Infrecuente presentación del liquen plano / Infrequent presentation of lichen planus

El liquen plano oral es una enfermedad inflamatoria crónica, afecta principalmente a la mucosa yugal, la lengua y las encías ante agresión T linfocitaria, dirigida frente a las células basales del epitelio en la mucosa oral. Se presenta un paciente con irritación y molestias dolorosas en la mucosa de la boca, que se irradiaba a las encías y le ocasionaba disfagia, El examen histológico evidenció infiltrado inflamatorio predominantemente linfocítico en bandas con dilatación vascular exostosis y degeneración vacuolar del estrato basal compatible con liquen plano. Se decide tratamiento esteroideo tópico y oral con remisión total de las mismas al 11 día sin rebrote de las lesiones y asintomático.

Oral lichen planus is a chronic inflammatory disease, mainly affecting buccal mucosa, tongue and gums due to T-lymphocytic aggression and directed against basal cells of the epithelium in the oral mucosa. We present a male patient with irritation and painful mucosal discomfort, which irradiated to the gums and caused dysphagia. Histological examination showed predominantly lymphocytic inflammatory infiltrate in bands with vascular dilation, exostosis and vacuolar degeneration of the basal layer compatible with lichen planus. Topical and oral steroid treatment was decided with total remission after 11 days without regrowth of the lesions and asymptomatic.

Oral lichen planus in a young patient: a case report with nine-year follow-up / Líquen plano oral em paciente jovem: um relato de caso com acompanhamento de nove anos

INTRODUCTION: Oral lichen planus is an inflammatory condition that affects the stratified squamous epithelium of the oral mucosa. It occurs more frequently in female patients and it is rarely observed in children, adolescents, or young adults. This study aims to report a case of oral lichen planus in a young patient with a nine-year followup. CASE REPORT: A 19-year-old man reported to the Dentistry Department with a complaint of an asymptomatic white lesion on the dorsum and left lateral border of his tongue, which had appeared a few weeks before. Two weeks later, a second lesion, very similar to the previous one, appeared on the central region of his tongue. An incisional biopsy was performed. The histological slides were stained with hematoxylin-eosin and the expression of interleukin-1beta (IL-1ß) and tumor necrosis factor-alpha (TNF-α) was assessed by immunohistochemistry. No pharmacological treatment was prescribed. The clinical and histopathological findings were suggestive of oral lichen planus. The IL-1ß/TNF-α expression was low. There was a spontaneous regression of the lesions after approximately one year. The nine-year follow-up showed no signs of recurrence. CONCLUSION: This case presents atypical features such as the age of the patient and the spontaneous remission of the lesions.

INTRODUÇÃO: O líquen plano oral é uma condição inflamatória que acomete o epitélio escamoso estratificado da mucosa oral. Ocorre mais frequentemente em pacientes do gênero feminino e é raramente encontrado em pacientes pediátricos ou juvenis. O objetivo do presente estudo é relatar um caso de líquen plano oral em um paciente jovem com acompanhamento de nove anos. RELATO DE CASO: Um rapaz de 19 anos procurou atendimento no Departamento de Odontologia com a queixa de uma lesão branca assintomática em região de dorso e borda lateral esquerda de sua língua, com tempo de evolução de algumas semanas. Duas semanas depois, uma segunda lesão, muito similar à primeira, apareceu na região central de sua língua. Uma biópsia incisional foi realizada. As lâminas histológicas foram coradas com hematoxilina-eosina e a expressão de interleucina-1beta (IL-1ß) e de fator de necrose tumoral alfa (TNF-α) foram avaliadas por imunohistoquímica. Nenhum tratamento farmacológico foi prescrito. Os achados clínicos e histopatológicos foram sugestivos de líquen plano oral. A expressão de IL-1ß/TNF-α foi baixa. Houve uma regressão espontânea das lesões após aproximadamente um ano. O acompanhamento de nove anos não detectou sinais de recorrência. CONCLUSÃO: Esse caso apresenta características atípicas, como a idade do paciente e a remissão espontânea das lesões.

