mRNA and lncRNA expression profiles as potential targets for diagnosis and treatment of oral lichen planus.

To assess the effectiveness of photobiomodulation therapy for managing oral lichen planus (OLP) and recurrent aphthous stomatitis (RAS), including their outcomes and patient satisfaction with the safety profile. A systematic review was conducted by searching electronic databases like PubMed Central, PubMed, Cochrane, CrossRef, Google Scholar, and Embase. Articles published until June 2025 were reviewed using MeSH (Medical Subject Heading) and various combinations of the keywords: oral lichen planus, Recurrent Aphthous Stomatitis, photobiomodulation therapy, and conventional drug therapy. We considered two different outcomes, such as pain and the size of the lesion. Due to the heterogeneity of the data, we did not conduct any statistical analysis. Initially, 560 publications were selected for this review article, and after analyzing all these, only 12 articles fulfilled the inclusion and exclusion criteria. In all those studies, the laser wavelength, power output, and duration of irradiation changed between 630-980 m, 20-30 mW, and 10 sec-15 min have been described. Topical medications used in the comparative group were amlexanox, triamcinolone acetonide, granofurin, and socosenyl. Our findings showed that the photobiomodulation laser group is more effective for decreasing the pain and lesion size of RAS and OLP in comparison with the topical medication group. We can conclude that photobiomodulation therapy was better for treating RAS and OLP with greater healing, patient satisfaction, and lower recurrence rate in comparison with other topical drug therapies.

Oral lichen planus (OLP) is a chronic autoimmune disorder of the oral mucosa that often requires long-term treatment due to its relapsing nature. While corticosteroids remain the first-line therapy, refractory cases necessitate alternative treatments. Cyclosporine, an immunosuppressant, has shown potential efficacy in OLP management, but lacks comparative studies with oral prednisolone, a commonly used systemic corticosteroid. To compare the efficacy and safety of oral cyclosporine versus oral prednisolone in managing refractory oral lichen planus. A prospective, randomized, controlled trial was conducted at a tertiary care hospital in eastern India, enrolling patients with refractory OLP. Participants were randomly assigned to receive either oral cyclosporine or oral prednisolone. Efficacy was evaluated using improvement in the oral disease severity score (ODSS), dermatology life quality index (DLQI), and visual analogue scale (VAS), while safety was assessed by monitoring adverse events, laboratory markers, and patient tolerance. Both treatment groups showed significant improvement in ODSS and DLQI scores ( P < 0.05). The cyclosporine group had a 92.7% reduction in ODSS compared to 88.8% in prednisolone group( P =0.03), while DLQI improved by 84.8% versus 78.08% ( P =0.04). Prednisolone was associated with higher rates of hyperglycemia and hypertension, whereas cyclosporine posed a risk of nephrotoxicity and relapses. A short follow-up period and a small sample size were limitations. To conclude, cyclosporine appears to be an effective and safe alternative to prednisolone, warranting further studies with a larger sample size and extended follow-up.

To evaluate the prevalence of mood disorder symptoms and measure the quality of life in women with vulvar dermatoses attending a specialized vulvar clinic in southern Sweden. A questionnaire-based study among consecutive women attending the vulvar unit at the Department of Dermatology and Venereology at Skåne University Hospital. Sociodemographic factors were collected; depression and anxiety were assessed with the Hospital Anxiety and Depression Scale (HADS) and health-related quality of life with the EQ-5D VAS. In all, 217 of 242 women participated (response rate 90%). Data was collected from March 2020 to January 2023. The largest diagnostic group was lichen sclerosus (62%), followed by lichen planus (9.2%) and pain disorders (5.5%). Symptoms of depression and anxiety were highest among women with pain disorders (n=12, anxiety symptoms 58.3%, depression symptoms 20%), followed by Candida vulvovaginitis (n=7, anxiety symptoms 57.2%, depression symptoms 0.0%) and pruritus vulvae (n=7, anxiety symptoms 42.9% and depression symptoms14.3%). Differences between these groups were not significant. The mean EQ-5D VAS score was 69.7±19.7. Women with pain disorders, Candida vulvovaginitis, and pruritus vulvae showed the highest levels of mood symptoms. These findings support the importance of assessing mood symptoms and quality of life in the management of women with vulvar disease.

