Liquen oral, patrones reaccionales liquenoides y cáncer oral: estudio clínico e histopatológico retrospectivo de 12 años / Oral lichen, lichenoid reaction patterns and oral cancer: retrospective clinical and histopathological study of 12 years

Antecedentes: el liquen plano es una enfermedad con probabilidad de transformación maligna. La afectación oral se presenta en el 60 al 70% y el riesgo de cáncer oral es de 0-12,5%. La distinción entre liquen y reacción liquenoide oral es dificultosa. Se han descripto numerosos criterios para distinguirlas y se han asociado a riesgo de transformación maligna, pero aún así hay varias inconsistencias. Objetivo: determinar las características epidemiológicas y anatomopatológicas de los pacientes con liquen y reacción liquenoide oral. Establecer la frecuencia de progresión a cáncer considerando si hay diferencia entre los grupos. Diseño: estudio descriptivo, retrospectivo, observacional y longitudinal. Métodos: se recopilaron datos de pacientes evaluados en el Hospital Lagomaggiore de Mendoza, desde enero de 2003 a diciembre de 2014. Se incluyeron pacientes mayores de 18 años con confirmación histopatológica de liquen o reacción liquenoide oral. El análisis se realizó con Graph Pad Instat y se utilizaron medidas de tendencia central, de dispersión, test de normalidad y test exacto de Fisher. Resultados: se incluyeron 110 pacientes con confirmación histopatológica. Cuatro pacientes desarrollaron cáncer oral, 4,23% de los líquenes y 2,56% de las reacciones liquenoides. No hubo diferencia significativa entre grupos. En todos los casos, el cáncer oral ocurrió sobre la zona afectada previamente. Conclusiones: se registraron cuatro pacientes con progresión a cáncer oral. Estos hallazgos justifican el tratamiento y seguimiento. Se requieren más estudios para determinar si el liquen oral y las reacciones liquenoides son entidades separadas (AU)

Background: lichen planus is a disease with probability to become malignant. Oral affection occurs between 60% and 70% and the risk of oral cancer is from 0% to 12.5%. The difference between lichen and lichenoid oral reaction is troublesome. The literature has described numerous criteria to differentiate them and they have been associated to the risk of a malignant transformation, but there are still many inconsistencies. Objetive: to determine epidemiological and anatomopathological characteristics in patients with lichen and lichenoid oral reactions. To settle the frequency of progression to cancer, putting under consideration if there are differences between each group. Study design: Descriptive, retrospective, observational and longitudinal study. Methods: data have been taken from evaluated patients at Lagomaggiore Hospital in Mendoza, from January 2003 until December 2014. Patients over 18 years old with histopathological diagnosis of lichen or lichenoid oral reactions were included. The analysis was done with Graph Pad Instat and there were used central trends, dispersal, normal test and exact Fisher's test measures. Results: we include 110 patients with histopathological diagnosis confirmed. Four patients developed oral cancer; 4.23% of patients with lichen and 2.56% of patients with lichenoid reactions. We did not find a significant difference between groups. In all cases oral cancer occurs in the previously affected zone. Conclusions: there were registered four patients with cancer progression. These findings justify the follow up and treatment. More studies are needed to establish if oral lichen and oral lichenoid lesions are different entities (AU)

Tattoo reactions-An epidemic on the surge: A report of 3 cases.

Tattooing has been practiced in India since ancient era. It has tremendous religious and spiritual significance. In addition, tattooing for cosmetic purposes has become quite popular in recent times. With this increasing trend, there is also an increased risk of adverse effects. Here, we have described two cases of lichenoid reaction developing to red ink in double- colored tattoos and a case of sarcoidal reaction to green tattoo.

Queratosis liquenoide / Lichenoid keratosis

La queratosis liquenoide se presenta como una lesión solitaria, en forma de una mácula o pápula de color rojo, violáceo o marrón, que aparece predominantemente en mujeres y se localiza en el tronco. Su histología es semejante a la del liquen plano. Su origen es desconocido, aunque se presume que corresponde al resultado final de un proceso inflamatorio de una lesión preexistente, principalmente léntigo solar, queratosis actínica yqueratosis seborreica.