Assessment of salivary opiorphin in oral lichen planus

Opiorphin is a pentapeptide, which could be isolated from human fluids and has a decreasing effect on pain. Aim: Since lichen planus is a chronic mucocutaneous disease, which causes pain or burning feeling in the oral mucosa, this study aimed to compare salivary opiorphin levels of oral lichen planus (OLP) patients with healthy subjects. Methods: This case-control study, was performed on 24 patients with OLP lesions and 21 healthy subjects. After collecting unstimulated saliva, opiorphin levels were compared between two groups through statistical analyses. Results: There was not any significant difference between OLP patients and healthy subjects according to salivary opiorphin concentration (p=0.378). Also, in the OLP group, opiorphin concentration was not significantly different between males and females (p=0.601). Analytical analysis could not show any remarkable difference between various severity of OLP lesions regarding to salivary opiorphin levels (p=0.653). Conclusion: In this study, salivary opiorphin levels was not significantly different between patients with OLP and healthy subjects; however, more studies are suggested for better assessment of salivary opiorphin levels in various types of OLP lesions and its correlation with pain severity

Research progress in animal models of oral squamous cell carcinoma and common oral mucosal diseases / 中国基层医药

The pathogeneses of oral squamous cell carcinoma and most oral mucosal diseases are unclear. Therefore, establishing animal models with similar pathogeneses is significant for clinical prevention, diagnosis, and treatment of related diseases. At present, scholars have established animal models for different focuses. This paper aims to introduce the methods for establishing animal models of oral squamous cell carcinoma and common oral mucosal diseases, compare their advantages and disadvantages, and provide evidence for related basic research.

Gingivitis descamativa crónica: una manifestación gingival del liquen plano bucal / Chronic desquamative gingivitis: a gingival manifestation of oral lichen planus

RESUMEN El término de gingivitis descamativa ha evolucionado con el decursar de los años. La clasificación de la enfermedad periodontal vigente en Cuba la incluye dentro de los procesos inflamatorios crónicos superficiales. La Academia Americana de Periodontología y la Federación Europea de Periodoncia, han destinado un apartado para esta enfermedad denominado: alteraciones inflamatorias e inmunes. Se presentó una paciente de 27 años de edad, con ardor, sangramiento gingival y molestias al cepillado, la cual acudió a la consulta de Estomatología General Integral. Durante el examen clínico se constató la presencia de zonas eritematosas a nivel de encía marginal e insertada, con exposición del tejido conectivo. Luego de concluida la atención primaria en Periodoncia, la paciente fue remitida a la atención secundaria donde se le diagnosticó un liquen plano bucal con manifestaciones gingivales. Se instauró el tratamiento adecuado hasta la desaparición de las lesiones.

ABSTRACT The term desquamative gingivitis has evolved over the years. The current classification of periodontal disease in Cuba includes it among chronic superficial inflammatory processes. The American Academy of Periodontology and the European Federation of Periodontology have assigned a section for this disease called inflammatory and immune alterations. We present a 27-year-old female patient with burning, gingival bleeding and discomfort when brushing, who came to the General Comprehensive Dentistry consultation. Erythematous areas were observed during clinical examination, at the level of the inserted and marginal gingiva, with exposure of the connective tissue. After the completion of primary periodontal care, the patient was referred to secondary care where she was diagnosed with oral lichen planus with gingival manifestations. Appropriate treatment was instituted until the lesions disappeared.

Efficacy of low-energy laser in the treatment of erosive oral lichen planus in 43 patients / 中国基层医药