Pediatric dermatoses presenting as follicular papules are common entities encountered in clinical practice. These are a heterogeneous group of disorders of infectious or noninfectious origin that commonly present as regularly spaced, small papules with or without perifollicular inflammation. Inflammatory causes include follicular eczema, pityriasis rubra pilaris, lichen nitidus, follicular seborrheic dermatitis, keratosis pilaris and its variants, keratosis circumscripta, follicular psoriasis, lichen spinulosus, follicular lichen planus, follicular mucinosis, perforating folliculitis, follicular porokeratosis, and follicular dermographism. These conditions may arise due to filaggrin mutations, keratinization defects, autoimmunity, or microbial triggers. Nutritional causes include phrynoderma and scurvy, while connective tissue diseases such as dermatomyositis and chronic cutaneous lupus erythematosus are autoimmune. Additional categories include infectious, genetic, hormonal, environmental, frictional, malignant, nevus-related, iatrogenic, and idiopathic entities. An early and accurate diagnosis is essential for proper management and reducing disease-associated apprehension in children and/or their parents. This review attempts to describe the role of history taking and clinical examination, including morphology, location, pattern of distribution, and associated features, while dealing with a child with follicular-based papules. In addition, it delineates the role of dermoscopy and pathological examination in reaching a correct diagnosis. Furthermore, it describes the available treatment options and disease course of various follicle-based dermatoses.

Clinical and Dermoscopic Characteristics of Facial Hyperpigmentation Disorders in Skin of Color.

We report a patient with a rare case of radiation-induced lichen planus (LP) confined to the irradiated breast area following radiotherapy for breast cancer. The clinicopathological features and temporal association supported the diagnosis of radiation-induced LP, with complete resolution following corticosteroid treatment. Our patient’s case indicates that radiation-induced LP is a distinct immune-mediated dermatosis and suggests that ionizing radiation may not only cause direct tissue damage but also influence local immune regulation, potentially predisposing a patient to cutaneous autoimmunity.

Early diagnosis of oral squamous cell carcinoma (OSCC) is critical, yet most oral potentially malignant disorders (OPMDs) are benign, and patients frequently undergo unnecessary invasive scalpel biopsies, creating diagnostic delays and patient harm. A rapid, non-invasive molecular diagnostic tool could improve early detection and reduce unnecessary procedures. This study aims to determine whether a previously validated microbiopsy-based multigene assay (qMIDSV2) could be adapted into a rapid, non-invasive brush biopsy test (qMIDSV3) for accurate OSCC detection. A prespecified hypothesis was that qMIDSV3 could distinguish OSCC from low-risk OPMD and contralateral normal mucosa with high diagnostic sensitivity. This prospective diagnostic case-control study validated a multigene mRNA test (qMIDSV3) for OSCC detection using 1090 oral brush biopsies from 545 patients. Each patient provided paired brush biopsies from oral lesion and contralateral non-lesion mucosa, including OSCC (n = 443), oral leukoplakia (OL; n = 63), and oral lichen planus (OLP; n = 39). qPCR quantified mRNA levels of four genes (INHBA, S100A16, YAP1, POLR2A) from each brush biopsy, and an algorithm generated a malignancy index for cancer risk stratification. qMIDSV3 distinguished OSCC from OL and OLP with AUC 0.975, sensitivity 95.7%, specificity 95.1%, and overall accuracy 95.5%. False-positive and false-negative rates were 4.9% and 4.3%, demonstrating high specificity for detecting malignant cells rather than premalignant or inflammatory lesions. Our findings highlight the clinical utility of qMIDSV3 as a rapid case-finding or triage test, potentially sparing over 90% of low-risk OPMD patients from unnecessary invasive tissue biopsies while accurately identifying OSCC cases. Non-invasive brush biopsy allows safe, repeatable sampling for long-term surveillance with minimal patient harm and enhancing early oral cancer detection. By reducing unnecessary scalpel biopsies and specialty referrals, qMIDSV3 provides a molecularly guided and rapid triage pathway.

