Incidence Of Oral Lichen Planus Research Articles

Vascular Endothelial Growth Factor Level in Patients With Oral Lichen Planus: A Systematic Review and Meta-Analysis

Background According to the possible role of vascular endothelial growth factor (VEGF) in the incidence of oral lichen planus (OLP) lesions, it seems necessary to evaluate this factor in patients with OLP. Objective The present study aims to investigate the level of VEGF in patients with OLP. Methods In this systematic review and meta-analysis, the search was conducted in online databases, including PubMed, Web of Science, and Scopus. The data were analyzed in the Stata v. 14 software at a 95% confidence interval (CI) and using a random effect model. The standardized mean difference was used to measure the difference in VEGF level between the two groups of control and OLP. The data heterogeneity was quantified by the I2 index. Results There was no significant difference between the two groups in terms of VEGF (SD=0.46, 95% CI: -2.13, -3.05, P=0.730) and the I2 index showed significant heterogeneity among the results of the studies (I2=97.9%). Based on the results of the immunohistochemistry, there was a significant difference in the VEGF level between the two groups (SD=3.30, 95% CI: 6.25, -0.36); however, the difference between the two groups was not statistically significant via the ELISA method (P=0.530). Conclusion The VEGF level in patients with OLP is higher compared to healthy people. Therefore, the serum factors which indicate VEGF should be considered an effective risk factor for OLP.

Global Prevalence and Incidence Estimates of Oral Lichen Planus

Integrated information on the global prevalence and incidence of oral lichen planus (OLP) is lacking. To examine the global prevalence and incidence of OLP in a systematic review and meta-analysis. A systematic review of population-based studies and clinic-based studies reporting the prevalence and incidence of OLP was performed using 3 electronic medical databases (Cochrane Database of Systematic Reviews, Embase, and MEDLINE) from their inception to March 2019. The search terms included "(lichen planus or LP) and (prevalence or incidence or epidemiology)." No language restriction was applied. Observational descriptive studies investigating the prevalence and incidence of OLP were included. Data were extracted by continent, sex, and other characteristics. The risk of bias was assessed by the Joanna Briggs Institute Critical Appraisal Instrument for Studies Reporting Prevalence Data using random-effects models to synthesize available evidence. The primary outcome was the prevalence (with 95% CIs) of OLP among the overall population and among subgroups. Between-study heterogeneity was assessed using the I2 statistic. Among 46 studies, the overall pooled estimated prevalence of OLP was 0.89% (95% CI, 0.38%-2.05%) among the general population (n = 462 993) and 0.98% (95% CI, 0.67%-1.43%) among clinical patients (n = 191 963). Among the 15 population-based studies, the prevalence of OLP was 0.57% (95% CI, 0.15%-2.18%) in Asia, 1.68% (95% CI, 1.09%-2.58%) in Europe, and 1.39% (95% CI, 0.58%-3.28%) in South America. Among the 31 clinic-based studies, the prevalence was 1.43% (95% CI, 1.12%-1.83%) in Africa, 0.87% (95% CI, 0.61%-1.25%) in Asia, 1.03% (95% CI, 0.51%-2.09%) in Europe, 0.11% (95% CI, 0.07%-0.16%) in North America, and 3.18% (95% CI, 0.97%-9.95%) in South America. The pooled prevalence of OLP by sex was 1.55% (95% CI, 0.83%-2.89%) for women and 1.11% (95% CI, 0.57%-2.14%) for men in the population-based studies and 1.69% (95% CI, 1.05%-2.70%) for women and 1.09% (95% CI, 0.67%-1.77%) for men in the clinic-based studies. In 5 clinic-based studies providing the age distribution of patients with OLP, the prevalence by age was 0.62% (95% CI, 0.33%-1.13%) among patients younger than 40 years and 1.90% (95% CI, 1.16%-3.10%) among patients 40 years and older. This study identified the global prevalence and incidence of OLP in terms of its spatial, temporal, and population distribution. The overall estimated pooled prevalence of OLP was 0.89% among the general population and 0.98% among clinical patients. A higher prevalence of OLP was found in non-Asian countries, among women, and among people 40 years and older. The findings should be considered with caution because of the high heterogeneity of the included studies.

Incidence of squamous cell carcinoma in oral lichen planus: a 25-year population-based study.