Lichenoid keratosis occurs as a solitary lesion in form of a red, purple or brown, macule or papule which appears predominantly in women, and in the trunk. Its histology is similar to lichen plannus. Its origin is unknown, although it is presumed that it corresponds to the final result of an inflammatory process of a preexistinglesion, mainly solar lentigo, actinic keratosis and seborrheic keratosis.

Reacción liquenoide en mucosa bucal asociada a restauración de amalgama: reporte de caso clínico / Lichenoid reaction in oral mucosa associated with amalgam restoration: case report

La reacción liquenoide en la mucosa bucal es una de las formas más frecuentes de las reacciones de hipersensibilidad retardada como respuesta inmune que puede estar relacionada al mercurio u otro componente de la amalgama. La reacción liquenoide es una lesión clínica e histológicamente indistinguible del liquen plano bucal. La única diferencia estriba en que desaparece al retirar el agente causante. Este trabajo tiene como objetivo presentar un caso de lesión liquenoide en mucosa bucal en una mujer de 34 años que solicito asistencia odontológica para diagnóstico y tratamiento de una lesión blanca en la mucosa yugal y encía vestibular derecha adyacente a los dientes 16 y 17 que presentaban restauración de amalgama. Se realizó una biopsia incisional y examen histopatológico teniendo un resultado compatible con el Liquen Plano. Con el consentimiento de la paciente las restauraciones de amalgama fueron substituidas por resina compuesta. Fue verificada la regresión continua de la lesión durante el seguimiento clínico del caso. El diagnóstico definitivo de lesiones liquenoides asociadas a la presencia de restauración de amalgama como factor etiológico es de suma relevancia porque de esta forma se obtiene un tratamiento basado en una intervención simplificada y local, diferente de la compleja actuación que ocurre en tratamientos que envuelven enfermedades auto-inmunes como el liquen plano.

Lichenoid reaction in the buccal mucosa is one of the most frequent forms of delayed hypersensitivity reaction as an immune response, which could be related to mercury or another amalgam component. It is a rare manifestation that is an important differential diagnosis in the group of buccal leucoplakias; and it is the reason of many controversies, particularly regarding lichen planus. The aim of this paper is to present a buccal mucosa lichenoid lesion case in a 34 year-old woman who requested odontologic assistance to be diagnosed and treated for a white lesion, located in the jugal mucosa and right vestibular gum, adjacent to teeth 16 and 17, which had amalgam restorations. An incisional biopsy and a histopatologic exam were made. The result was compatible with Liquen Planus. With the patient's consent the amalgam restorations were replaced with compound resin. A continuous regression of the lesion was verified during the clinical monitoring of the case. The final diagnosis of lichenoid lesions related to amalgam restorations as an etiologic factor is remarkable because by means of this a treatment based on a simplified and local intervention is obtained, which is different from the complicated procedure for treatments that involve auto-immune diseases like lichen planus.

Oral lichenoid lesions: Clinico-pathological mimicry and its diagnostic implications.

Oral cavity is commonly affected by number of lichenoid lesions, whose clinical and histopathologic features overlap due to the presence of inflammatory cells in connective tissue. Segregation of these lichenoid lesions is mandatory as each may embody a distinct disease entity in terms of cause, diagnosis and prognosis. The literature discussed in the article is an attempt to segregate individual lichenoid lesions by defining clinical and histopathologic variations among each other, which avoids the diagnostic problem.

Oral lichenoid lesions associated with amalgam restorations: report of two cases / Lesões liquenóides bucais associadas a restaurações de amálgama: relatos de dois casos

PURPOSE: Dental amalgam has been used as a dental restoration for more than 165 years. However, some patients with these restorations may present oral lichenoid lesions (OLL). OLL are chronic oral mucosal contact reactions to dental amalgam. Their diagnosis usually is based on the direct contact of the affected mucosa with the amalgam restorations, clinical appearance, and lack of migrations. A patch-test for mercury can be performed to confirm the diagnosis. Thus, the objective this work was to discuss the occurrence of this disease and your possibilities of existing differential diagnostic. CASE DESCRIPTION: Two clinical cases were diagnosed as related to OLL. In both cases, the patients complained of a burning sensation in the oral mucosa adjacent to the amalgam restorations. The treatment involved replacing the amalgam restorations by composite. A complete remission of the painful symptoms was observed after 17 days in one case and after one month in the other, although the lesions in the oral mucosa did not disappear completely. CONCLUSION: Dentists should be aware of OLL occurrence close to amalgam restorations and should be able to diagnose it and recommend the best treatment option.

