Oral Lichen Planus Lesions Research Articles

HSP90 Complex From OLP Lesion Induces T-Cell Polarization via Activation of Dendritic Cells.

To investigate the effects of the heat shock protein 90 (HSP90) complex from oral lichen planus (OLP) lesion tissues on dendritic cell (DC) activation and the polarization of naïve T cells. Expression of HSP90 in OLP lesions and healthy control (HC) mucosa was evaluated by single-cell RNA sequence, IHC, qRT-PCR, and immunoblotting. HSP90 complex was extracted by immunoprecipitation from oral mucosa as the agonist of DCs. Expression of IFN-α and MHC was detected by flow cytometry. After cocultured with pre-stimulated DCs, polarization of naïve T cells was investigated by cytokine analysis. HSP90 was significantly higher in the lamina propria of OLP lesion and closely related to lymphocyte infiltration. HSP90 complex of OLP lesion activated DCs via TLR9 and increased their IFN-α secretion and MHC II expression. Pre-stimulated DCs increased the proportion of Th17 cells. HSP90 complex isolated from OLP lesion activated TLR9/IFN-α of DCs and further promoted the polarization of naïve T cells toward Th17 immunity.

Interleukin 9 in Oral Lichen Planus: an immunohistochemical study before and after treatment by intralesional steroid injection.

Oral Lichen Planus (OLP) is a chronic inflammatory mucocutaneous disorder of the oral mucosa. Th9 cells secrete IL9, which induces elevated levels of MMP9, exacerbating OLP disease severity. IL9 also increases Th17 levels in OLP lesions. This study aimed to detect IL9 tissue expression in patients with OLP compared to normal controls and to correlate its expression with disease severity and response to intralesional steroid therapy. This study involved 18 patients with OLP and 18 healthy, age- and sex-matched volunteers. The REU scoring system was used to monitor OLP lesions before and after treatment with 20mg/mL intralesional triamcinolone acetonide every 2 weeks for four sessions. Biopsies for H&E and IL-9 expression were taken from patients and controls, with repeat biopsies after the fourth session for patients. A highly statistically significant increase in IL9 expression was observed in the patient group compared with the control group. A highly statistically significant decrease in both the REU score and post-treatment IL-9 expression was detected in the patient group. We can conclude that IL9 is a tissue marker of OLP activity. Future studies on therapies targeting IL-9 in OLP are needed.

Clinical Improvement and P63-Deficiency Correction in OLP Patients After Photobiomodulation.

Background: Oral lichen planus (OLP) is a chronic inflammatory disease associated with the formation of symptomatic lesions in the mouth. P63 is essential for epidermal development and regeneration. Weak expression of this protein has been shown in OLP lesions. Photobiomodulation (PBM) therapy has been reported to reduce OLP symptoms, but its ability to correct the molecular perturbations of the disease has not been studied. This study aimed to evaluate the efficacy of PBM in OLP treatment by evaluating changes in p63 expression and their association with clinical response. Methods: Twenty OLP patients underwent PBM with a diode laser (810 nm), (0.50 W, 30 s, 1.2 J/cm2), 3 times weekly for a month. The treatment efficacy index (EI) was calculated based on pain-level values and clinical scores of lesions before and after therapy. Biopsies were taken before and after therapy, analyzed immunohistochemically for p63 expression, and compared with 10 healthy controls. Results: P63 levels in OLP lesions were significantly lower than those in normal oral mucosa. After treatment, the pain level and clinical scores of the lesions decreased significantly. The calculated EI showed PBM effectiveness in 90% of cases. Increased p63 positivity and staining intensity were observed after therapy. Conclusions: The established p63 deficiency in OLP lesions is likely an important molecular mechanism in the pathogenesis of the disease. Laser irradiation at 810 nm increased p63 expression to a level close to that found in the healthy epithelium and significantly improved the symptoms and clinical signs of OLP. All of this determines the effectiveness of PBM therapy in the management of OLP.

Expression of neutrophil extracellular trap-related proteins and its correlation with IL-17 and TNF-α in patients with oral lichen planus.

