oral lichen planus

口腔扁平苔藓
  • 文章类型: Journal Article
    背景和目的:嘴唇扁平苔藓(LPL)是一种慢性炎症性疾病,类似于光化性唇炎,盘状红斑狼疮,移植物抗宿主病,和苔藓对牙科材料或药物的反应。这项研究的目的是对扁平苔藓嘴唇受累进行文献综述,并报告一项回顾性观察性研究,组织病理学,以及一组LPL独特受累患者的病变演变。材料和方法:从医学与药学大学“CarolDavila”口腔病理学系的患者病历中检索诊断为LPL的患者的临床资料。从2003年到2023年,使用PubMed和WebofScience进行了同时进行的电子文献研究。结果:分析了11例诊断为独特LPL的患者(男女比例为1.75,平均年龄63.64岁±12.52)。所有患者均表现为下唇病变;临床形式为萎缩性(6例)和糜烂性(5例),组织病理学检查证实了诊断.用皮质类固醇局部治疗后,大多数患者完全缓解.文献综述显示了24项研究(16例病例报告和8例病例系列),其中包括84例患者。在17项研究中报道了孤立的嘴唇受累,五篇文章伴有口腔扁平苔藓,而两篇文章没有提到这个标准。结论:我们的研究带来了有关孤立的嘴唇扁平苔藓的新数据,该扁平苔藓主要影响男性患者的下唇。在22至75岁之间的患者中,全世界都有报道。局部皮质类固醇是处方的主要治疗方法,通常可以缓解病变。嘴唇扁平苔藓对于口腔保健医生提供者以及皮肤科医生来说是具有挑战性的诊断。
    Background and Objectives: Lichen planus of the lip (LPL) is a chronic inflammatory condition that resembles actinic cheilitis, discoid lupus erythematosus, graft-versus-host disease, and lichenoid reaction to dental materials or drugs. The purpose of this study was to conduct a literature review on lichen planus lip involvement and to report a retrospective observational study that characterises and explores the clinical, histopathological, and evolution of the lesions in a group of patients with unique involvement of LPL. Materials and Methods: Clinical data of patients diagnosed with LPL was retrieved from the medical charts of the patients referred to the Oral Pathology Department of the \"Carol Davila\" University of Medicine and Pharmacy. A concurrent electronic literature research was carried out using PubMed and Web of Science from 2003 to 2023. Results: Eleven patients diagnosed with unique LPL were analysed (male/female ratio was 1.75, mean age 63.64 years ± 12.52). All patients presented lesions of the lower lip; the clinical forms were atrophic (six cases) and erosive (five cases), and the histopathological exam confirmed the diagnosis. After topical treatment with corticosteroids, most of the patients had complete remission. The literature review revealed 24 studies (sixteen case reports and eight case series) which comprised 84 patients. Isolated lip involvement was reported in 17 studies, and five articles with concomitant oral lichen planus, while two articles did not mention this criterion. Conclusions: Our study brings new data on isolated lichen planus of the lip that primarily affects the lower lip with predominance in male patients. It was reported worldwide in patients between 22 and 75 years old. Topical corticosteroids were the main treatment prescribed and they usually brought remission of the lesions. Lichen planus of the lip is a challenging diagnosis for oral health practitioner providers as well as for dermatologists.
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  • 文章类型: Case Reports
    管理顽固性口腔扁平苔藓(OLP)可能具有挑战性。激光治疗已被建议作为皮质类固醇的替代治疗。光动力疗法(PDT)是一种非侵入性技术,无需手术即可去除病变。光生物调节疗法(PBMT)可以促进病变的愈合和恢复。
    目的是用PDT和PBMT的组合治疗整个颊粘膜的无反应的双侧OLP。
    一名43岁的泰国男性表现为双侧颊粘膜的网状OLP严重疼痛,累及上前庭和下前庭区。使用泼尼松龙全身性类固醇或氟轻松局部皮质类固醇均未缓解病变。在用10%的5-氨基乙酰丙酸(5-ALA)以热塑性凝胶形式和635nm的二极管激光器在100至400mW下进行10次PDT后,能量密度为20至30J/cm2连续波模式,结合使用635nm二极管激光器在200至300mW下在连续波中具有6至10J/cm2的能量密度的PBMT的五个临时会话,患者报告除病灶缓解外,烧灼感减轻,无任何并发症。
    可以通过结合PDT和PBMT来管理具有灼烧感的广泛传播的顽固性OLP。
    UNASSIGNED: Managing recalcitrant oral lichen planus (OLP) can be challenging. Laser therapy has been suggested as an alternative to corticosteroids for treatment. Photodynamic therapy (PDT) is a non-invasive technique that enables the removal of lesions without surgery. Photobiomodulation therapy (PBMT) can promote healing and recovery of the lesions.