OBJETIVO: O amálgama dentário tem servido como restaurador dentário a mais de 165 anos. Entretanto, alguns pacientes com estas restaurações têm demonstrado a ocorrência de lesões liquenóides orais (LLO). As LLO são reações de contato da mucosa oral crônicas ao amálgama dentário. Geralmente, o diagnóstico da lesão é feito pelo contato direto da mucosa afeta com a restauração de amalgama, pela aparência clínica, e a ausência de migrações. Um teste de contato para o mercúrio pode ser realizado para confirmar o diagnóstico. Assim, o objetivo deste trabalho foi discutir a ocorrência desta doença e suas possibilidades de diagnóstico diferencial existentes. DESCRIÇÃO DO CASO: Dois casos clínicos foram diagnosticados como LLO. Em ambos os casos, os pacientes relataram sofrer de sensação de queimação na mucosa oral adjacente às restaurações de amálgama. Para ambos pacientes, os tratamentos envolveram a substituição das restaurações de amálgama. Completa remissão da sintomatologia dolorosa foi observada após 17 dias em um caso e após 30 dias em outro, embora as lesões na mucosa intrabucal não tenham desaparecido completamente. CONCLUSÃO: Os cirurgiões-dentistas devem estar cientes da ocorrência da LLO relacionadas a restaurações de amálgama e devem saber como fazer o diagnóstico correto para assim recomendar a melhor forma de tratamento.

Hanseníase simulando erupção liquenóide: relato de caso e revisão de literatura / Leprosy simulating lichenoid eruption: case report and literature review

A hanseníase relaciona-se à formação de grande variedade de lesões cutâneas, desde manchas, pápulas, placas e nódulos, até infiltração difusa, dependendo da resposta imune do indivíduo. A apresentação clínica foge, muitas vezes, do padrão habitual, fazendo com que especialistas confundam o diagnóstico. O artigo descreve um caso raro de hanseníase, simulando erupção liquenoide, abordando os diferentes aspectos das manifestações clínicas, do diagnóstico e do tratamento desta entidade nosológica.

Leprosy is associated with the occurrence of various skin lesions such as macules, papules, plaques, nodules, and even diffused infiltration, depending on the patient's immune response. Its clinical presentation is often different from the usual pattern, leading to confusion in diagnosis. The present article describes a rare case of leprosy simulating lichenoid eruption and explores different aspects of the clinical manifestations, diagnosis, and treatment of this nosologic entity.

Queratosis liquenoide benigna / Benign lichenoid keratosis

La queratosis liquenoide benigna es una dermatosis relativamente frecuente, con presentación clínica en determinados ocasiones, que puede llegar o lo confusión con el melanoma. Se plantea que puede ser una lesión benigna en regresión. La dermatoscopia es de gran utilidad para lo orientación diagnóstica. El diagnóstico es histopatológico, por lo cual en los casos confusos lo realización de una biopsia está indicada. Se realizo uno revisión de lo literatura sobre la clínica, histopatología y dermatoscopia de lo queratosis liquenoide benigna.

Benign lichenoid keratosis is a relatively common dermatosis which clinical presentation in some cases causes confusion with melanoma. It is suggested that it may be a regressing benign lesion. Dermascopy is very useful for diagnostic orientation. The histopathological diagnosis, thus confusing where the biopsy is indicated. A review of the literature on benign lichenoid keratosis clinical, histopathology and dermascopy pattems is exposed.