Neutrophil extracellular traps (NETs) are produced by polymorphonuclear neutrophils (PMNs) stimulated by interleukin-17 (IL-17) and tumor necrosis factor α (TNF-α). However, the level and role of NETs in oral lichen planus (OLP) remain poorly understood. This study aimed to investigate the expression of NETs in OLP and explore the correlation between NETs and the levels of IL-17 and TNF-α. The expression and distribution of NET-related proteins in tissue samples from each group were assessed using hematoxylin-eosin (HE) staining and immunofluorescence (IF). Additionally, the expression of NET-related proteins in peripheral blood samples from each group was evaluated using cell IF technique and fluorescence spectrophotometry. The relative formation level of NETs in each group was determined by fluorescence spectrophotometry via plasma co-culture. Furthermore, the levels of inflammatory cytokines IL-17 and TNF-α in plasma and culture supernatant were measured using enzyme-linked immunosorbent assay (ELISA). NET-related proteins were located in the subepithelial and lamina propria layers of OLP lesions. OLP had significantly higher expression of NET-related proteins in lesion tissues and peripheral blood compared to the healthy control (HC) group (p < 0.05). The rate of NETs formation in the erosive-stage OLP (EOLP) group was significantly higher than that in the HC group (p < 0.05), in contrast, no significant increase was observed in the non-erosive OLP (NEOLP) group (p > 0.05). Furthermore, the levels of IL-17 and TNF-α in the EOLP group were significantly elevated compared to those in the NEOLP group and HC group (p < 0.05), while the levels in the NEOLP group did not significantly differ from those in the HC group (p > 0.05). The rate of NETs formation showed a positive correlation with the levels of IL-17 and TNF-α in plasma. The expression of NET-related proteins was upregulated in OLP lesion tissues and peripheral blood. Elevated levels of IL-17 and TNF-α in peripheral blood plasma positively correlated with the rate of NETs formation, suggesting that IL-17 and TNF-α mediate the formation of NETs in OLP patients, and may thereby contribute to the development of OLP.

DAPK-1 as a Potential Early Marker for Malignant Transformation Risk of Oral Lichen Planus.

Introduction Oral lichen planus (OLP) comprises a chronic inflammatory autoimmune disease observed in the oral cavity. It most commonly manifests as white papules arranged confluently, drawing a picture of white lines in the form of a network (reticular form). It may emerge in other forms as well. In our study, the erosive form presents the most clinical interest. Among the biomarkers that participate in the tumorigenesis process, DAPK-1 seems promising, rendering its study necessary. This study focuses on the investigation of the presence of the DAPK-1 using immunohistochemistry in OLP compared to oral squamous cell carcinoma (OSCC), oral leukoplakia (OL), a well-established oral potentially malignant disorder, and normal oral epithelium to evaluate its possible role as an early predictor of the possibility of malignant transformation risk of OLP lesions. Methods To monitor the expression profile of the tumor suppressor protein DAPK-1, an immunohistochemical detection took place in 18 samples of OLP (reticular and erosive type), in 22 OSCC samples of all degrees of differentiation, in 30 OL samples of all degrees of dysplasia, and five normal tissue samples used as the control group. To complete the above procedure, immunohistochemistry was used in a semiquantative manner. The paraffin-embedded tissue samples were selected from the archives of the Department of Oral Medicine/Pathology, School of Dentistry, Aristotle University of Thessaloniki, Greece, from biopsies performed in this department as well as from St. Lukas Hospital of Thessaloniki, Greece, between 2014 and 2019. The study was conducted per the Research and Ethics Committee guidelines of Aristotle University, School of Dentistry, and the Helsinki II declaration (protocol number 29/21.11.2018). Results The statistical analysis showed that there was no statistically significant difference in DAPK-1 staining between normal tissues and OLP (p=0.588, independent-samples Kruskal-Wallis test). On the other hand, there was a statistically significant difference between OSCCs and OLPs (p<0,001, independent-samples Kruskal-Wallis test), with the extent of expression of DAPK-1 being greater in OLP than in OSCC. In addition, there was a statistical difference in DAPK-1 expression between OLPs and OLs (p=0,001, independent-samples Kruskal-Wallis test), with DAPK-1 being expressed more in OLP than in OL. Conclusion The DAPK-1, as a pro-inflammatory with its role as a tumor suppressor factor, was highly expressed in OLP, both reticular and erosive. The relatively milder expression of DAPK-1 in OL means that, between the two disorders, OLP is less likely to progress to oral cancer. On the other hand, OLP could also offer the background for further investigation of a possible correlation between methylation (immunohistochemical expression of proteins, deriving from potentially DNA-methylated genes) and the development of inflammation. It appears that DNA methylation is important in the regulation of inflammatory genes. Conversely, inflammation may regulate the DNA methylation of many genes involved in carcinogenesis and thus should be taken into account when studying the methylation behavior of genes such as DAPK-1 in pathologies characterized by a sparse inflammatory infiltrate.