    UNASSIGNED: The objective was to treat unresponsive bilateral OLP of the whole buccal mucosae with a combination of PDT and PBMT.
    UNASSIGNED: A 43-year-old Thai male presented with the severe painful reticular type of OLP of bilateral buccal mucosae involving upper and lower vestibular areas. The lesions were not remitted with either prednisolone systemic steroids or fluocinolone topical corticosteroids. After undergoing ten sessions of PDT with 10% 5-Aminolevulinic acid (5-ALA) in the form of thermoplastic gel and a 635 nm diode laser at 100 to 400 mW with an energy density of 20 to 30 J/cm 2 in continuous wave mode, combined with five interim-sessions of PBMT using a 635 nm diode laser at 200 to 300 mW with an energy density of 6 to 10 J/cm 2 in continuous wave, the patient reported relief of burning sensation beside remission of lesions without any complications.
    UNASSIGNED: The wide-spreading recalcitrant OLP with burning sensation can be managed by combining PDT and PBMT.
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  • 文章类型: Letter
    暂无摘要。
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  • 文章类型: Case Reports
    Verrucous xanthoma is a rare benign muco-cutaneous lesion, whereas oral lichen planus is a chronic inflammatory disease relatively common in the clinical setting. Verrucous xanthoma and oral lichen planus can reportedly coexist according to foreign literature. Owing to the low incidence of verrucous xanthoma and the rarity of co-occurrence of these two diseases, the mechanism underlying the co-occurrence of the two diseases remains inconclusive. In this work, a case of oral verrucous xanthoma complicated with oral lichen planus was reported. Related literature was reviewed to discuss the clinical classification, pathological classification, and possible pathogenesis of the two diseases.
    疣状黄瘤是一种罕见的良性黏膜皮肤病变,而口腔扁平苔藓则是口腔门诊中较为常见的一种慢性炎症性疾病。国外已有文献报道,疣状黄瘤与口腔扁平苔藓可以存在伴发现象。由于疣状黄瘤的低发病率,两病共存的情况较为罕见,目前,对于两种疾病伴发的内在机制尚无定论。本文报道了1例口腔疣状黄瘤合并口腔扁平苔藓的临床病例,并回顾相关文献,探讨两种疾病伴发的临床分类、病理分型及可能的发病机制。.
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  • 文章类型: Journal Article
    扁平苔藓(LP)是一种影响皮肤的炎症性疾病,头发,指甲和粘膜。糜烂性LP是一种慢性且难以治疗的扁平苔藓亚型,以粘膜表面病变为特征,特别是在口腔和生殖器区域。侵蚀性LP的患病率尚未确定。迄今为止,治疗包括手术干预,光动力疗法,激光治疗,和全身或局部药物,包括类固醇和免疫调节剂。LP通常需要更长的治疗时间,被称为癌前病变,转化率为0.4%至12%。此外,近25%的外阴糜烂性LP患者对局部皮质类固醇有抗性,这是治疗的首选。本研究报告6例,平均年龄3.33岁,他们被诊断患有糜烂性LP病变,以前在局部治疗中失败,病灶内,和全身性类固醇,和羟氯喹.然后,这些患者每天服用10mg托法替尼。有趣的是,有了新的治疗方法,患者的平均总体满意度评分为9.16,满分10分(范围:8-10),平均疼痛缓解评分为9.16/10分(范围:9-10分),患者症状也在治疗开始后平均1.33个月开始改善(范围:1-2.5个月).