Objective:To investigate the clinical efficacy of low-energy laser in the treatment of erosive oral lichen planus (OLP) and its effect on patients' pain.Methods:Eighty-six patients with erosive OLP who were treated in Shanxian Central Hospital from February 2018 to January 2020 were included in this study. They were randomly divided into control and observation groups ( n = 43/group). The control group was treated by local injection of dexamethasone, and the observation group was treated with semiconductor low-energy laser irradiation. All patients were treated for 8 weeks. Pain scores and physical sign score before and after treatment were evaluated in each group. Therapeutic effects were compared between the two groups. Area of lesion was measured in each group. Recurrence of erosive OLP was calculated at 3 and 6 months after surgery. Results:Before treatment, there were no significant differences in visual analogue scale (VAS) score and physical sign score between the two groups (both P > 0.05). At 7, 14, 28 and 56 days after treatment, VAS score and physical sign score were significantly decreased in each group compared with those before treatment, and VAS score and physical sign score in the observation group were significantly lower than those in the control group (all P < 0.05). Total response rate in the observation group was significantly higher than that in the control group [93.02% (40/43) vs. 83.72% (36/43), χ2 = 1.81, P > 0.05). Before and 1 month after treatment, there was no significant difference in area of lesion between control and observation groups (both P > 0.05). At 3 and 6 months after surgery, area of lesion in the observation group was (0.31 ± 0.14) cm 2 and (0.32 ± 0.12) cm 2, respectively, which were significantly smaller than those in the control group [(0.42 ± 0.18) cm 2, (0.48 ± 0.19) cm 2, t = 3.16, 4.67, both P < 0.05). At 3 and 6 months after treatment, recurrence of erosive OLP in the observation group was 2.33% (1/43) and 13.95% (6/43), respectively, which were significantly lower than those in the control group [13.95% (6/43), 37.21% (16/43), χ2 = 3.89, 6.11, both P < 0.05]. Conclusion:There is no significant difference in the short-term efficacy of low-energy laser versus conventional corticosteroids in the treatment of erosive OLP. However, low-energy laser has a more obvious short-term pain relief effect than conventional corticosteroids. It can accelerate the healing of injured tissue and decrease the recurrence rate of erosive OLP.

Research progress on the adverse reactions of triamcinolone acetonide in oral lichen planus and its countermeasures / 中国医师杂志

Oral lichen planus (OLP) is a common chronic inflammatory oral mucosa disease, which is closely related to immune deficiency. Triamcinolone acetonide is considered to be the drug of choice for treatment of OLP due to its anti-inflammatory, anti-allergic and immunosuppressive effects. However, long-term application of triamcinolone acetonide can produce a variety of adverse reactions, and it prone to rebound after discontinuation, which greatly hinders the clinical diagnosis and treatment of OLP. This article reviews the adverse reactions of triamcinolone acetonide in the treatment of OLP and its coping strategies in order to provide some reference for the clinical treatment of OLP.

Association of serum level of 25-hydroxy vitamin D with oral lichen planus: a case-control study / Asociación del nivel sérico de 25-hidroxi vitamina D con el liquen plano oral: un estudio de casos y controles

Introduction: Vitamin D deficiency is a global health problem that can be a risk factor for a broad range of diseases such as some autoimmune diseases. Due to the autoimmune base of lichen planus, it seems that a reduction of the serum level of vitamin D is related to lichen planus. In this study, we investigate the relation between serum level of vitamin D and oral lichen planus patients (OLP). Material and Methods: In this case-control study, 35 patients with OLP (including 15 men and 20 women) and 70 healthy volunteers (including 35 men and 35 women), aged between 30-60 years old, referred to Qazvin University of Medical Sciences were investigated. None of these volunteers had systemic diseases. Vitamin D levels were measured with ELFA (Enzyme Linked Fluorescent Assay) and the data was analyzed using the chi-squared test and t-test. Results: The mean serum level of vitamin D in the control group was 23.7±9ng/ml and in the case group was 18.12±8/7ng/ml. The results show that the serum level of vitamin D in patients with OLP is significantly less than in the control group (p<0.05). Conclusion: According to the results, the serum level of vitamin D in patients with OLP was significantly lower than that of healthy people.