Expression of Programmed Death Ligand 1 and Indoleamine 2,3-Dioxygenase in Oral Lichen Planus and Oral Lichenoid Lesions.

Oral lichen planus (OLP) and oral lichenoid lesions (OLL) are inflammatory T-cell mediated disorders of the oral mucosa (OM). Both are associated with an increased risk of oral squamous cell carcinoma, with OLL possibly having a higher rate of malignant transformation than OLP. Programmed death ligand 1 (PD-L1) and indoleamine 2,3-dioxygenase (IDO) are immunosuppressive molecules possessing inhibitory effect on T-cells and have been implicated in carcinogenesis. The aim of this study was to examine the expression of PD-L1 and IDO in OLP and OLL. Sixty-eight formalin-fixed, paraffin-embedded tissue samples diagnosed as OLP, compatible with OLP, or OLL were divided into OLP (n = 39) or OLL (n = 29) groups based on both clinical and histopathological diagnostic criteria. Samples of healthy OM (n = 9) served as controls. Samples were immunohistochemically stained for PD-L1 and IDO, and staining distribution and intensity were evaluated. Immunohistochemical expression of PD-L1 was increased in the basal and intermediate layers of epithelium in OLP and in lamina propria in both OLP and OLL compared to controls. OLP and OLL showed increased expression of IDO in epithelium and lamina propria compared to controls. PD-L1 staining intensity in the basal epithelial layer, and IDO staining intensity in lamina propria were increased in OLP compared to OLL. The results indicate that the expression of PD-L1 and IDO increases in OLP and OLL, suggesting that these molecules may play a role in the pathogenesis of both disorders.

Comparative immunohistochemical expression of Beta catenin and CD163 between dysplastic / non-dysplastic oral lichen planus and lichenoid lesions (EX-VIVO STUDY)

BackgroundOral lichen planus is a well-known chronic inflammatory mucocutaneous disorder, which has clinical and histological presentation that mimics oral lichenoid reaction. According to the fifth edition of WHO, both conditions are considered as oral potentially malignant disorders. Recent studies on oral potential disorders documented deregulation of some signaling molecules related to the Wnt/β-catenin pathway. Therefore this study aimed to compare the immune expression of β-catenin & CD163 in dysplastic /non-dysplastic cases of Oral lichen planus & oral lichenoid lesion. In addition, a statistical correlation between both immune markers was done regardless of the type of the study group.MethodsFour study groups were designated as 2 groups of Oral lichen planus (one dysplastic & one non –dysplastic) and the other 2 groups were oral lichenoid lesions (one dysplastic & one non –dysplastic). Ten cases in each group were collected and investigated by immunohistochemistry. The area percent of beta catenin and also counting of m2 macrophages expressing + CD163 marker was calculated in the study groups.ResultsThe Statistical analysis highlighted a statistically significant difference between the studied groups. Moreover, Pearson correlation test reported a significant moderate positive correlation between beta catenin & CD163 expression in the studied cases.ConclusionOur findings supported new perceptions of the mechanism by which tumor associated macrophage specific β-catenin signaling promotes the aggressive behavior of oral potential malignant disorders.Clinical relevanceEvidence of the relationship between beta catenin and M2 macrophages (+ CD163) may enhance the development of macrophage-based strategies for treatment and improve the prognosis of such cases.