Proteomic profiling offers thorough insights into protein structure and function, as well as it acts as an essential approach for analyzing molecular changes at the tissue level. However, because of the proteome's diversity and dynamic nature, biomarker discovery remains challenging. By combining proteomics with bioinformatics, the level of understanding in relation to molecular interactions and disease processes can be improved. Through an integrative approach, few limitations can be addressed, thereby promoting proteomic profiling for the discovery of new therapeutic targets and novel biomarkers for a variety of disorders. To identify differentially expressed protein markers and their key molecular pathways associated with Oral Potentially Malignant Disorders. Systematic Review was conducted following the PRISMA guidelines and the protocol registered in the International Prospective Register of Systematic Reviews (PROSPERO) with the registration ID number CRD42024557545. A comprehensive literature review was performed using electronic databases, yielding 12,797, studies from which 15 eligible articles were selected. The Newcastle-Ottawa Scale was used to assess the risk of bias. Vote counting was performed to identify proteins reported in more than one study. A bipartite network was constructed using Cytoscape to identify shared and disease-specific protein markers. Lesion-wise protein-protein interaction networks were generated using STRING and analysed in Cytoscape to identify highly interconnected hub proteins, and pathway enrichment analysis for these hubs was performed using Reactome. A total of fifteen studies (Leukoplakia (LK) - n = 1, Proliferative Verrucous Leukoplakia (PVL) - n = 2, Oral Submucous Fibrosis (OSMF) - n = 7, and Oral Lichen Planus (OLP) - n = 5) were included. The Newcastle-Ottawa Scale was used to evaluate methodological quality and the quality of studies included in this systematic review was high for 4 articles and moderate in the remaining 11. The most commonly employed technique was mass spectrometry. A total of 318 candidate proteins (LK - 14, PVL - 82, OSMF - 172, and OLP - 50) were identified across the oral potentially malignant disorders. Key markers identified through vote counting included ERO1A, NUCB1, RHOA, and IL36A for PVL; LUM, KRT1, KRT9, ALB, and VIM for OSMF; and ALB, LYZ, HP, HBB, and AMY1A for OLP. The bipartite network showed that OSMF and OLP shared the highest number of proteins, indicating the strongest overlap among lesions. Network analysis further highlighted distinct hub proteins for each lesion: for LK- AMY1A, AMY1B and APOA1; for PVL- CFL1, RHOA and CDC42; for OSMF- HSP90AA1, ENO1 and SERPINA1; and for OLP- HP, B2M, and ORM1. Lesion-specific pathway enrichment revealed that LK was associated with epithelial differentiation, PVL with oncogenic signaling, OSMF with stress-driven fibrosis, and OLP with immune-mediated inflammation. Proteomic expression offers insights into disease pathogenesis by identifying important molecular changes across OPMDs. However, the majority of biomarkers are still in the exploratory stage due to the considerable variation in lesion types, sample sources, proteomic techniques, and reporting systems. In order to create reliable and clinically applicable biomarkers, future studies should concentrate on combining multi-omics techniques with large-scale, standardized cohorts.

The microbial contribution to desquamative gingivitis (DG), a frequent and debilitating form of immune-mediated oral lichen planus (OLP), remains undefined. This study employed shotgun metagenomic sequencing to investigate the role of the oral microbiome in DG site involvement and severity, as well as OLP disease activity. In this exploratory, cross-sectional study, supragingival plaque samples were collected from nine OLP patients at desquamative gingivitis-affected sites (DG sites), sites not affected by desquamative gingivitis (non-DG sites), and pooled full-mouth samples. Shotgun metagenomic sequencing was performed to reveal oral microbial profiles and their functional pathways. Disease severity was assessed using the Oral Lichen Planus Disease Activity Scale (OLP-DAS) and the Desquamative Gingivitis Clinical Score (DGCS). Associations between microbial profiles and disease severity were assessed using Spearman's correlation. Microbial and functional pathway profiles were compared between DG and non-DG sites using the paired Wilcoxon signed-rank test. A p-value <0.05 was considered statistically significant. Significant differences in microbial composition between DG and non-DG sites were identified, including 6 genera and 17 species (p < 0.05). Several taxa showed notable correlations with disease severity (r ≥ 0.7), according to DGCS, with 10 genera and 16 species positively associated with DGCS, and 5 genera and 8 species associated with OLP-DAS. Notably, the fructan biosynthesis pathway showed a significant inverse correlation with DG severity (r = - 0.70, p < 0.05) and was linked to Actinomyces sp. oral taxon 448, which was enriched in DG sites. This suggested that increasing disease severity may be associated with reduced microbial polysaccharide-production potential. The DG microbiome shows distinct functional and taxonomic changes. Fructan biosynthesis was more abundant in DG sites than in non-DG sites, but showed an inverse correlation with DG severity, highlighting candidate biomarkers and potential therapeutic targets.