    Lichen planus (LP) is an inflammatory disease that affects the skin, hair, nails and mucous membranes. Erosive LP is a chronic and difficult-to-treat subtype of lichen planus, characterized by lesions on mucosal surfaces, particularly in the oral and genital areas. The prevalence of erosive LP has not been determined. To date, treatment has consisted of surgical intervention, photodynamic therapy, laser therapy, and systemic or topical drugs, including steroids and immunomodulatory agents. LP usually need longer periods of treatment and are known as precancerous lesions with a 0.4% to 12% conversion rate. In addition, nearly 25% of patients who develop erosive LP of the vulva are resistant to topical corticosteroids, which are the first choice of treatment. This study reports 6 cases with a mean age of 3.33 years, who were diagnosed with erosive LP lesions and previously failed in treatment with local, intralesional, and systemic steroids, and hydroxychloroquine. These patients were then treated with 10 mg of tofacitinib per day. Interestingly, with the new treatment, the patients\' mean overall satisfaction score was 9.16 out of 10 (range: 8-10), the mean pain relief score was 9.16 out of 10 (range: 9-10) and patients\' symptom improvement also began an average of 1.33 months after starting treatment (range: 1-2.5 months).
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  • 文章类型: Journal Article
    口腔扁平苔藓(OLP)是一种影响皮肤和粘膜的自身免疫起源的慢性炎性疾病。这项研究的目的是评估红外热成像(IRT)作为口腔扁平苔藓(OLP)患者诊断工具的有效性。以及味觉障碍,在有和没有舌头参与的情况下。在87名患者的样本中进行了病例对照研究,分为三组:健康个体(对照组;n=43),无舌头受累的OLP患者(n=24),和OLP患者的舌头受累(n=20)。评估患者症状和病变的临床特征。使用IRT:背侧获得了舌头的四个热图像,左右侧面,和舌尖。一般味觉感知能力和主观甜味,酸,咸,在所有三组中评估苦味感觉。三组间IRT值差异无统计学意义(p≥0.05)。在舌头受累的OLP患者中,在疾病的混合形式中观察到显着更高的值(p=0.032)。有和没有舌头受累的OLP患者的味觉没有明显变化(p=0.69)。IRT可以作为评估OLP活动与舌头有关的补充工具。然而,在这个领域需要更多的研究。
    Oral lichen planus (OLP) is a chronic inflammatory disease of autoimmune origin that affects the skin and mucous membranes. The aim of this study was to assess the effectiveness of infrared thermography (IRT) as a diagnostic tool in patients with oral lichen planus (OLP), as well as disturbances in taste perception, in cases with and without tongue involvement. A case-control study was carried out in a sample of 87 patients divided into three groups: healthy individuals (controls; n = 43), OLP patients without involvement of the tongue (n = 24), and OLP patients with involvement of the tongue (n = 20). The patient symptoms and the clinical characteristics of the lesions were assessed. Four thermal images of the tongue were obtained using IRT: dorsum, right and left lateral surface, and tip of the tongue. General taste perception capacity and subjective sweet, acid, salty, and bitter sensation were evaluated in all three groups. There were no statistically significant differences in the IRT values among the three groups (p ≥ 0.05). In the OLP patients with involvement of the tongue, significantly higher values were observed in the mixed forms of the disease (p = 0.032). The OLP patients with and without involvement of the tongue showed no significant alterations in taste sensation (p = 0.69). IRT may serve as a complementary tool for assessing the activity of OLP with involvement of the tongue. However, more research is needed in this field.