Assessment of Clinical Outcomes in Patients with Oral Lichen Planus and Oral Lichenoid Lesions (OLP &amp; OLL) Following Treatment with Topical Corticosteroids

Objective: To assess the clinical outcomes in patients with oral lichen planus and oral lichenoid lesions (OLP &amp; OLL) following treatment with topical corticosteroids. Methodology: A total of 175 patients diagnosed with OLP and OLL were recruited from the outpatient department. This cross-sectional study was conducted at Institute of Dentistry (IOD) &amp; CMH, Lahore from July 2023 to December 2023. Inclusion criteria included patients aged 18 years and above with clinically and histopathologically confirmed OLP or OLL lesions. All enrolled patients received topical corticosteroid therapy according to a standardized protocol. Patients were instructed on proper application techniques and advised to adhere to the prescribed treatment regimen. Clinical evaluation of the oral mucosal lesions was performed at baseline and at regular follow-up. Outcome measures included changes in lesion size, severity of symptoms (pain, burning sensation), and overall improvement in clinical appearance. Results: The mean age of the patients was 52.4 years (SD: 10.3). In terms of gender distribution, among the included patients 25 patients (28.57%) were male and 25 patients (71.42%) were female. Among the symptoms observed, Pain was reported by 95 patients (54.28%), Burning Sensation by 110 patients (62.85%), Discomfort by 75 patients (42.85%), and Other symptoms by 20 patients (11.42%). In the clinical outcomes observed with topical corticosteroids, reduction in lesion size was noted in 140 patients, accounting for 80.0%, complete resolution of lesions occurred in 60 patients, representing 34.3%, and reduction in symptoms was reported by 155 patients, constituting 88.6%. Oral candidiasis was noted in 7 patients (4.0%), Mucosal atrophy occurred in 13 patients (7.42%), whereas the majority. Conclusion: In conclusion, our study underscores the efficacy of topical corticosteroid therapy in managing oral lichen planus (OLP) and oral lichenoid lesions (OLL). With 80.0% of patients experiencing a reduction in lesion size, 34.3% achieving complete resolution of lesions, and 88.6% reporting a reduction in symptoms, our findings highlight the significant therapeutic benefits of topical corticosteroids.

Cancer Stem Cell Marker CD147 Expression in Erosive Oral Lichen Planus Compared to Moderately and Severely Dysplastic Leukoplakia

Oral lichen planus is a frequent, chronic autoimmune disease that affects the oral mucosa and is characterized as an oral potentially malignant disorder. The aim of our study is to examine the presence of CSCs bearing CD147 (a marker related to local inflammation and associated with various cancers) through immunohistochemistry in oral lichen planus (OLP) compared to oral leukoplakia (OL) and healthy tissues. These findings could contribute to clinical practice by providing a marker for the prognostic assessment of OLP lesions with regards to their potentially malignant nature. The study sample consisted of paraffin-embedded oral mucosa specimens from the archives of the Department of Oral Medicine/Pathology, School of Dentistry, Aristotle University of Thessaloniki, Greece during the period 2009–2019. The study sample contained 24 cases of OLP (14 erosive and 10 reticular) and 30 cases of oral leukoplakia, which were compared to 5 normal oral epithelium samples derived from healthy epithelium adjacent to fibromas from other cases. Cell membrane staining of CD147 was observed mostly in the basal and parabasal cell layer. The statistically significantly higher expression of CD147 in the erosive lichen planus subgroup than in the moderately and severely dysplastic leukoplakia subgroup (p = 0.01) constituted the most important finding of this study. The characteristic expression of CD147 in erosive OLP suggests the presence of epithelial cells with CSC characteristics, but its lower expression in oral leukoplakias suggests a more intense relation of the CD147 marker with inflammation rather than with oral dysplastic progression.

Oral lichen planus and lichenoid lesions: etiopathogenesis, diagnosis and treatment.

Oral lichen planus and lichenoid lesions: etiopathogenesis, diagnosis and treatment.

B Cells Infiltration Potentially Responded Better to Systemic Corticoids in Oral Lichen Planus and Oral Lichenoid Lesions.

