Oral lichen planus to oral lichenoid lesions: Evolution or revolution (original) (raw)
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Clinicopathologic Correlation of Oral Lichen Planus and Oral Lichenoid Lesions: A Preliminary Study
The Scientific World Journal, 2014
Oral lichen planus (OLP) and oral lichenoid lesions (OLL) are clinically and histologically similar lesions but their treatment planning and prognosis are different. The review of the literature indicates numerous criteria to distinguish these two lesions; however there is a lot of inconsistency. Thus, the aim of this study was to determine the correlation of histopathology and clinical OLP and OLL diagnosis and to clarify which histopathologic criteria could best distinguish these two diagnoses. A retrospective study showed that clinically diagnosed 92 OLPs and 14 OLLs have been confirmed histopathologically in 52.2% and 42.9% of cases, respectively. In addition, histopathology showed statistically significant more eosinophils (P<0.0005), plasma cells (P<0.0005), and granulocytes (P<0.05) in OLL than OLP. To establish histopathological diagnosis of OLP and OLL it should be mandatory to define the type of cells in mononuclear infiltrate, which can be associated more accurat...
A retrospective clinicopathologic study of lichen planus and lichenoid lesions in the oral cavity
Padjadjaran Journal of Dentistry
Lichen planus is a common oral disorder which may represent the manifestation of varies clinical presentation and microscopic findings. In this retrospective study of 86, cases of oral lichen planus (OLP) were compared with 73 cases of oral lichenoid lesions (OLL). Various clinicohistopathological features were studied. The object of this study was to compare clinical and microscopic findings in order to present evidence that supports the position of true lichen planus. Biopsy specimens were obtained from every patient. The biopsy specimens were fixed in 10 percent formalin, embedded in paraffin, sectioned at 4 microns and stained by means of routine hemotoxylin and eosin procedures. The histologic specimens were examined and evaluated without knowledge of clinical findings. The mean age at presentation of patients with OLP was 42.5 years as compared to 47.0 years for OLL. There was no significant difference between the ethnic groups, site of lesions and the distribution of the clin...
BACKGROUND: The aim of this study was to determine the correlation of histopathology and clinical OLP and OLL diagnosis and which histopathologic criteria could best distinguish the OLP and OLL. MATERIALS AND METHODS: The retrospective study group comprised 60 patients who were referred to the Department of Oral Medicine Govt. dental college Srinagar. Diagnosis was based on clinical examination and medical and dental history, intake of drugs, and duration of the lesions. Only patients who underwent biopsy were included in the study. The clinical diagnosis of OLP was established in 50 patients (34 females; 16 males; ratio f/m = 2.12:1), while in 10 patients OLL was diagnosed (4 females; 6 males, ratio f/m = 0.66:1). Clinical diagnosis of OLL was established due to the presence of hyperkeratotic lesions adjacent to amalgam fillings with asymmetric and mainly unilateral distribution and patient medical history related to drugs, which provoke lichenoid changes in oral mucosa. RESULTS: In 56% (28/50) of patients, clinical diagnosis of OLP was histopathologically confirmed, while in 6%(3/50) of cases there was a partial confirmation and only some criteria were fulfilled. In 14%(7/50) of OLP patients, both clinical and histopathologic diagnosis were concordant, while in 24% (12/50) of patients histopathologic diagnosis was nonspecific, being described as inflammation and keratosis. Clinical and histopathological diagnoses coincide in 50% (5/10) of OLL patients. In clinically diagnosed OLL, in one case the diagnosis of OLP was established, and 3 (30%)cases had inflammation and keratosis, while in 1(10%) cases squamous cell carcinoma(OSCC) was diagnosed histopathologically.
Brazilian Dental Journal, 2004
Oral lichen planus (OLP) is a chronic inflammatory disease with different clinical presentations that can be classified as reticular or atrophic-erosive. Sixty-two OLP patients were studied to evaluate the clinical-pathologic characteristics of their OLP lesions and to investigate possible differences in their biological behavior. The most common clinical presentation was the reticular type (62.9% vs 37.1%). Atrophic-erosive presentations showed significantly longer evolution (chi square=4.454; p=0.049), more extensive lesions (chi square=16.211; p=0.000) and more sites affected than reticular ones (chi square=10.048; p=0.002). Atrophic-erosive OLP was more frequently found on the tongue, gingiva and floor of the mouth. No statistically significant differences could be identified between reticular and atrophic-erosive clinical presentations in terms of age, sex, tobacco habit, plasma cortisol level and depth of inflammatory infiltrate. We concluded that the classification of OLP lesions as reticular vs atrophic-erosive is a simple, easy to use classification that can identify clinical presentations with different biological behavior.
