for vulvar LS. A diagnosis of OLP before vulvar LS was most common (50.0%). The most frequently used treatment for both conditions was topical corticosteroids. Oral squamous cell carcinoma (SCC) did not develop in any patient, but vulvar SCC developed in 2 (2.3%). OLP and vulvar LS may coexist, commonly beginning in the patient's seventh decade. Topical corticosteroids are often used to manage both conditions. The coexistence of both diseases did not seem to portend a greater malignancy risk.

Direct immunofluorescence cannot be used solely to differentiate among oral lichen planus, oral lichenoid lesion, and oral epithelial dysplasia

Background/purposeSome red and white lesions may have similar manifestations, making them difficult to be diagnosed. A direct immunofluorescence (DIF) assay can assist in making a final diagnosis of oral lichen planus (OLP). The aim of this study was to evaluate and compare the DIF profile in patients who had the clinical presentations of OLP and were histopathologically diagnosed with OLP, OLL (oral lichenoid lesion), or OED (oral epithelial dysplasia). Materials and methodsThe data were obtained from the medical records of 136 patients with the clinical presentations of OLP. Demographic information, histopathological diagnosis, malignant transformation, and DIF results were collected and analyzed. ResultsIn this study, 117 patients (86.0%) were DIF-positive, while 19 patients (14.0%) were DIF-negative. The highest DIF-positivity rate was in the OLP group (88.9%) followed by the OLL (83.7%), and the OED groups (81%). There were no significant differences in DIF-positivity rate, type of immunoreactants, location, or interpretation among these groups. Shaggy fibrinogen at the basement membrane zone (BMZ) was the most common DIF pattern in all groups. ConclusionThe DIF assay alone cannot be regarded as sufficient evidence for OLP, OLL, and OED differentiation. A histopathological examination is required to determine the presence of epithelial dysplasia or malignancy. To diagnose dysplastic lesions with the clinical manifestations of OLP, careful clinicopathologic correlation is mandatory. Due to the lack of scientific evidence to identify the primary pathology and the ongoing malignancy risk of epithelial dysplasia, meticulous long-term follow-up plays a crucial role in patient management.

Prognosis of oral epithelial dysplasia in individuals with and without oral lichen planus.

To investigate the role of oral lichen planus (OLP) on the long-term prognosis of oral epithelial dysplasia (OED). Retrospective single-centre cohort study using the 2007-2019 database of the Head and Neck Cancer and Oral Medicine units of University College London Hospital. The exposure of interest was the presence of OLP, and the prognostic outcomes included the development of new primary episodes of OED, progression to malignancy and mortality. Cox proportional hazard and Poisson regression models were performed. A total of 299 patients, of whom 144 had OED arising on the background of OLP (OLP/OED) and 155 had OED without underlying OLP (non-OLP/OED), were included. A pre-existing diagnosis of OLP was significantly associated with a twofold increased risk of subsequent primary OED events (HR=2.02, p= 0.04), which also developed faster (1.46 vs. 2.96 years, p= 0.04) and with more involvement of non-cancer-prone sites (p= 0.001) than in the non-OLP/OED group. There was no difference between groups in the progression to malignancy or mortality. Oral lichen planus/OED patients are at higher risk of multiple episodes of primary OED, which can develop faster and at non-cancer-prone sites as compared to non-OLP/OED individuals. Further research is needed to clarify the effects of OLP upon progression to OSCC and mortality.

Artificial Intelligence-Based Diagnosis of Oral Lichen Planus Using Deep Convolutional Neural Networks.

The aim of this study was to employ artificial intelligence (AI) via convolutional neural network (CNN) for the separation of oral lichen planus (OLP) and non-OLP in biopsy-proven clinical cases of OLP and non-OLP. Data comprised of clinical photographs of 609 OLP and 480 non-OLP which diagnosis has been confirmed histopathologically. Fifty-five photographs from the OLP and non-OLP groups were randomly selected for use as the test dataset, while the remaining were used as training and validation datasets. Data augmentation was performed on the training dataset to increase the number and variation of photographs. Performance metrics for the CNN model performance included accuracy, positive predictive value, negative predictive value, sensitivity, specificity, and F1-score. Gradient-weighted class activation mapping was also used to visualize the important regions associated with discriminative clinical features on which the model relies. All the selected CNN models were able to diagnose OLP and non-OLP lesions using photographs. The performance of the Xception model was significantly higher than that of the other models in terms of overall accuracy and F1-score. Our demonstration shows that CNN models can achieve an accuracy of 82 to 88%. Xception model performed the best in terms of both accuracy and F1-score.

Is oral lichen planus a potentially malignant disorder?: A critical appraisal; a commentary on the letter to the editor.

Is oral lichen planus a potentially malignant disorder?: A critical appraisal; a commentary on the letter to the editor.