Introducción: La deficiencia de vitamina D es un problema de salud global que puede ser un factor de riesgo para una amplia gama de enfermedades, como algunas enfermedades autoinmunes. Debido a la base autoinmune del liquen plano, parece que una reducción del nivel sérico de vitamina D está relacionada con el liquen plano. En este estudio, investigamos la relación entre el nivel sérico de vitamina D y los pacientes con liquen plano oral (LPO). Material y Métodos: En este estudio de casos y controles, 35 pacientes con LPO (incluidos 15 hombres y 20 mujeres) y 70 voluntarios sanos (incluidos 35 hombres y 35 mujeres), con edades comprendidas entre 30 y 60 años, remitieron a la Universidad de Medicina de Qazvin. Se investigaron las ciencias. Ninguno de estos voluntarios padecía enfermedades sistémicas. Los niveles de vitamina D se midieron con ELFA (ensayo fluorescente ligado a enzimas) y los datos se analizaron utilizando la prueba de chi-cuadrado y la prueba t. Resultados: El nivel sérico medio de vitamina D en el grupo de control fue de 23,7 ± 9 ng / ml y en el grupo de casos fue de 18,12 ± 8/7 ng / ml. Los resultados muestran que el nivel sérico de vitamina D en pacientes con OLP es significativamente menor que en el grupo de control (p<0.05). Conclusión: De acuerdo con los resultados, el nivel sérico de vitamina D en pacientes con LPO fue significativamente menor que en personas sanas.

Effects of interleukin-35 on the balance of helper T cell 17/regulatory T cell in peripheral blood of patients with oral lichen planus / 中华口腔医学杂志

Objective@#To investigate the effects of exogenous interleukin (IL)-35 on the balance of helper T cell 17 (Th17) and regulatory T cell (Treg) in peripheral blood of patients with oral lichen planus (OLP).@*Methods@#Totally 12 peripheral blood samples of OLP patients (OLP group, one male and 11 female, 26-68 years old; four cases of reticular OLP and eight cases of erosive OLP) were collected from patients of Department of Oral Mucosal Specialist of the Affiliated Hospital of Guizhou Medical University from October to December 2016. During the same period, thirteen normal peripheral blood samples were collected from the Physical Examination Center of the Affiliated Hospital of Guizhou Medical University (normal control group, one male and 12 female, 20-68 years old). The peripheral blood mononuclear cells (PBMC) were extracted in sterile condition and CD4+ T cells were sorted by flow cytometry (FCM). Quantitative real-time PCR (qPCR) technique was used to detect the mRNA expression levels of retinoid-related orphan nuclear γt (RORγt) and forkhead box3 (Foxp3). The CD4+ T cells were divided into experimental group and control group. The CD4+ T cells of experimental group were cultured in vitro by adding rhIL-35, and the CD4+ T cells of control group were cultured with the same volume of phosphate buffered saline (PBS). After the completion of the culture, the cells were collected. The expression levels of the same factors were detected by qPCR.@*Results@#The expression [M(Q25, Q75)] of Foxp3 [0.15 (0.09, 0.30)] and RORγt mRNA [1.04 (0.45, 2.15)] in the CD4+ T cells of OLP were significantly higher than those in normal control group [0.04 (0.02, 0.06), 0.10 (0.05, 0.11)] (Z=-4.134, P<0.01; Z=-3.699, P<0.01). The ratio of ROR γt/Foxp3 mRNA in OLP group [6.22(3.67, 15.34)] was higher than that in normal control group [2.50 (1.24, 5.23)] (Z=-2.665, P=0.007). In the CD4+ T cells of OLP patients, the expression of Foxp3 mRNA in the experiment group [0.40 (0.21, 1.22)] was higher than that in the control group [0.15 (0.11, 0.26)](Z=-2.510, P=0.012), and the expression of ROR γt mRNA between two groups showed no significant difference (P>0.05). The ROR γt/Foxp3 mRNA ratio [3.44 (1.55, 8.16)] of the experiment group was lower than that in the control group [6.22 (4.43, 12.21)] (Z=-2.746, P=0.006).@*Conclusions@#There was a Th17/Treg imbalance with predominated by Th17 cells in the peripheral blood of patients with OLP. Exogenous rhIL-35 had an immunomodulatory effect on the balance of Th17/Treg.