Oral lichen planus (OLP) is a chronic inflammatory condition of the oral mucosa. Multiple studies have shown that approximately 1% of patients with OLP will develop oral squamous cell carcinoma (OSCC), however, no study has taken a population-based multicenter approach to demonstrate this association. Our main objective was to determine the incidence of OSCC in OLP in a specific population and secondarily to assist physicians regarding appropriate long-term monitoring of patients with OLP. We conducted a population-based retrospective cohort study. Patients with OLP from 1986 through 2010 were identified using the Rochester Epidemiology Project (REP) for Olmsted County, Minnesota. For each OLP case (n = 303), we randomly selected two age- and gender-matched referents (n = 606). OLP diagnosis was established based on the World Health Organization (WHO) criteria. Medical records were reviewed for development of OSCCafter the OLP diagnosis (index date). The association between OLP and development of OSCC was assessed. In total, 303 patients with incident OLP were identified; the overall incidence of OLP per 100,000 person-years was 11.4 (95% CI, 10.1-12.7). Among the OLP cohort, 7 had OSCC (incidence of OSCC, 3.1%; 95% CI, 0.6-6.4%) at 20 years after OLP diagnosis. Three OSCC cases were identified among the referents. Patients with OLP were 4.8 times more likely to have OSCC than the matched referents. The median time to OSCC development was 14.7 years earlier for the OLP cohort. Patients with OLP, particularly the erosive type, have an increased incidence of OSCC development and should be monitored closely.

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

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.

Increased oral lichen planus in a chronic hepatitis patient associated with elevated transaminase levels before and after interferon/ribavirin therapy

Oral lichen planus (OLP) is the most frequent oral lesion found in patients with hepatitis C virus (HCV) infection. The aims of this study were to investigate the prevalence of OLP among chronic hepatitis C patients, to clarify the role of HCV in the pathogenesis of OLP, and to assess its relationship to transaminase levels. Two groups of subjects were studied; 277 hepatitis C patients were examined for OLP (Group 1) and 5273 outpatients seeking dental care within 1 year were used as a control (Group 2) to determine the prevalence of OLP in the general population. The dental and hepatic records were collected and analyzed. The prevalences of OLP were 4.7% ( n = 13) in Group 1 and 2.0% ( n = 104) in Group 2 and significantly differed (P = 0.002). All 13 OLP cases occurred in hepatitis C patients who had experienced elevated alanine transaminase levels of > 80 IU/L within the 2 previous years, regardless of whether they were treated with interferon-ribavirin combination therapy or not. There was a strong association between elevated transaminase levels and the development of HCV-related OLP lesions (P = 0.014). Of the 13 OLP patients, two were in the group with a sustained virologic response (SVR) to HCV therapy, two were in the group without an SVR, and nine were in the non-therapy group. The incidence of OLP in hepatitis C patients did not significantly differ between those who showed an SVR to HCV therapy and those who did not respond or did not receive therapy (P = 0.560). We concluded that: (1) elevation of transaminase levels is associated with the detection of HCV-related OLP, and (2) HCV-related OLP can remain unchanged for years after an SVR to HCV therapy. The findings revealed that the role of HCV in OLP pathogenesis is due to host factors induced by HCV rather than a direct cytopathic effect of HCV.

How common is oral lichen planus?

Medline and ISI Web of Science were searched, along with references of identified papers. Studies reporting the prevalence or incidence of oral lichen planus (OLP) were included. Papers were examined for five criteria: use of a clinic- or population-based study; adequate demographic description (by sex and age group) of the population; adequate demographic description of the sample (if the population was sampled); adequate demographic description of the OLP cases identified; and histological confirmation of the clinical diagnosis. Forty-five relevant papers were identified, of which 21 were clinic-based and 24 were population studies. All but one of the population studies was deficient. The one remaining study, while having some defects, was probably of sufficient quality to make its findings useful. An overall age-standardised prevalence of 1.27% (0.96% in men and 1.57% in women) can be calculated from this study. Only one of the studies identified for the review contained sufficient detail about its methods and of its findings to enable an estimate of population prevalence to be calculated. This did not distinguish between OLP and lichenoid reactions, however. Further, well-designed, studies with using standardised methods and criteria, are required in a number of different populations.