Oral lichen planus (OLP) and oral lichenoid lesion (OLL) are chronic inflammatory diseases involving the oral mucosa. B cells infiltration in OLP and OLL, however, little is known about these cells in OLP and OLL. To analyze the function and infiltrating features of B lymphocytes in OLP and OLL, and to preliminarily evaluate their correlation with clinical outcomes. Tissue samples were collected from OLP, OLL, and healthy mucosa. The phenotypes and amounts of B cells in tissues were analyzed by single-cell sequencing. Their proportion and infiltrating features in tissues were examined by immunohistochemistry and immunofluorescence. With the systemic medication of corticoids, the correlation between B cells infiltrating characteristics and the clinical outcomes were evaluated. A quantified proportion increase of B cells was shown in both OLP and OLL. B cells in OLP demonstrated heightened activation and enhanced regulation in immune response. A cohort of 100 patients with OLP/OLL and 13 healthy controls were examined to investigate the B cells infiltration pattern. B cells were distributed in the superficial layer of lamina propria in 92.9% and 41.9% of OLP and OLL, respectively(P < 0.01); focally distributed in 25.0% and 62.9% of OLP and OLL, respectively(P < 0.01). With the systemic medication of corticoids, the cases with B cell infiltration (B+) in OLP and OLL groups showed a statistically significant reduction in REU scores before and after treatment (P < 0.01). B cells are widely present in OLP and OLL, and B cell infiltration in OLP and OLL are related to the better therapeutic effect of oral corticoids.

Systemic associations of oral lichen planus and oral lichenoid lesions, a retrospective case-control study of 301 patients

Systemic associations of oral lichen planus and oral lichenoid lesions, a retrospective case-control study of 301 patients

Salivary Histamine Levels in Patients with Oral Lichen Planus Lesions.

Background and Objectives: An oral lichen planus (OLP) chronic lesion refers to a group of oral potentially malignant disorders (OPMDs) that still lack a proper understanding from the point of view of relevant biomarkers for diagnostics and prognosis. The aim of the study was to assess the salivary histamine levels in patients with oral lichen planus lesions. Materials and Methods: The study included a group of 76 patients with oral lichen planus. General diseases and medication taken, smoking habits, severity of pain assessed using a visual analogue scale (VAS), oral hygiene status, and duration of OLP were evaluated. ELISA diagnostics for histamines in saliva levels were assessed. Results: The histamine levels in the OLP group were higher (0.468) in comparison with the control group (0.056), without a statistically significant value p = 0.090 (Mann-Whitney U Test). The median age of 76 OLP patients was 63 years (min 22.0-max. 81), with the biological sex being 80.3% females and 15 19.7% males. The average duration of OLP lesion presence was 29.4 months (SD 37.1) and the median value was 14.5 months. The median of the VAS was 3.0. OLP assessment in accordance with the Malhotra methodology showed the highest frequency-30.3% for only two of the point areas involved and 17.1% for three points. Clinical assessment of the different OLP grades, severity, and oral site involvement and the VAS in correlation with histamine salivary levels showed a lack of statistical significance in the investigated population. Conclusions: Undertaking further research could provide further possibilities for searching for general factors in OLP development.

Clinical and mycological analysis of colonization by Candida spp. in oral leukoplakia and oral lichen planus.

This study aims to analyze the prevalence of Candida spp. colonization in oral leukoplakia and oral lichen planus lesions, verify the influence of systemic and local factors, besides identify and determine the in vitro antifungal susceptibility profile of Candida species. Samples were collected by swabbing from oral lesions and healthy mucosa and cultured on Sabouraud Dextrose and CHROMagar® Candida plates. Species identification was confirmed with MALDI-TOF MS analysis. Candida spp. was found in 36.8% of cases of oral leukoplakia and 18.2% of cases of oral lichen planus. Candida albicans was the only species found in oral lichen planus lesions (n = 2, 100%) and the most prevalent in oral leukoplakia (n = 5, 76.4%). Among the non-albicans Candida species found in oral leukoplakia were C. parapsilosis (n = 2, 25.5%) and C. tropicalis (n = 1, 14.1%). Candida isolates were susceptible to all antifungals tested. C. albicans was the most commonly found species in the studied lesions. No correlation was found between systemic and local factors with positive cases of oral lichen planus. However, smoking and alcohol consumption may be associated with positive cases of oral leukoplakia, especially the non-homogeneous clinical form. In addition, there is a possible predisposition to associated Candida colonization in cases of epithelial dysplasia found in oral leukoplakia. The antifungal medications tested showed excellent efficacy against isolates.