Oral lichen planus and HCV infection

Chronic infection by hepatitis C virus (HCV) can lead not only to the development of hepatic cirrhosis, but also to the emergence of extra-hepatic manifestations (EHMs), such as oral lichen planus (OLP). Here, we describe a clinical presentation of massive, erosive OLP in an HCV-positive patient whose clinical management was difficult. Full remission was achieved after sustained virological response by using direct-acting anti-retrovirals. This case report demonstrates not only the importance of diagnosing EHMs for identification of HCV infection, but also the importance of controlling it for management of OLP and EHMs.

Salivary Transferrin Levels in Patients with Oral Lichen Planus

Objective: To compare salivary transferrin levels between patients with oral lichen planus (OLP) and healthy subjects. Material and Methods: In this descriptive, analytical, crosssectional study, 11 patients with OLP and 22 healthy subjects were selected after matching in terms of age and gender. OLP was confirmed by two oral medicine specialists based on clinical and histopathological criteria. Salivary samples were collected by spitting. The patients were asked to collect their saliva in their oral cavity and then evacuate it into sterilized Falcon tubes. The procedure was repeated every 60 seconds for 5-15 minutes. A total of 5 mL of saliva was collected using this method. The samples were collected from 8 to 9 in the morning in a fasting state to avoid circadian changes. The collected salivary samples were immediately placed next to ice and transferred to the laboratory to be centrifuged at 4°C at 800 g to isolate squamous cells and cellular debris. Then the samples were frozen at -80°C until the samples were prepared. An ELISA kit was used to determine salivary transferrin levels. Data were analyzed with descriptive statistics (means and standard deviations) and t-test for independent groups using SPSS 17. Statistical significance was set at p<0.05. Results: The mean salivary transferrin concentrations in patients with OLP and healthy subjects were 0.9055±0.28229 and 1.5932±0.80041 mg/dL, respectively (p<0.05). Conclusion: The salivary transferrin levels in patients with OLP were significantly lower than those in healthy subjects.

Research progress of dental implant in patients with oral lichen planus / 中华口腔医学杂志

In recent years, the range of indications for dental implants has undergone many modifications and has been widened. In the past, oral lichen planus was regarded as contraindication for the placement of implants. According to recent literature, some patients with oral lichen planus have been selected for dental implantology, indicating comparable implant survival rate to patients without oral lichen planus. Nevertheless, clinical information on this topic is still scarce and evidence-based treatment guidelines are not available. This paper reviews the research progress of dental implant in patients with oral lichen planus, discusses the benefits and risks of implant rehabilitation in this group of patients and proposes treatment recommendations based on existing studies.

Clinical research of Lishi-Jianpi-Quyu decoction combined with conventional western medicine for the patients with oral lichen planus / 国际中医中药杂志

Objective@#To evaluate the therapeutic effect of Lishi-Jianpi-Quyu decoction combined with conventional western medicine for the oral lichen planus (OLP).@*Methods@#A total of 80 OLP patients who met the inclusion criteria were divided into two groups by random number table method, 40 in each group. The control group was treated with conventional medicine, while the research group were treated with Lishi-Jianpi-Quyu decoction on the basis of control group. Two groups were treated for 4 weeks. The severity of oral mucosal lesions was assessed by REU scale, and oral discomfort was assessed by VAS scale. The serum tumor necrosis factor-α (TNF-α), IL-6 and IL-8 levels were detected by ELISA, peripheral blood CD3+, CD4+ levels were detected by flow cytometry, and the ratio of CD4+/CD8+ was calculatedand the clinical efficacy was evaluated.@*Results@#The effective rate of research group was 82.5% (33/40), while the control group was 62.50% (25/40), and the difference between two groups was statistically significant (χ2=9.031, P=0.003). After treatment, TNF-α (1.19 ± 0.28 μg/L vs. 3.59 ± 0.72 μg/L, t=19.807), IL-6 (11.14 ± 2.04 ng/L vs. 16.34 ± 3.20 ng/L, t=8.666), IL-8 (1.15 ± 0.61 ng/L vs. 2.04 ± 0.76 ng/L, t=5.776) of research group were significantly lower than the control group (P<0.01). The serum CD3+ (64.02% ± 5.16% vs. 58.07% ± 4.85%, t=5.314), CD4+ (41.26% ± 3.61% vs. 37.15% ± 3.04%, t=5.508), CD4+/CD8+ (1.60 ± 0.43 vs. 1.31 ± 0.40, t=3.668) of research group were significantly higher than those of the control group (P<0.01). After treatment, the REU score and VAS score in the research group were significantly lower than that in the control group (t=10.980, 11.146, P<0.01).@*Conclusions@#The Lishi-Jianpi-Quyu decoction combined with conventional western medicine can improve the clinical symptoms of OLP, reduce the level of serum inflammatory cytokines, and enhance the body's immunity and improve the curative effect.