Epidemiological survey of oral lichen planus among HCV-infected inhabitants in a town in Hiroshima Prefecture in Japan from 2000 to 2003

The objective of our study was to evaluate the natural history of oral lichen planus (OLP) and other extrahepatic manifestations in the inhabitants of an area in Japan that is hyperendemic for hepatitis C virus (HCV) infection. Over 4 years, 224 adult inhabitants with HCV infection were examined for OLP by a single oral surgeon. All subjects were interviewed regarding the natural history of other extrahepatic manifestations they had developed. The antibodies to HCV (anti-HCV) and serum HCV RNA were determined. Anti-HCV were detected in sera from 224 subjects (100%); HCV RNA in 210 (93.8%). Of the 224, 88 had at least 1 oral examination for OLP during the 4-year period. In 2000, 2001, 2002 and 2003, OLP was observed in 8.5 (5/59), 14.8 (8/54), 20 (11/55) and 21.4% (12/56) of subjects, respectively. OLP prevalence increased as the subjects grew older. The incidence of OLP over the 4 years among all subjects with HCV infection was 17.0% (15/88, 2 men and 13 women). None experienced natural healing or the development of malignant transformations. Between 2000 and 2003, there was an increase in the prevalence of type 2 diabetes mellitus (DM), thyroid dysfunction, skin disease, renal disease and hypertension. Screening for extrahepatic manifestations should be conducted in patients with risk factors for HCV infection.

High incidence of oral lichen planus in an HCV hyperendemic area

GASTROENTEROLOGY 2000;119:882-883

Preliminary investigation of the association of oral lichen planus and hepatitis C

Objective. The aim of this investigation was to determine if an association exists between hepatitis C virus and oral lichen planus. Study Design. Three groups of subjects were selected: 505 patients with hepatitis C virus infection (group 1), 100 patients with oral lichen planus (group 2), and a randomly selected control group (age- and gender-matched) of 100 healthy subjects (group 3). The prevalence of oral lichen planus was determined in groups 1 and 3, and the prevalence of hepatitis C virus infection was established in groups 2 and 3. Results. The prevalence of oral lichen planus was 3.36% ( n = 17) in group 1 and 1% ( n = 1) in the control group; the prevalence of hepatitis C virus infection was 23% ( n = 23) in group 2, and 5% ( n = 5) in the control group. No significant differences were observed in the incidence of oral lichen planus in group 1 between those patients who received interferon and those who did not. The 17 patients in group 1 who manifested oral lichen planus and hepatitis C virus infection simultaneously exhibited a marked tendency to have only reticular lesions (70.6%), with involvement of the buccal mucosa in 88.2% of these patients, the tongue in 29.4%, and the gingiva in 11.8%. Analyzing a randomized subgroup of 143 patients from group 1 (subgroup 1) that was matched by age and gender with groups 2 and 3, we found that the incidence of oral lichen planus in patients with hepatitis C virus infection (subgroup 1) was greater than in the control group (5.59% vs 1%), though this was not statistically significant ( χ 2 = 0.119; p = 0.06). In contrast, group 2 exhibited a statistically significant higher incidence of hepatitis C virus infection (23%) than the controls (5%; χ 2 = 0.259, p = 0.0002). Conclusions. The prevalence of hepatitis C virus infection in patients with oral lichen planus was greater than in the control series. In our opinion this observation warrants the investigation of potential concomitant hepatitis C virus infection in patients with oral lichen planus.

Effect of cessation of tobacco use on the incidence of oral mucosal lesions in a 10–yr follow‐up study of 12 212 users

To study the effect of cessation of tobacco use on the incidence of lichen planus, leukoplakia and other oral mucosal lesions. A 10-yr cohort study in a rural population of Ernakulam district, Kerala, India. Some 12,212 tobacco users were interviewed and examined in a baseline survey and re-examined annually for 10 years. At each examination they were exposed to health educational programs to encourage them to quit their tobacco use. The incidence rates were calculated using person-years method among those who stopped their tobacco use and all others. A total of 77,681 person-years of observation accrued among men and 32,544 among women. Among men 6.5% of these and among women 14.4% were in the stopped category. The incidence of oral lichen planus did not show any consistent association with cessation of tobacco habits (incidence ratio 1.35) but for leukoplakia there was a substantial drop in the incidence after cessation (incidence ratio 0.31). Several other tobacco-associated oral mucosal lesions such as oral lichen planus-like lesion, smoker's palate, preleukoplakia, central papillary atrophy of the tongue and leukoedema showed either zero, or very small incidence, after cessation. The reported association between tobacco use and lichen planus appears to be indirect but for all other lesions it is direct. The cessation of tobacco use led to a substantial fall in the incidence of leukoplakia and other lesions implying a reduced risk for oral cancer after cessation of tobacco use.