Lymphocyte and CD62E expression in lichen planus and lichenoid reaction

BackgroundIt is difficult to distinguish the clinical and histopathological aspects of oral lichen planus lesions from those of oral lichenoid reaction. Some criteria were proposed to distinguish them, mainly because they have different biological behaviors. The aim of the present study was to compare the lymphocyte population and the expression of E-selectin between these lesions.MethodsParticipants with a clinical diagnosis of oral lichen planus (GOLP) and oral lichenoid reaction (GOLR) who needed to perform a biopsy were selected. The tissue was frozen and immunostaining was performed for CD3/CD4, CD3/CD8, CD4/CLA, CD8/CLA, and CD62E. The analysis of each immunostaining was accomplished using the ImageJ program.ResultsIn total, 25 participants with oral lichen planus and 11 with oral lichenoid reaction were seen. In the evaluation of CD3 + CD4+/CD3 + and CD3 + CD8+/CD3 + proportions, there was a higher percentage of these cells in the oral lichen planus group when compared with the oral lichenoid reaction group (p = 0.027 and p = 0.038 respectively). The average number of CLA + lymphocytes for CD4+/CLA + and CD8+/CLA + in both groups was not statistically significant (p = 0.840; d = 0.363). In GOLP, the number of CD4 + CLA+/E-selectin and CD8 + CLA+/E-selectin was not statistically significant (p = 0.951 and p = 0.454 respectively); neither in GOLR (p = 0.454 and p = 0.989 respectively).ConclusionOur results indicate that CD3 + CD4+, CD3 + CD8+, CD4 + CLA+, CD8 + CLA + lymphocytes and E-selectin are present in both lesions. However, the proportion of CD3 + CD4+/CD3 + and CD3 + CD8/CD3 + cells is higher in the oral lichen planus group when compared with the oral lichenoid reaction group, suggesting that these cells may be important for the etiopathogenic mechanism of these lesions.

A Clinicohistopathological Characterization of Oral Lichen Planus: A Cross-Sectional Study.

Based on the modified diagnostic criteria for oral lichen planus (OLP) proposed by Van der Meij and Van der Waal, the objective of the current investigation was to demonstrate a clinicohistopathological association in the diagnosis of OLP. Data were retrieved from 250 individuals who visited the Department of Oral Medicine and Radiology and were diagnosed with OLP between September 2018 and December 2021. Upon completion of the histopathological analysis, the precise diagnosis of OLP was made. Repeat biopsies were performed in the cases suspecting malignant transformation during the follow-up phase. The data were analyzed using SPSS software. The Fisher's exact test and chi-square test of association were used to establish the significant differences between the variables at a 5% significance level. Of the 250 patients, 48% and 52% were males and females, respectively. The two clinical manifestations observed were reticular (n=145, 58%) and erosive types (n=105, 42%). The most frequently impacted locations were the buccal mucosa (n=150, 60%) and labial mucosa (n=100, 40%). Fourteen individuals (two with reticular form and 12 with erosive form) later during follow-up showed dysplasia, with moderate (n=2) to mild (n=12) dysplastic alterations. Koilocytes were reported in 84 cases (34%), which included 35 (24%) reticular cases and 49 (47%) erosive lesions. The histopathological features such as acanthosis, epithelial atrophy, hyperkeratosis, presence of neutrophils, koilocytes, and epithelial dysplasia were shown to be statistically significant between the clinical forms (p<0.001). The results of the current study highlight the concordance of histopathological and clinical diagnoses, especially for early definitive diagnosis of OLP. More research studies are warranted to validate the trend of epithelial dysplasia in OLP associated with human papillomavirus (HPV) and to explore the course of the lesions that might be affected by this trait.

Application of a computer program in the assessment of psychological parameters of patients with lichen planus of the oral mucosa

BACKGROUND: The relevance of the study of oral lichen planus (OLP) does not raise doubts given the unclear etiological nature of this dermatitis, potential for malignancy, and difficulty in performing therapeutic measures.&#x0D; AIM: To assess the psychoemotional state of patients with various forms of OLP using a computer program (ConScale).&#x0D; MATERIAL AND METHODS: We examined 287 patients with a verified diagnosis of OLP. The average age of the patients was 47.89.0 years; men, 121 (42.1%); women, 166 (57.9%).&#x0D; RESULTS: Psychological parameters were assessed using ConScale according to the Beck Anxiety Inventory (BAI) and Beck Depression Inventory (BDI). In comparison with the control group (n=32) of comparable age and sex according to BAI and BDI, significant differences were found in patients with erosive-ulcerative, exudative-hyperemic, and bullous forms of LP. A relationship was found between these clinical forms of OLP and psychological conditions such as anxiety and depression.&#x0D; CONCLUSION: The results indicate the need to include psychological testing of patients with OLP in the protocol for a comprehensive assessment of the patients condition and treatment with individually selected sedatives.

EVALUATION OF THE TISSUE EXPRESSION OF THE VITAMIN D RECEPTOR (VDR) IN PATIENTS WITH ORAL LICHEN PLANUS

<h3>Objectives</h3> To evaluate the tissue expression of the vitamin D receptor (VDR) in samples of oral lichen planus (OLP) and whether there is a correlation with clinical-demographic parameters and disease severity. <h3>Study Design</h3> Tissue samples were selected from patients whose clinical and histopathologic diagnosis of OLP was performed according to the criteria of the American Academy of Oral and Maxillofacial Pathology. Clinical parameters such as sex, age, location, clinical type, symptoms, extraoral manifestations, and response to corticosteroid therapy were recorded. The immunohistochemistry technique was used for semiquantitative evaluation of VDR expression in the epithelial and subepithelial regions. Density of VDR+ cells was determined using a grid reticle (0.0961 mm²). <h3>Results</h3> All cases (<i>n</i> = 15) were women with an average age of 49 years. The clinical types erosive (<i>n</i> = 8; 53.3%) and reticular (<i>n</i> = 7; 46.6%) were the most frequent. High expression of VDR+ cells was observed throughout the epithelial region in 100% of cases and, in the subepithelial region, the average percentage of immunostained inflammatory cells was 80.5%. <h3>Conclusions</h3> VDR tissue expression was high in OLP, but there were no relations with the clinical-demographic characteristics and severity parameters of this disease.