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  • 文章类型: Case Reports
    钛和金属合金广泛用于植入物,皇冠,和桥梁在种植牙科由于其生物相容性。在一例45岁女性患者的病例报告中,在不同的时间点将多个植入物置于五种不同的六分仪中.值得注意的是,口腔苔藓样病变(OLL)发生在植入物放置后的三个六分仪中,强烈建议牙种植体或假体是OLL的致病因素。病变为网状型,周围有红斑,有症状。虽然有几种保守治疗,包括反复局部应用皮质类固醇,一再继续,未观察到明显的症状改善或缓解.因此,进行了手术切除和从pal软组织收获的游离牙龈移植物(FGG)置换病变。在FGG后的10年随访期间未观察到临床症状或病变复发。
    Titanium and metal alloys are widely used in implants, crowns, and bridges in implant dentistry owing to their biocompatibility. In this case report of a 45-year-old female patient, multiple implants were placed in five different sextants at different time points. Notably, oral lichenoid lesions (OLL) occurred in three sextants following implant placement, strongly suggesting that the dental implants or prostheses were the causative factors for OLL. The lesion was of the reticular type with erythematous surroundings and was symptomatic. Although several conservative treatments, including repeated topical application of corticosteroids, were repeatedly continued, no discernible improvement or alleviation of symptoms was observed. Consequently, surgical excision and replacement of the lesion with a free gingival graft (FGG) harvested from the palatal soft tissue were performed. No clinical symptoms or recurrence of lesions were observed during 10 years of follow-up post-FGG.
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  • 文章类型: Case Reports
    甲癣是一种罕见的发现,其特征是指甲具有均匀且同时存在的脆性,过度的纵向生长,脊线,和失去光泽。通常,二十甲营养不良(TND)/甲癣是一种特发性疾病,但有时皮肤病如斑秃,扁平苔藓,和牛皮癣被发现与它有关。我们报告了一名年轻男性的三甲/TND病例,伴有肥厚型皮肤扁平苔藓,网状口腔扁平苔藓,和指甲扁平苔藓,在皮肤镜检查和组织病理学的帮助下被诊断出来。许多皮肤疾病,系统性疾病,感染会导致指甲营养不良;因此,正确的诊断对于治疗根本原因至关重要。早期干预改善了患者的预后,减轻了他们的心理压力和美容问题。
    Trachyonychia is an uncommon finding characterized by the nails having a uniform and simultaneous presence of fragility, excessive longitudinal growth, ridging, and loss of luster. Usually, twenty-nail dystrophy (TND)/trachyonychia is an idiopathic condition, but sometimes dermatoses such as alopecia areata, lichen planus, and psoriasis are found to be associated with it. We report a case of trachyonychia/TND in a young male with the concomitant presence of cutaneous lichen planus of hypertrophic type, reticular oral lichen planus, and nail lichen planus, which was diagnosed with the aid of dermoscopy and histopathology. Many cutaneous disorders, systemic illnesses, and infections can cause nail dystrophy; therefore, a proper diagnosis is crucial to treat the underlying cause. Early intervention improves patients\' prognosis and alleviates their psychological strain and cosmetic concerns.
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  • 文章类型: Journal Article
    目的:本研究的目的是调查银屑病是否构成OLP的合并症,并阐明抑郁和焦虑治疗的效果。
    方法:我们分析了2014-2022年临床和组织学诊断为OLP的连续患者队列。结果与年龄和性别相匹配的对照系列中获得的结果形成对比。OLP与性别的相关性,年龄,烟草,酒精,牛皮癣,使用Pearson检验卡方评估抑郁和焦虑的治疗。采用多因素回归分析评价银屑病与OLP的相关性。为了评估统计模型的质量,使用了Akaike信息标准(AIC)。
    结果:该研究涉及1016例患者,738名女性(72.6%),和278名男性(27.4%)。平均年龄59.38(±12.55)岁。在508例OLP患者中,有16例(3.15%)合并银屑病,对照组为5例(0.98%)。年龄,性别,吸烟和饮酒习惯不是银屑病与OLP患者相关性的预测变量.根据多变量分析,OLP的奇数比(OR)为银屑病(OR3.13,1.20-9.68),与单变量分析相比,抑郁药物(OR1.88,1.13-3.19]和焦虑治疗(OR2.06,1.18-2.70)更高。
    结论:据我们所知,这是第一项显示OLP患者银屑病潜在风险的研究,应考虑我们的结果,以提高对OLP共病的认识.
    OBJECTIVE: The aim of the present study was to investigate whether psoriasis disease constitutes a risk factor for OLP, by assessing the prevalance of psoriasis in a test group with OLP and the control group without.
