Oral lichen planus: A look from diagnosis to treatment.

Córdova, Pablo; Rubio, Aida; Echeverría, Paula

doi:10.17126/joralres.2014.015

Cited by 12 publications

(16 citation statements)

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“…Autoimmune hypothesis is supported by a number of characteristics of the disease: chronic course; manifestation in adults; predominantly affecting the female gender; presence of T-lymphocytes in the lesion; other autoimmune comorbidities; effi cacy of immunosuppressive therapy. 1,21 TGF-β1 suppresses immune response to selfantigens and its defi ciency predisposes the body to the development of autoimmune diseases. Low expression of this growth factor in OLP lesions is reported.…”

Section: Pathogenesismentioning

confidence: 99%

“…Their higher expression of keratinocytes in the affected areas is another indication of the involvement of autoimmunity in the pathogenesis of the disease. 1,21 According to Langerhans-mediated autoimmune hypothesis, autoantigens are the apoptotic keratinocytes themselves. After their phagocytosis, LC activate Th, and they in turn -CD8 + Tc, thereby enhancing cell death.…”

Section: Pathogenesismentioning

confidence: 99%

“…After their phagocytosis, LC activate Th, and they in turn -CD8 + Tc, thereby enhancing cell death. 1,21 Evidence from different authors has suggested the involvement of humoral immunity in the pathogenesis of the disease due to circulating autoantibodies against desmogleins 1 and 3 22 and anti-basal cell antibodies 23 they detected in the serum of patients with OLP.…”

Section: Pathogenesismentioning

confidence: 99%

“…At this stage, complete eradication of the disease cannot be achieved by any method. 21 It is essential to eliminate local irritating or aggravating factors in the oral cavity (sharp edges of fi llings, fractured teeth, harmful habits). Scaling and instructions for optimum oral hygiene improve the condition in patients with gingival LP.…”

Section: Treatmentmentioning

confidence: 99%

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Oral Lichen Planus – Known and Unknown: a Review

et al. 2018

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Lichen planus is a chronic mucocutaneous inflammatory disease aff ecting 1-2% of the general population with maximum prevalence of the disease in women above the age of 40. Its aetiology remains unclear and the pathogenesis is still the object of much speculation. It is considered to be an autoimmune disorder mediated mainly by the T-lymphocytes. The present paper presents the most well-known external agents (viruses in particular), internal agents like stress, and the heat shock protein thought to be trigger factors and describes the action of diff erent cells and proteins associated with the development of that disease. Diagnosis is based on clinical and histopathologic evidence; direct and indirect immunofluorescence techniques can also be of use. Despite the wide variety of therapeutic modalities, treatment outcomes are often insufficient. Currently, topical corticosteroids are widely accepted as a standard therapy, but also retinoids, calcineurin inhibitors and other immunosuppressants can be administered. Because of the aspect relevant to these drugs, priority is given to alternative harmless methods such as LLLT and PDLT. There is an ongoing controversy in the literature about the possible premalignant character of oral lichen planus, however, periodic followup is recommended.

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Section: Pathogenesismentioning

confidence: 99%

Section: Pathogenesismentioning

confidence: 99%

Section: Pathogenesismentioning

confidence: 99%

Section: Treatmentmentioning

confidence: 99%

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Oral Lichen Planus – Known and Unknown: a Review

et al. 2018

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“…At this stage, complete eradication of the disease cannot be achieved by any method. 9 Topical corticosteroids are considered a gold standard in the treatment of OLP but they can produce adverse effects including thinning of the oral mucosa, secondary candidiasis and tachyphylaxis. 5,9,10 Retinoids and several potent immunosuppressive agents like cyclosporine and tacrolimus have been proposed as alternatives to corticosteroids for influencing the symptoms but they all may cause adverse effects.…”

mentioning

confidence: 99%

Effects of Low Level Laser Therapy on Erosive-atrophic Oral Lichen Planus

Mutafchieva¹,

Draganova-Filipova²,

Zagorchev³

et al. 2018

Folia Medica

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Background: The erosive-atrophic form of oral lichen planus (OLP) is associated with severe pain and burning sensation and is often unresponsive to treatment. Topical corticosteroids are considered as a medication of first choice but they can produce adverse effects. Therefore, new therapeutic approaches are required. Aim: The aim of this study was to investigate the effectiveness of biomodulation with diode laser in patients presenting with long-standing erosive-atrophic OLP. Materials and methods: Twelve patients, clinically and histologically diagnosed with OLP, participated in this study. The level of pain and the clinical scores of total 59 lesions were recorded before treatment using visual analog scale and Thongprasom sign scoring system respectively. All patients received low level laser therapy (LLLT) with diode laser (810 nm) with parameters (0.5 W, 30 s, 1.2 J/cm2) three times weekly for a month. The response rate was assessed according to the decrease in pain and sign scores. Treatment efficacy index was calculated. Results: There was a significant reduction in pain after LLLT (p<0.0001). Improvement in clinical signs was achieved in 59.3% of the lesions. At the end of the treatment 5.1% of the lesions exhibited score 5; 6.8% - score 4, 11.9% of the lesions were scored 3 and 8.5% and 30.5% showed score 2 and score 1, respectively. Complete resolution was revealed in 37.3% of the lesions. All patients experienced some degree of improvement. Most of the cases showed moderate recovery. Conclusion: The present results indicate that LLLT is an effective and harmless modality for management of erosive-atrophic OLP.

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