Histopathological findings in oral lichen planus and their correlation with the clinical manifestations

Oral Surgery and Implantology School of Medicine and Dentistry, University of Santiago de Compostela, Spain.
Medicina oral, patologia oral y cirugia bucal (Impact Factor: 1.17). 08/2011; 16(5):e641-6. DOI: 10.4317/medoral.16983
Source: PubMed


To highlight the most characteristic histopathological findings of oral lichen planus and their correlation with the clinical manifestations and forms.
We performed a retrospective study of 50 biopsied and diagnosed cases of oral lichen planus obtained over a period of 11 years, spanning from May 1998 to April 2009. We analyzed the age and sex of the patient, type of lichen planus, location and different histopathological findings, comparing them with the clinical lesions.
Seventy eight percent of the patients are female and 22% are male, with an average age of 56.06 years for both sexes. The most frequent clinical form is reticular, present in 78% of the cases, and the most common location is the buccal mucosa, present in 70% of the patients. Hydropic degeneration of the basal layer and lymphocytic infiltration in the subepithelial layer are observed in the entire sample. Signs of atypia were identified in 4% of the cases, but without dysplasic features. Other common histological findings were the presence of necrotic keratinocytes (92%), hyperplasia (54%), hyperkeratosis (66%), acanthosis (48%), and less frequently, serrated ridges (30%) and the presence plasma cells (26%).
Oral lichen planus is a disease that is more common in women, usually appearing in the fifth and sixth decades of life. The most common clinical form is reticular, manifesting mainly in the buccal mucosa. Histological findings characteristic of oral lichen planus include hydropic degeneration of the basal layer, lymphocytic infiltration in the subepithelial layer and the absence of epithelial dysplasia; however, it is also frequent to observe hyperplasia phenomena at the epithelial level, hyperkeratosis, acanthosis and the presence of necrotic keratinocytes.

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Available from: Abel García-García, May 06, 2015
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    • "The histologic specimens were stained with hematoxylin and eosin and the diagnosis was confirmed by optical microscopic examination. The presence of hyperkeratosis, parakeratosis, vacuolization of the basal layer, band-like infiltrate, keratinocytes necrosis, incontinentia pigmenti, dysplasia, lymphocytes exocytosis and sawtooth rete ridges were examined (14). These parameters were graduated: 0= absence, 1= low grade, 2= moderated and 3= severe. "
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    ABSTRACT: Unlabelled: INTRODUCCION: Cytokeratins (CK) are molecules of the cytoskeleton that contribute to the cellular differenciation. We studied the expression of CK1, CK13 and CK14 in thirty-three patients with OLP. The biopsied lesions were located in the dorsal surface of the tongue, the palatal keratinized mucosa and the nonkeratinized buccal mucosa. Objectives: This study aimed to determine the expression of CK1, CK13 and CK14 in oral lichen planus (OLP) and its relations with: clinical patterns, prognosis, drugs and tobacco intake and histopathological features. Study design: Immunohistochemical analysis, retrospective, descriptive, observational and no randomized study. Results: No significant difference was observed in the expression of CK1 in patients with or without drug treatment. No association was found with the amount of drugs intake or smoking nor with the histopathological features examined. Samples immunostained with CK13 were all positive in the suprabasal layers, and 13 of them in the basal layer. In these last ones, statistical analysis showed significance in the grade of vacuolization of the basal layer (p=0.023) and in the degree of exocytosis (p=0.0025), this, making the degree of affection higher for both parameters. Thirty-two tissue sections were immunostained with CK14. CK14 was expressed in the basal layer in 97% of samples and in the suprabasal layer in 94% of samples. Conclusions: The three CK were altered in OLP. CK1 does not have a direct connection with the presence of orthokeratosis. The finding of the CK13 in the basal layer is related to the agression of the lymphocytic infiltration in the epithelium, due to the basal stratum vacuolization and the increase in lymphocytic exocitosis. The presence of CK14 in the suprabasal stratums is not a parameter to predict malignancy. The CK in OLP do not follow the normal pattern of keratinized or non-keratinized mucosa.
    Full-text · Article · Mar 2014 · Medicina oral, patologia oral y cirugia bucal
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    • "However, the etiology of OLP remains unknown with a multifactorial pathogenesis.[1] There are many fundamental factors that have been associated, such as: Anxiety, diabetes, autoimmune diseases, intestinal diseases, stress, hypertension, infections, and genetic predisposition.[910] "
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    ABSTRACT: The objective of this study was to assess the level of salivary IgA and IgG in oral lichen planus (OLP) and oral lichenoid reactions (OLR) patients as diagnostic factors to the differential diagnosis of OLP, OLR diseases. Saliva sample were obtained from 50 OLP, 50 OLR patients and 50 healthy subjects between April 2010 and October 2011. The clinical relevant data taken into account were: Demographical data, previous medication, and level of salivary IgA and IgG. Each sample was assessed to determine the level of salivary IgA by ELISA test and salivary IgG by radial immune diffusion. The mean of salivary IgA and IgG in patients were 119.01 ± 114.18 mic/ml and 3.25 ± 1.81 mic/ml, respectively. There were no significant differences for salivary IgA and IgG between OLP and OLR, but the mean of salivary IgA and IgG in OLP and OLR patients were significantly more than normal group (P-value < 0.05). The cut-off value was set at >72 mic/ml for salivary IgA in both OLP and OLR groups and set at >3.7 mic/ml for salivary IgG. On comparing the AUCs, there was no significant difference between AUCs for IgA (0.715 ± 0.05vs. 0.69 ± 0.5, for OLP and OLR patients, respectively,P-value = 0.7) and IgG (0.681 ± 0.05 vs. 0.548 ± 0.06, for OLP and OLR patients, respectively, P-value = 0.1). Our results showed that the level of salivary IgA and IgG in OLP and OLR patients is higher than healthy controls, but they cannot be used as diagnostic factors to the differential diagnosis of OLP and OLR.
    Full-text · Article · Oct 2012
    • "In cases where such treatment proves to be inefficient, intralesional injection of corticosteroids may be prescribed. Most erosive LP requires systemic corticosteroid regimen.[2910] Evolution of LP varies according to the clinical type. "
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    ABSTRACT: Well documented cases of oral lichen planus, a cell mediated immune condition is infrequently reported in paediatric population. This study was undertaken to obtain epidemiological data retrospectively and also to explore the possibility of any association that might exist among the clinical and histopathological features in paediatric patients suffering from oral lichen planus. A retrospective study was carried out on 22 patients, younger than 18 years with clinical and histopathological diagnosis of oral lichen planus over a period of 14 years. The clinical characteristics and histopathological features were observed. The statistical analysis of the data was performed using Statistical Analysis Software (SAS), Version 9.1. Analysis of data of 22 patients revealed that the average age of patient is 15.18 years with equal male and female predilection. The most common site is buccal mucosa (50%) and most frequent clinical form is erosive (63.64%). Focusing on the histopathological findings, parakeratosis was found in 86.36% of the cases, acanthosis in 63.64% of cases, moderate basal cell degeneration was identified in 63.64% of cases and dense lymphocytic infiltration at juxtaepithelial connective tissue region was found in 59.09% of cases. Oral lichen planus in paediatric population is rare and appeared between 8 to 18 years of age. There is no significant gender predominance. The most common clinical form is erosive, manifesting mainly in buccal mucosa. Histopathological findings characteristic of oral lichen planus in paediatric patients include parakeratosis, acanthosis, liquefaction degeneration of basal cells and lymphocytic infiltration in the subepithelial layer.
    No preview · Article · Sep 2012 · Journal of Oral and Maxillofacial Pathology
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