We report a novel poly-(ethylene) glycol (PEG) hydrogel bead-based assay that permits measurement of protein biomarkers in complex samples such as saliva without sample processing and with limits of detection and dynamic range that are comparable or better than the current gold-standard, enzyme-linked immunosorbent assay (ELISA) without requiring detection antibodies and enzyme amplification. Additionally, in comparison to ELISA, the analysis time is >2 times shorter and the workflow is simpler. The PEG-based hydrogel beads preconcentrated protein biomarkers by covalent capture and in parallel removed interferent proteins by molecular weight cutoff without being affected by salts. The captured proteins were fluorescently labeled during their photochemical release from hydrogel beads. The released proteins were bound to immobilized antibodies and fluorescence was measured to determine their concentrations. Using the reported hydrogel beads, we measured proteins such as interleukin 6 (IL6) and interleukin 8 (IL8) at pg/mL concentrations in 200 μL of unprocessed saliva in ∼100 min. We applied the hydrogel beads to measure IL6 and IL8 in minimally stimulated saliva of oral lichen planus (OLP) patients and healthy individuals.

Genetic architecture of 67 oral diseases and their links to systemic diseases.

Oral lichen planus (OLP) is a chronic inflammatory disorder mediated by cellular immunity. Xerostomia is not a typical feature but has been reported by a subset of patients and may reflect underlying salivary gland alterations. The mechanisms contributing to xerostomia in OLP remain unclear. This study evaluated the levels of autoantibodies against the muscarinic M3 receptor (anti-M3R Ab) in the labial minor salivary glands, saliva, and serum of OLP patients with xerostomia and compared them with those of healthy controls. In this case-control study, unstimulated whole saliva, serum samples, and labial minor salivary gland biopsies were obtained from 35 patients with OLP and xerostomia and 25 healthy controls. Anti-M3R Ab levels were measured using enzyme-linked immunosorbent assay (ELISA). Statistical analyses included Mann-Whitney U test, Spearman correlation coefficients, and multiple logistic regression. Anti-M3R Ab levels were significantly reduced in minor salivary gland tissue of OLP patients compared with controls. Lower anti-M3R Ab levels in minor salivary glands were statistically associated with higher xerostomia scores and lower unstimulated salivary flow rates. Correlation analyses showed a significant inverse relationship between glandular anti-M3R Ab levels and xerostomia severity. The reduction of anti-M3R Ab within minor salivary gland tissue may represent a localized immunological alteration contributing to xerostomia in OLP. These findings underscore the importance of localized, rather than systemic, immune mechanisms in the salivary gland dysfunction observed in OLP.

