SummaryBackground An association between hepatitis C virus (HCV) infection and lichen planus (LP) has been investigated, but results have been inconsistent. Objectives To investigate the relationship between LP and HCV seropositivity. Methods In a cross-sectional study we tested the sera of 303 consecutive newly diagnosed patients with histologically proven LP referred to three Italian centres for the presence of anti-HCV IgG. A comparable control group was also tested. Next, in a systematic review, studies were identified by searching different databases in April 2004. Inclusion criteria were: (i) analytical study design; (ii) clinical and histological diagnosis of LP; and (iii) serological test for anti-HCV antibodies as main outcome. The risk of bias was assessed on the basis of characteristics of the study group, appropriateness of the control group and study design. Pooled data were analysed by calculating odds ratios (ORs), using a random effects model. Results In the cross-sectional study, nearly one in five (19AE1%) of the LP group was HCV positive, while a much lower prevalence of infection was found in the control group (3AE2%) [OR 7AE08; 95% confidence interval (CI) 3AE43-14AE58]. The systematic review yielded 25 relevant studies, six of which had a low risk of bias. There was a statistically significant difference in the proportion of HCV-seropositive subjects among patients with LP, compared with controls (OR 4AE80; 95% CI 3AE25-7AE09). Following subgroup analyses, the variability of HCV prevalence in patients with LP seemed to depend on geographical area, but not on age. Conclusions Anti-HCV circulating antibodies are more common in patients with LP than in controls, although such an association may not be significant in some geographical areas.

Burning mouth syndrome (BMS) or stomatodynia is characterized by a spontaneous burning pain in the oral mucosa without known cause or recognized treatment. This double-blind, randomized, placebo-controlled, single-center study evaluated the effects of systemic Hypericum perforatum extract in patients with BMS. Forty-three patients participated, of whom 39 (35 women, four men, aged 64.9 +/- 4.7 years) completed the study. The patients took indistinguishable 300-mg capsules containing either H. perforatum extract (hypericin 0.31% and hyperforin 3.0%) or placebo three times a day for 12 weeks. The intensity of burning pain was evaluated using a 10-cm visual analog scale (VAS) before the first dose and at visits after 4, 8, and 12 weeks. Furthermore, we also recorded the number of oral mucosa sites with reported burning symptoms and the self-reported descriptions of the patient's condition before and after the treatment. Pain, measured using the VAS, was similar at the beginning of the study and even though a slightly better performance in the test group, the difference was not statistically significant (P = 0.2216). The results failed to demonstrate that 300 mg of H. perforatum extract taken three times a day for 12 weeks improved the pain of BMS patients, although the general reduction in the number of sites with reported burning sensation, a less accurate and objective score, was significant.

Objectives: Evaluating data of patients affected by oral mucoceles, examined at the Unit of Oral Medicine and Pathology of the University of Milan between January 1994 and December 2008. Study Design: Concise review on oral mucoceles and analysis of the clinical files of patients who underwent excisional biopsy (patient age, medical history, diagnosis, date and site of the biopsy, histopathological diagnosis and recurrences if any). Results: During the period June 1994-December 2008, 158 mucoceles were observed (93 males and 65 females), with the most frequent site being the lower lip (53%) (p=0.001 by Fisher's test). The mean age of the patients was 31.9 years, with a peak of occurrence in the first four decades of life (75%). Conclusions: Mucoceles are lesions commonly seen in an oral medicine service, mainly affecting young people and lower lips.

The results of this study seem not to support a role for the usually reported causative or precipitating factors of BMS and efforts should be addressed towards different aetiologies including possible neuropathic mechanisms of BMS.