Diagnosis and treatment of skin diseases manifesting as desquamative gingivitis / 中华皮肤科杂志

Skin diseases manifesting as desquamative gingivitis (DG) can be divided into recurrent DG-and chronic DG-related skin diseases,including oral lichen planus,mucosal pemphigoid,pemphigus vulgaris and so on.A thorough medical history,detailed oral and histopathological examinations and serum immunological tests can be helpful for correct diagnosis of DG-related skin diseases.The treatment of DG-related skin diseases includes topical and systemic therapies.It is necessary to individualize treatment protocols due to treatment response.During the treatment of DG,oral hygiene should be strengthened,secondary fungal and bacterial infections should be avoided,and attention should be paid to the protection of oral cavity and periodontal tissues.

Clinical research of Huashi-Xingyu-Qingre decoction combined with conventional western medicine therapy for the oral lichen planus / 国际中医中药杂志

Objective To investigate the clinical application of Huashi-Xingyu-Qingre decoction for the treatment of oral lichen planus (OLP).Methods According to the random table method,83 OLP patients were divided into control group (n=41) and the research group (n=42).The patients in the control group were treated with conventional medicine,while the patients in the research group were treated with Huashi-Xingyu-Qingre decoction on the basis of control group.Two groups of patients were treated for 6 weeks.The clinical total effective rate of two groups after treatment was counted.The serum haptoglobin,vitamin D binding protein,AT-Ⅲ,IL-6,IL-8,TNF-α and peripheral blood CD3+,CD4+,CD4+/CD8+ were determined respectively before and after treatment.The adverse reaction incidence and recurrence rate of two groups were observed.Results The total effective rate of research group was 92.9％ (39/42),while the total effective rate of control group was 63.4％ (26/41),and the difference between two groups was statistically significant (22=10.589,P=0.001).After treatment,the serum haptoglobin (6.11 ± 0.72 μg/ml vs.5.58 ± 0.69 μg/ml,t=3.423) of research group were significantly higher than the control group (P＜0.05),while the serum vitamin D binding protein (1.48 ± 0.25 μg/ml vs.2.06 ± 0.31 μg/ml,t=9.394),AT-Ⅲ,IL-6,1L-8,TNF-α of research group were significantly lower than the control group (t were 17.561,12.664,7.423,13.763,P＜0.01),and the peripheral blood CD3+,CD4+,CD4+/CD8+ of research group were significantly higher than the control group (t were 5.368,4.694,3.558,P＜0.01).The recurrence rate of control group was 30.8％ (8/26),which was significantly higher than the research group of 7.7％ (3/39) (x2=5.909,P=0.015).Conclusions The clinical curative effect of Huashi-Xingyu-Qingre decoction on the treatment for OLP is significantly,which can improve the patient's serum differential proteins and inflammatory cytokines,improve the body's immune function.It has the high security of the forward curative effect,which provides new thinking for clinical treatment of CFS.