Upregulation of psoriasin/S100A7 correlates with clinical severity in patients with oral lichen planus

ObjectivesThe aim of this study was to: (1) investigate the expression patterns of antimicrobial peptides (AMPs), specifically psoriasin (S100A7) and calgranulin A and B (S100A8/A9), in patients with oral lichen planus (OLP) compared to healthy individuals; (2) evaluate the oral health-related quality of life (OHrQoL) in OLP patients versus healthy controls; (3) investigate the impact of clinical severity of OLP on OHrQoL; and (4) assess the influence of AMP expression on clinical severity and OHrQoL in OLP patients.Materials and methodsOral mucosal biopsies (n = 38) were collected from healthy individuals (n = 17) and patients with OLP (n = 21). Levels of AMPs (S100A7, S100A8, S100A9) and pro-inflammatory cytokines interleukin-8 (IL-8) and tumor necrosis factor alpha (TNFα) were assessed by RT-qPCR. AMP protein localization was identified by indirect immunofluorescence analysis. OHrQoL was assessed using the OHIP-G14 questionnaire, and clinical severity was evaluated with the Oral Disease Severity Score (ODSS). Correlations between OLP manifestation, OHrQoL, and AMP expression were evaluated.Results(1) S100A7 (p < 0.001), IL-8 (p < 0.001), and TNFα (p < 0.001) mRNA levels were significantly upregulated in OLP tissue compared to healthy tissue, while S100A8 (p < 0.001) and S100A9 (p < 0.001) mRNA levels were downregulated. Immunofluorescence staining revealed an enhanced expression of S100A7 and decreased protein expression of S100A9 in OLP tissue. (2) OLP patients (9.58 ± 8.32) reported significantly higher OHIP-G14 scores compared to healthy individuals (0.67 ± 0.87; p < 0.001), particularly in the categories “physical pain” (p < 0.001) and “psychological discomfort” (p = 0.025). (3,4) Clinical severity (25.21 ± 9.77) of OLP correlated positively with OHrQoL (ρ = 0.497) and psoriasin expression (ρ = 0.402).ConclusionsThis study demonstrated differential expression patterns of AMPs in OLP and highlighted the correlation between the clinical manifestation of OLP and OHrQoL. Further research approaches should address the role of psoriasin in the risk of malignant transformation of OLP.Clinical relevancePsoriasin is a putative biomarker to monitor disease severity including malignant transformation of OLP lesions. OHIP-G14 scores can be useful to monitor OHrQoL in OLP patients.

Corticosteroids and Immunosuppressants on Oral Lichen Planus’ Treatment

Dear Editor, Lichen planus (LP), a chronic inflammatory condition primarily targeting skin and mucous membranes, was first outlined by Wilson in 1869 and histologically by Dubreuilh in 1906 [1]. It predominantly affects women in their 4th and 5th decades [2]. Oral lichen planus (OLP) occurs mainly on the buccal mucosa, gingiva, and tongue, presenting in six types, with erosive ones causing eating discomfort. While 25% of LP cases manifest solely orally, some lesions can appear in areas like the anogenital region and esophagus [2]. OLP is postulated to be a T cell-mediated response to antigens, with potential ties to chronic liver diseases and higher prevalence in regions like Japan and Southern Europe [3]. Comorbidities like diabetes, hypertension, and stress may also contribute [4]. Dental materials can mimic OLP, and specific drugs, including NSAIDs and beta-blockers, might induce it in some individuals [5]. Asymptomatic OLP lesions generally need no treatment. For symptomatic forms, treatment targets symptom alleviation and lesion removal, primarily using topical corticosteroids. Resistant lesions may require intralesional or systemic corticosteroids, with alternatives like immunosuppressives, retinoids, antifungals, and metronidazole also being effective [6]. OLP has a premalignant nature with a 0.4-1.74% risk of turning malignant, typically from its atrophic or erosive form [7]. Treatment aims to alleviate pain, heal ulcers, minimize cancer risks, extend symptom-free periods, and uphold oral health. This report presents intralesional corticosteroid therapy for three patients with symptomatic OLP, presenting symptoms like pain and burning.