ABSTRACTBackgroundOral lichen planus (OLP) is a chronic inflammatory mucocutaneous disease that may affect oral health parameters. This study examined the relationships between periodontal status, dental health, and oral health‐related quality of life (OHRQoL) in patients with reticular and nonreticular OLP.MethodsThis cross‐sectional observational study included 112 patients from the Department of Cranio‐Maxillofacial Surgery with histopathologically confirmed OLP. Periodontal status was assessed using the periodontal screening index (PSI), dental health was assessed using the decayed, missing, filled teeth (DMFT) index, and OHRQoL was assessed using the German Oral Health Impact Profile 14 (OHIP‐14). Patients were stratified into reticular and nonreticular OLP groups. Analyses were exploratory and based on group comparisons and correlation statistics.ResultsPatients with nonreticular OLP demonstrated significantly higher PSI scores than those with reticular OLP (p < 0.01), indicating poorer periodontal health. DMFT scores did not differ between groups. OHRQoL was significantly impaired in patients with nonreticular OLP (OHIP‐14: 15.55 ± 10.60 vs. 11.06 ± 10.88; p = 0.02). The OHIP‐14 showed a moderate association with the PSI and a weak association with the DMFT.ConclusionsThe clinical subtype of OLP is associated with differences in periodontal status and OHRQoL. Further longitudinal studies are required. These findings suggest that oral health conditions may be worth considering in the clinical management of OLP patients.Trial RegistrationThe study was prospectively registered (Ref. No. 2019‐033.f‐S) in accordance with institutional ethical requirements.

To evaluate the efficacy and safety of apremilast use in various types of lichen planus (LP) and its association with demographics, dosage, and duration. PubMed, EMBASE, and Cochrane CENTRAL were searched for articles that reported apremilast use in any form of LP from inception to July 2024. Eighteen articles were identified, of which 6 studies (17 patients) met the eligibility criteria. Demographic details, type of LP, prior therapies, concomitant therapies, dose and duration used, efficacy and adverse effect profile, and reasons to stop apremilast. Among 17 patients included, 12 (71%) were female, and oral LP was the most common subtype (88%). Forty-one percent of all patients, including 5/15 (33%) oral and 1/1 (100%) oral + cutaneous and 1/1 (100%) esophageal LP patients, achieved remission. Disease progression (29%) was the major reason for treatment discontinuation. No life-threatening adverse effects were reported. Among patients who achieved remission, most were female (7/7) and required treatment for <6 months (6/7); the majority (6/7) did not need concurrent therapy and experienced minimal adverse effects. Relapse and long-term follow-up data were not available. Apremilast appears to be a promising monotherapy for LP, particularly for oral LP in patients who have not responded to multiple treatments. It is generally well tolerated, with a favorable safety profile. However, heterogeneity in dosing, limited follow-up data, and small sample size necessitate further studies to establish apremilast's role in LP management.

Background and Aim:Oral lichen planus (OLP) is a chronic inflammatory disease that can show potential for malignant transformation, unlike cutaneous lichen planus (CLP). The exact molecular reasons behind this difference are not well known. This study aimed to evaluate the expression of 3 biomarkers namely MDM2, SOX2, and Ki-67 in OLP and CLP to assess their relationship with cell proliferation and possible malignant potential.Methods:This retrospective study was carried out at Sina Hospital in Tabriz, Iran, from April 2022 to June 2023. Fifty paraffin-embedded tissue samples were analyzed, including 25 oral and 25 cutaneous lichen planus cases. Sections were stained immunohistochemically for MDM2, SOX2, and Ki-67. Two pathologists, blinded to patient information, evaluated the slides. Expression was classified as negative, low, or high. Data were analyzed in SPSS version 26 using descriptive statistics and Fisher’s Exact Test, with a P-value ⩽ .05 considered significant.Results:In CLP, all samples were negative for Ki-67, while SOX2 and MDM2 were positive at low levels in only 8% of cases. In OLP, Ki-67 was low in 16%, SOX2 in 20%, and MDM2 was high in 40% of samples. A significant correlation among the 3 markers was seen in OLP (P < .001), but not in CLP. SOX2 expression differed significantly between erosive and non-erosive OLP (P = .047).Conclusion:OLP, especially its erosive form, shows higher molecular activity compared with CLP. The coordinated expression of MDM2, SOX2, and Ki-67 supports their role in cell proliferation and malignant potential. MDM2, in particular, may serve as an early indicator for identifying OLP cases at higher risk of malignant transformation.