Reação liquenoide oral ao amálgama: uma lesão ainda vista / Oral lichenoid reaction to amalgam: a lesion still seen

O amálgama dental ainda é amplamente utilizado na prática odontológica, apesar do acordo assinado na Convenção de Minamata, na qual 140 países comprometeram-se a reduzir o uso do mercúrio. O uso desse material restaurador pode desencadear reações liquenoides orais (RLO) cujas lesões apresentam semelhanças clínicas e histológicas com líquen plano oral (LPO), dificultando o diagnóstico. Aqui relatamos o caso de uma paciente do sexo feminino, de 72 anos, que foi encaminhada com uma lesão na mucosa bucal esquerda, com 10 meses de evolução e queixa de dor. A lesão era adjacente ao segundo molar inferior esquerdo que tinha uma restauração de amálgama. A paciente não apresentava doença sistêmica ou hábitos deletérios e não estava usando drogas continuamente. O diagnóstico clínico presuntivo foi RLO versus LPO. Sessenta dias após a substituição da restauração do amálgama, observou-se a regressão completa da lesão e o diagnóstico final de RLO foi realizado. A avaliação clínica associada aos resultados obtidos após a substituição do material suspeito pode ser suficiente para estabelecer o diagnóstico, embora em alguns casos seja necessária a avaliação histopatológica.

Dental amalgam is still widely used in dental practice, despite the agreement signed at the Minamata Convention, in which 140 countries have committed to reducing the use of mercury. The use of this restorative material may trigger oral lichenoid reactions (OLR) whose lesions show clinical and histological similarities with oral lichen planus (OLP), making diagnosis difficult. Here we report the case of a female patient, 72-year-old, who was referred with a lesion in the left buccal mucosa, with 10 months of evolution and complaint of pain. The lesion was adjacent to the second lower left molar which had an amalgam restoration. The patient had no systemic disease or deleterious habits and was not using drugs continuously. The presumptive clinical diagnosis were OLR versus OLP. Sixty days after the replacement of amalgam restoration the complete regression of the lesion was observed and the final diagnosis of OLR was done. Clinical assessment associated with the results obtained after the replacement of suspect material may be sufficient to establish the diagnosis, although in some cases it may be necessary histopathological evaluation.

Cytokines, cortisol, and nitric oxide as salivary biomarkers in oral lichen planus: a systematic review

Abstract The etiopathogenesis of oral lichen planus (OLP) is still not fully elucidated, and it is believed that its development could involve a neuro-immune-endocrine profile. This systematic review investigated the relationship between cytokines, cortisol, and nitric oxide (NO) in the saliva of OLP patients. An electronic search was conducted in Pubmed/Medline, Scopus, LIVIVO, and Web of Science databases with no restriction of language to identify studies published up to December 2017. Data extraction was performed using the Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA) guidelines. A total of 140 articles were retrieved, and 32 articles fulfilled the inclusion criteria (cytokines = 17; cortisol = 9; NO = 6). The most studied cytokines in the saliva of OLP patients were interleukins IL-4, IL-6, IL-8, IFN-ү, and TNF-α, which were higher in OLP patients than in healthy controls (HC). Salivary cortisol was found to be higher in OLP than in HC in most (55.5%) of the selected studies, and all studies related to NO found higher levels of this marker in OLP than in HC. Despite controversial results, our review suggests that OLP patients have an increased inflammatory response, as indicated by the proinflammatory profile of salivary cytokines. In addition, we conclude that salivary cytokine and NO measurements may have significant diagnostic and prognostic potential for monitoring disease activity and therapeutic responses in OLP.

Expression and significance of interleukin-35 in lesion tissue of oral lichen planus patients / 中华口腔医学杂志