Factors involved in the remission of oral lichen planus treated with topical corticosteroids

AimTo determine the factors that affected the complete clinical remission of oral lichen planus (OLP) treated with topical corticosteroids.Material and methodsWe retrospectively evaluated the charts of patients diagnosed as OLP. Age, sex, current medical conditions, medications, type of OLP, Thongprasom score, pain level assessed by a numeric rating scale (NRS), Candida infection, topical steroid treatment preparation, duration of treatment until the first complete clinical remission, and follow-up duration were assessed as variables.ResultsIn total 100 patients, after complete remission, 22 patients reported a relapse within 1.5–45 months, with a mean of 15.6 ± 13.2 months. Age, duration, gingiva and vestibule area, hypertension, dyslipidemia, Thongprasom score, preparation and topical corticosteroid potency were factors affecting the remission. Multivariate logistic regression analysis revealed that the patients’ age and duration of treatment were significant factors after adjusted for age, sex, and independent factors with a P-value < 0.1 in the univariate analysis. The likelihood of having incomplete remission of the OLP lesion increased by 7.9% for every year increase in age and increased by 2.3% for every month of treatment.ConclusionsThere are many different factors between the complete remission and incomplete remission groups. However, age and duration of treatment were significant factors affecting the remission of OLP.

Evaluation of Turmeric, Ashwagandha, and Aloe Vera in the Management of Oral Lichen Planus Lesion.

This study was conducted to evaluate the efficacy of turmeric, ashwagandha, and aloe vera in the management of oral lichen planus (OLP) lesion. Thirty patients with histologically confirmed symptomatic OLP with gingival presentation were included in this comparative investigation. Three groups of participants were created: Group I consisted of turmeric; group II included ashwagandha; and group III included aloe vera. For 3 weeks in a row, they were told to apply topical treatments twice a day. The patients were recalled for 4 to evaluate the cessation of symptoms. The participants in all the groups showed a considerable improvement in the burning lesion size and pain after 4 months of follow-up. For the treatment of OLP, turmeric, ashwagandha, and aloe vera can be useful as substitute topical medications, particularly for those who are not responsive to topical corticosteroids.

COVID-19 and its possible association with oral lichen planus: An institutional experience

Introduction: Lichen planus is a chronic mucocutaneous disease that may affect the skin or any other mucosal surface. Although the etiology is largely unknown, role of stress in initiation or aggravation of the disease is a well-known fact. Apart from respiratory distress, COVID-19 has also been found to be associated with triggering autoimmune reactions such as oral lichen planus (OLP). Apart from its direct ill effect on health, the confusing nature, and the unknown course of COVID-19, the psychological stress of the lockdown and quarantine tremendously increased the stress levels. All this could be a trigger for the onset or exacerbation of existing OLP lesions. Objective: The primary outcome is to understand the likely association between OLP and COVID-19. The secondary outcome is to understand the role of COVID-19 in the pathogenesis of OLP if it is present. Materials and Methods: It was a unicentric cross-sectional study conducted on 57 patients suffering from OLP who had reported to the dental outpatient department of our tertiary health care center from September 2021 to April 2022. The clinical sign and symptoms associated with the OLP was recorded. A detailed history of COVID-19 exposure, vaccination status, and history of hospitalization were recorded. Results: The mean age of study participants was found to be 36.8 years the male:female ratio was found to be 1:2. Out of 57 patients, 45 patients had given a positive history of COVID-19 exposure. Conclusion: Apart from the immune dysregulation, the tremendous increase in stress levels due to COVID-19 has impacted everyone’s life very badly. The sudden increase in cases of OLP in post-COVID patients may be attributable to a combination of factors such as low Vitamin D levels COVID-19 and other comorbidities.

Oral lichen planus and lichenoid lesions - challenges and pitfalls for the general dental practitioner

Lichen planus is a chronic, mucocutaneous inflammatory condition which, due to its prevalence, will be familiar to the dental profession. However, diverse forms of presentation, important differential diagnosis, potential malignant change and monitoring requirements often result in challenges for those in primary care. This paper looks to examine these challenges and provide information to support those who are involved in recognition and management of patients with lichen planus.