Salivary aldehyde dehydrogenases (ALDHs), particularly ALDH3A1, are increasingly recognized as potential contributors to oral defense against aldehyde-associated stress at the oral-environment interface. Unlike freely secreted salivary enzymes, measurable salivary ALDH activity primarily reflects intracellular and vesicle-associated enzymes derived from salivary gland epithelial cells, oral mucosal cells, immune cells, and exfoliated cellular components. Within the oral exposome, ALDHs expressed in oral epithelial and salivary gland tissues participate in the detoxification of reactive aldehydes, while salivary ALDH activity may serve as an indicator of local aldehyde-detoxification capacity and tissue redox status. Beyond aldehyde metabolism, emerging evidence suggests that ALDH-associated pathways are linked to redox regulation, epithelial stress adaptation, inflammatory signaling, and tissue repair through NAD(P)+-dependent processes and stress-responsive networks such as Nrf2 and SIRT1. This review provides a saliva-focused synthesis of ALDH biology, emphasizing isoform-specific functions and the potential importance of ALDH3A1 in oral epithelial defense. Altered salivary ALDH activity has been reported in association with oral conditions including periodontitis, oral lichen planus, radiation-induced salivary dysfunction, and oral squamous cell carcinoma (OSCC). Genetic factors, particularly ALDH2 polymorphisms, together with environmental exposures and microbial dysbiosis, may further influence aldehyde burden and oral disease susceptibility. Although current evidence supports the biological relevance of salivary ALDHs, their utility as clinical biomarkers or therapeutic targets remains investigational and requires further mechanistic and clinical validation.

Immune Checkpoint Inhibitor-Associated Autoimmune Bullous Disease: A Clinical Review.

The goal was to determine the incidence and risk factors of malignant transformation of oral lichen planus (OLP); oral lichenoid lesions without (OLL) or oral dysplasia with lichenoid features (ODLF). We identified a retrospective cohort of 188 patients with a pathological diagnosis of OLP, OLL, or ODLF, and a minimal 12-month follow-up. In each subgroup, we analyzed the rate of malignant transformation and performed a uni- and multivariate analysis of factors associated with malignant transformation. Diagnoses of OLL, OLP, and ODLF were made in 80.9%, 15.4%, and 3.7% of patients, respectively. The average follow-up was 51.5 months. The malignant transformation rates for OLL, OLP, and ODLF were 5.9% (n = 9), 0% (n = 0), and 42.9% (n = 3), respectively. Multivariate analysis performed on the entire cohort showed that the presence of dysplasia was significantly associated with transformation to OSCC (OR = 7.40; p = 0.01) as well as the asymmetry of lesion (OR = 8.81; p = 0.009), whereas there was a trend toward an association between plaque-like lesions and malignant transformation (p = 0.07). The risk of malignant transformation was only observed in OLL and ODLF. The presence of dysplasia is associated with a higher risk of malignant transformation. Clinical and histological diagnosis of plaque-like OLP is challenging, highlighting the need for future genomic investigations to enable a better molecular characterization of this condition.

Oral potentially malignant disorders (OPMDs) comprise a group of oral mucosal abnormalities associated with an increased risk of malignant transformation. Early diagnosis, appropriate management, and long-term follow-up are essential to reduce the likelihood of cancer progression. This study aimed to evaluate the clinical and histopathological characteristics of OPMDs, their dysplastic changes, and clinical outcomes of patients referred to Alborz dental school between 2019 and 2025.This combined retrospective and prospective cohort study included 50 patients diagnosed with OPMDs. Data were collected using a standardized clinician-completed checklist, along with comprehensive clinical examinations and histopathological assessments. Recorded variables included demographic characteristics, type and location of lesions, and associated risk factors. The study population consisted of 64% females, with the majority of patients aged between 40 and 60 years. Plaque-type oral lichen planus and non-homogeneous leukoplakia were the most frequently diagnosed lesions. The buccal mucosa and tongue were the most commonly involved sites. Burning sensation was reported by 52% of patients. Histopathological examination revealed lichenoid mucositis in 86% of patients, with mild epithelial dysplasia observed in 7%. In contrast, dysplastic changes were identified in 57% of patients with leukoplakia. Therapeutic interventions included topical corticosteroids and intralesional corticosteroid injections. At follow-up, 80% of patients exhibited persistent lesions with plaque-type morphology and white lesions being most common; however, a subset of patients reported reduction in pain and burning sensation. Early diagnosis and structured long-term follow-up are essential for appropriate risk assessment and early detection of potential malignant progression.