Objective@#To investigate the expression of Epstein-Barr virus-induced gene 3 (EBi3) and interleukin-12p35 (IL-12p35) in two subunits of interleukin-35 (IL-35) in oral lichen planus (OLP) lesions, and to explore the role of IL-35 played in the formation and development of OLP lesions.@*Methods@#Totally 41 samples of OLP lesions and 15 samples of normal tissues were collected from patients of the Department of Periodontology and Oral Medicine, Affiliated Stomatological Hospital of Guizhou Medical University from October 2010 to December 2016. The expression levels of EBi3 mRNA and IL-12p35 mRNA in the samples were detected by quantitative real-time PCR (qPCR) and the distribution and expression of protein EBi3 and IL-12p35 were detected by immunohistochemistry. The potential relationship between IL-35 and clinicopathological features of OLP was analyzed.@*Results@#The expression [M(Q25, Q75)] of EBi3 [3.38 (1.63, 11.25)] and IL-12p35 mRNA [6.39 (2.55, 14.30)] in OLP lesion tissues were significantly higher than those in normal control group [1.41 (0.33, 3.16), 2.47 (1.10, 5.14)] (Z=-2.806, P=0.005; Z=-2.276, P=0.023), respectively. The positive expression rates of EBi3 and IL-12p35 were 66% (27/41) and 39% (16/41), respectively, were significantly higher in OLP lesion tissues comparing with that in normal oral mucosa tissues [0%(0/15)] (P<0.05). The relative expressions of EBi3 and IL-12p35 were positively correlated (r=0.404, P=0.009). A significant correlation was found between EBi3 protein over expression and the degeneration of base cells in OLP lesions (χ2=9.172, P=0.010). The positive expression rate of IL-12p35 protein in erosive type lesions was higher than that in non-erosive type lesions (χ2=7.220, P=0.007). The positive expression rate of IL-35 protein in OLP lesions [34% (14/41)] was higher than that in normal control group (χ2=6.829, P=0.009). The expression rate of IL-35 in erosive type lesions (10/20) was significantly higher than that in eruption type lesions (4/21) (χ2=4.364, P=0.037).@*Conclusions@#The expression of IL-35 in OLP localized lesions was up-regulated, suggesting that IL-35 might play an important role in OLP lesion formation.

Piccardi-Lassueur-Graham-Little syndrome associated with frontal fibrosing alopecia

Abstract: Piccardi-Lassueur-Graham-Little syndrome is a rare entity characterized by progressive scarring alopecia of the scalp and keratotic papules on hairless skin, associated with non-scarring alopecia in the axilla and pubic area or lichen planus lesions. We describe the case of a 70-year-old woman who presented a Piccardi-Lasseur-Graham-Little syndrome, along with frontal fibrosing alopecia.

Increased salivary aldehyde dehydrogenase 1 in non-reticular oral lichen planus

Abstract: Background: Oral lichen planus is a potentially malignant disorder. One of the malignant transformation markers is cancer stem cells. One of the proposed marker for the detection of cancer stem cells's in head and neck cancer is aldehyde dehydrogenase. Recently it is shown that aldehyde dehydrogenase 1 expression in tissue samples is associated with oral lichen planus malignant transformation. Objective: This study evaluates salivary aldehyde dehydrogenase 1 in oral lichen planus. Method: Thirty patients and 30 age and sex-matched healthy volunteers were recruited. Oral lichen planus was diagnosed based on the modified World Health Organization criteria. Subjects in the case group were divided into reticular and non-reticular forms. Unstimulated salivary samples were collected at 10-12 AM. Saliva concentrations of aldehyde dehydrogenase 1 were measured by ELISA. Results: The differences between aldehyde dehydrogenase levels in the oral lichen planus group compared with the control group were not significant but aldehyde dehydrogenase in non-reticular oral lichen planus was significantly higher than that of the reticular form. Limitations of the study: This is a cross-sectional study, thus longitudinal studies in oral lichen planus may present similar or different results. Conclusions: The mechanism of malignant transformation in oral lichen planus is not defined. Previous analyses revealed that the aldehyde dehydrogenase 1 expression is significantly correlated with increased risk of transformation. This finding is consistent with our results because in the erosive and ulcerative forms of oral lichen planus, which have an increased risk of transformation, salivary aldehyde dehydrogenase 1 was overexpressed. A higher salivary aldehyde dehydrogenase level in non-reticular oral lichen planus can be a defensive mechanism against higher oxidative stress in these groups. Aldehyde dehydrogenase may be one of the malignant transformation markers in oral lichen planus. Further studies are needed for introducing aldehyde dehydrogenase as a prognostic indicator in certain lesions.