Líquen plano: breve revisão de suas características clínicas, etiológicas, laboratoriais e terapêuticas / Lichen planus: brief revision of clinicals, etiologicals, laboratorials and therapeuticals characteristics

Interessados pela importante dermatose denominada líquen plano, os autores fazem uma breve revisão da literatura abordando algumas características da doença, tais como clínica, etiologia, epidemiologia, diagnóstico e possíveis terapêuticas atuais, visando uma modesta contribuição ao estudo da mesma

Lichenoid dermatosis. A clinical and histopathological study

A distinctive skin problem has been observed for the last 10 years that appeared on the neck of a young adult. This encouraged us to conduct this study, to evaluate its clinical and histopathological picture. Thirty patients were studied in the Department of Dermatology, Baghdad Teaching Hospital, Iraq during a one-year period from November 1998 through to November 1999. There were 29 males and a female, their ages ranged from 11-50 years [mean 25 years]. Patients complained of rash on the back and sides of the neck, they were fully interrogated and examined and skin biopsy was carried out in 10 patients. The study showed that this disease has well defined clinical pictures, which affect young males mainly and appeared in summer time. The rash was located mostly on the back of the neck; it had dark-red to red-violeceous, rounded to oval, single or multiple plaques. The rash was mainly asymptomatic a part from appearance. The histopathological picture has many similarities with that of lichen planus actinicus, but with striking increased vascularity of the dermis. From the clinical and histopathological study, this skin problem deserve its own name lichenoid dermatosis, which was induced by solar radiation and has many similarities with lichen planus actinicus and could be confused with lichen simplex chronicus

Antidepressivo tricíclico e erupçäo liquenóide / Tricyclic antidepressive and liquenoid eruption

Os autores apresentam um caso de erupçäo liquenóide desencadeada sete dias após o início do uso de nortriptilina e realizam uma revisäo de literatura, na qual näo foram encontrados relatos desta associaçäo. É ressaltada a necessidade dos médicos, em particular, dos dermatologistas manterem atençäo permanente para possíveis novas associaçöes causais entre uma fármaco e determinado quadro clínico cutâneo.

Inflamacao liquenóide / Lichenoid inflamation

O liquen plano e outros vários quadros clínicos dermatológicos com morfología macroscópica semelhante, e por isso recebndo a designaçao de liquenóide ou somente apresentando o quadro histopatológico do líquen plano, que assim recebe o batismo de inflamaçao liquenóide, constituem o tema abordado neste estudo. O ceratinícito da camada basal é o alvo da agressao e o palco dos aconttecimentos patológicos, sobretudo de base molecular, que começam a ser conhecidos, embora ainda incompletamente. A base da inflamaçao liquenóide é uma reaçao imunológica de hipersensibilidade retardada, que aos poucos vem sendo esclarecida. A intensidade da inflamaçao liquenóide é variável, indo desde a destriçao da camada basal, com grande infiltraçao linfocitária da mesma e da derme papilar subjacente, até ao encontro fortuito de apenas focos inflamatórios liquenóides em variadas doenças cutâneas, como ceratoses, actínticas, ceratoses seborréicas, carcinomas, nevos melanocíticos e outras doenças cutâneas

Erupción liquenoide por reveladores a color: a propósito de un caso / Lichenoid eruption by color developers: a purpose of a case

Las erupciones liquenoides son un grupo de dermatosis con un cuadro semejante y en ocasiones indistinguible desde un punto de vista clínico e histológico al liquen plano. Se reporta el caso de un paciente masculino, de 46 años de edad, de ocupación fotógrafo con diagnóstico de erupción liquenoide por reveladores a color, enfermedad poco frecuente que se manifiesta con lesiones similares al liquen plano localizadas en zonas expuestas al producto industrial y se realiza revisión de la literatura

Líquenes planos sistematizados: a propósito de 10 casos / Systematized lichen planus: review on 10 cases

Presentamos 10 casos de líquenes planos sistematizados de los cuales 8 eran mujeres con un promedio de edad de 37 años, localizados predominantemente en tórax y miembros superiores y una forma hemilingual no descrita en la literatura. Ocho de ellos parecían disponerse siguiendo metámeras, excepto dos que adoptaban un patrón según se describen las líneas de Blaschko. Seis refirieron prurito de leve a moderado

Liquen estriado: a proposito de seis nuevos casos / Striatus lichen: a propouse of six cases

El liquen estriado es una dermatosis adquirida, que sigue las líneas de Blaschko, de escasa frecuencia y que afecta sobre todo a niños con neto predominio por el sexp femenino. Se caracteriza por presentar una districución unilateral y leneal de pápulas liquenoides que asientan usualmente sobre las extremidades. Presentamos sus rasgos clínicos, antecedentes y posibles asociaciones