    METHODS: A cohort of consecutive patients diagnosed clinically and histologically with OLP between 2014 and 2022 was analyzed. The results were contrasted with those obtained in control series matched for age and sex. The correlations between OLP and sex, age, tobacco, alcohol consumption, and psoriasis were assessed using Pearson chi-square test. Multivariate regression analysis was performed to evaluate the association between psoriasis and OLP. For the assessment of the quality of the statistical models, the Akaike information criterion was used.
    RESULTS: The study involved 1,016 patients; 738 women (72.6%) and 278 men (27.4%). The average age was 59.38 ± 12.55 years. Of 508 patients with OLP, 16 (3.15%) had comorbid psoriasis, and this was 5 (0.98%) in the control group. Age, sex, smoking, and alcohol habits were not predictive variables in the relationship between psoriasis and OLP in these patients. There were statistically significant differences in relation to the number of locations, with greater extension in patients with OLP and psoriasis (P = .002). According to the multivariate analysis, the odds ratio of OLP for psoriasis was 3.13 (95% CI 1.20-9.68).
    CONCLUSIONS: This is the first study showing the potential association between psoriasis and OLP, and the results should be considered to improve knowledge of comorbidity of OLP. Based on the results, it is recommended that clinicians collect data regarding history of psoriasis in patients with OLP, and consider possible multiple intraoral locations.
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  • 文章类型: Journal Article
    血脂异常和高脂肪饮食可能会增加口腔扁平苔藓(OLP)患者体内脂肪积累的易感性。本研究旨在探讨肥胖的危险因素,饮食模式,和脂质代谢。
    在2020年9月至2021年10月之间进行了一项基于人群的病例对照研究,招募了275对OLP病例和对照。关于脂质分布的信息,收集饮食频率和腰围。采用主成分和因子分析对患者的半定量膳食频率调查数据进行分析,提取特定的膳食模式。
    单因素分析显示,总胆固醇、甘油三酯,OLP组及低密度脂蛋白显著高于对照组和其他口腔黏膜病组(P<0.05,P<0.001,P<0.001)。与基线组相比,肥胖和超重患者在OLP组中更为常见.与健康粘膜组相比,OLP组(68%)的血脂异常更为常见(32%;P<0.001,OR=4.52,95%CI=2.49-8.18)。在受试者中描述了四种饮食模式。传统易感动物性食物模式(OR:24.81,95%CI:6.05-101.71,P<0.001)和动物性食物模式(OR:28.77,95%CI:8.10-102.15,P=0.001)与OLP风险增加相关。
    结果表明,高脂肪饮食,血脂异常和肥胖与OLP的疾病进展密切相关.富含加工食品和脂肪的饮食可能会增加OLP的风险。
    UNASSIGNED: Dyslipidemia and a high fat diet may increase the predisposition for accumulating body fat in patients with oral lichen planus (OLP). This study aimed to investigate the risk factors obesity, dietary patterns, and lipid metabolism.
    UNASSIGNED: A population-based case-control study was conducted between September 2020 and October 2021, recruiting 275 pairs of OLP cases and controls. Information on lipid profiles, diet frequency and waist circumference were gathered. Principal component and factor analysis were used to analyze the semi-quantitative dietary frequency survey data of patients to extract specific dietary patterns.
    UNASSIGNED: Univariate analysis showed that total cholesterol, triglycerides, and low-density lipoprotein were significantly higher in the OLP group than the control and other oral mucosal disease groups (P < 0.05, P < 0.001, and P < 0.001, respectively). Compared with the baseline group, obese and overweight patients were more common in the OLP group. Dyslipidemia was more common in the OLP group (68%) compared to the healthy mucosa group (32%; P < 0.001, OR = 4.52, 95% CI = 2.49-8.18). Four dietary patterns were described among the subjects. The traditional prone animal food pattern (OR: 24.81, 95% CI: 6.05-101.71, P < 0.001) and animal food pattern (OR: 28.77, 95% CI: 8.10-102.15, P = 0.001) were associated with an increased risk of OLP.
    UNASSIGNED: The results indicated that a high-fat diet, dyslipidemia and obesity were strongly linked to disease progression in OLP. A diet high in processed food and fat could increase the risk of OLP.
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