Many factors have been proposed to influence oral infection with yeast. The aim of this study was to determine the prevalence of oral yeasts in oral lichen planus (OLP) patients and control subjects, and to perform a multiple logistic regression analysis to identify factors that influence oral Candida infection in OLP patients. In this cross-sectional study, 90 new patients with OLP and 90 sex- and age-matched control subjects with no mucosal lesions were interviewed about their health status, use of medication, and smoking and alcohol habits. Swab and unstimulated whole saliva samples were collected and salivary pH was measured. A positive Candida culture was more prevalent among OLP patients (48.9%) than among control subjects (26.7%). Candida albicans was the most frequently isolated species in both groups. By logistic regression analysis, unstimulated whole salivary flow rates of 0.11-0.24 ml min(-1) (OR = 5.90) and 0.25-0.32 ml min(-1) (OR = 3.51) and benzodiazepine anxiolytics intake (OR = 8.30) were independently associated with the presence of Candida among OLP patients. Age, denture wearing, levels of dentition, decreased salivary pH, antihypertensive drugs, and alcohol consumption were not associated with oral Candida infection in OLP patients. The results indicate that data on benzodiazepine anxiolytics intake and evaluation of unstimulated whole salivary flow rate should be considered as part of the clinical evaluation to identify OLP patients at risk for Candida infection.

Patients with OLP resident in Serbia do not have evidence of chronic liver disease or infection with HBV or HCV. The exact aetiological role between hepatic disease and OLP remains unclear.

Recently, an interest in the study of oral candidiasis has markedly increased mainly because of its association with viral infections due to human immunodeficiency, but also because of its relation with potentially malignant lesions of oral mucosa. These lesions belong to the wide group of leukoplakia. Leukoplakia is a clinical term used to describe a range of nonspecific white lesions, whose appearance does not generally correlate well with histopathologic changes; therefore, biopsy should be performed in all cases to determine which are precancerous or potentially malignant ones. In order to study the association of Candida albicans and the types of mucosal lesions, we took 30 consecutive biopsies of oral mucosa and the smears for microbiologic examination from the changed surface of mucosa and from the rest of oral cavity. The study group consisted of 30 patients, 21 women and 9 men, with the average age of 50.23 years (range, 25-77 years). In 6 cases Candida was diagnosed in mucosal biopsy. In the smear from the lesion, it was present in 3 cases, and 2 cases were found in the smear from an unchanged oral mucosa. In 9/30 cases (30%) Candida was positive regardless of the smear area or mode of diagnosis. The most common lesion is leukoplakia, diagnosed in 12/30 cases (40%), in 6 female and 6 male patients. The average age of those patients was 52.42 years. The lesions were located as follows: cheek mucosa - 5 cases; gingival mucosa - 2; lower lip - 2; floor of the mouth - 2; soft palate - 1; Candida was present in 3/12 cases. The lesion with the second highest incidence is lichen planus (9 cases), with positive Candida infection in 4/9 (44.44%). Epithelial dysplasia, although diagnosed in a very small number of cases (1/30 or 3.3%) with leukoplakia, was associated with a Candida infection. Generally, Candida is present in potentially malignant oral mucosal lesions (in 3/12 or 25% of leukoplakia cases, in 4/9 or 44.44% of lichen planus cases, and 1/1 squamous papilloma), with an increasing incidence in lesions with serious dysplastic epithelial changes

Smoking and alcohol consumption are often coexistent factors making it difficult to assess the effects of these factors individually. In our study the highest prevalence of leukoplakia (33.3%) was established in subjects who smoked cigarettes and consumed alcohol, compared to those who smoke tobacco only (18.2%).

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