Oral lichen planus and oral lichenoid lesions: diagnostic and therapeutic considerations
Oral Surgery Oral Medicine Oral Pathology Oral Radiology and Endodontology, 2007
Several therapeutic agents have been investigated for the treatment of oral lichen planus (OLP). Among these are corticosteroids, retinoids, cyclosporine, and phototherapy, in addition to other treatment modalities. A systematic review of clinical trials showed that particularly topical corticosteroids are often effective in the management of symptomatic OLP lichen planus. Systemic corticosteroids should be only considered for severe widespread OLP and for lichen planus involving other mucocutaneous sites. Because of the ongoing controversy in the literature about the possible premalignant character of OLP, periodic follow-up is recommended.There is a spectrum of oral lichen planus–like (“lichenoid”) lesions that may confuse the differential diagnosis. These include lichenoid contact lesions, lichenoid drug reactions and lichenoid lesions of graft-versus-host disease. In regard to the approach to oral lichenoid contact lesions the value of patch testing remains controversial. Confirmation of the diagnosis of an oral lichenoid drug reaction may be difficult, since empiric withdrawal of the suspected drug and/or its substitution by an alternative agent may be complicated. Oral lichenoid lesions of graft-versus-host disease (OLL-GVHD) are recognized to have an association with malignancy. Local therapy for these lesions rests in topical agents, predominantly corticosteroids.
Drugs of Today, 2002
Oral lichen planus affects 1-2 per cent of the general adult population and is the most common noninfectious oral mucosal disease in patients referred to oral medicine and oral pathology clinics. According to clinical features and histopathologic analysis, there are several variants including linear, hypertrophic, bullous, erosive, palmoplantar, nodular, annular, atrophic, follicular, ulcerative, plaque-like, reticular, papular. The aim of this communication is to provide an update of the clinical and histological features of OLP, process of OLP diagnosis, causes of OLP, management of OLP patients and medical treatment of OLP lesions. The malignant potential of OLP is discussed and practical steps to reduce the risk of oral cancer in OLP patients are presented. The need for OLP patient education is highlighted.
Oral Lichen Planus: A Review of Etiopathogenesis, Clinical, Histological and Treatment Aspects
JBR Journal of Interdisciplinary Medicine and Dental Science, 2014
It is a well known fact that oral lichen planus (OLP) is a non infectious disease affecting the oral mucous membrane. It is considered to be an autoimmune disorder mediated mainly by the T-lymphocytes. It affects 1-2% of the general population with maximum prevelance seen among women above the age of 40. WHO considers it to be a potentially malignant disorder and the rate of malignant transformation has been put between 0.5-2%. This article mainly reviews the various pathogenetic mechanisms by which this unique disorder occurs along with the clinical, histopathological and treatment aspects.
Egyptian Dental Journal, 2017
Lichen planus (LP) is a chronic disease of the skin and mucous membrane. Oral lichen planus (OLP), the mucosal counterpart of cutaneous lichen planus that presents with a variety of clinical features, about 25% present with oral lesions alone. Patients may develop white striations, white papules, white plaques, erythema, erosions, or blisters affecting predominantly the posterior buccal mucosa bilaterally. The clinical presentation of OLP ranges from mild painless white keratotic lesions to painful erosions and ulcerations. The diagnosis of OLP was based on history, clinical findings and histopathological features. There is no consensus on a single set of criteria for the diagnosis of OLP. Some investigators use only the clinical criteria, while others use both clinical and histopathologic criteria. Furthermore final diagnosis was confirmed by Immunohistochemical staining (IHC) with CD8 precursor cells. The possibility of this lesion to turn malignant justifies the importance of early definitive diagnosis and long term follow up for patients with such disease.