Friday, January 21, 2011

Over Active Immune System and Oral Lichen Planus

When our immune system encounters something foreign, it responds by mounting an attack on it such as when one has a virus or infection. In order for our immune system to do do it's job to help us get well from the foreign substance, it has to recognize that the object is foreign, and not part of itself.

Usually, the immune system recognizes what is and what is not 'self.'

In autoimmune diseases, the immune system is unable to recognize some part of itself, and will attack it.

This could happen with one organ, a particular part of the body, or the entire body. There are many kinds of autoimmune diseases, which most people are unfamiliar with. Though it is not a common condition, Lupus is the one most people recognize as an autoimmune disease.

In my case my body has an autoimmune condition called Oral Lichen Planus. If you have been reading parts of this blog, you already know that. If you are new to the blog, you may be surprised to learn that Lichen Planus is a type of autoimmune condition. Previously in medical papers it has been referred to as an inflammatory condition, which it is. But, more recent research has shown it to me more than that.

Please note: picture does not represent present condition of my mouth, but is from 2004 and placed here for educational purposes.

Thursday, January 20, 2011

Oral Lichen Planus Caused by Allergy to Dental Fillings?

To determine contact allergies in patients with oral lichen planus and to monitor the effect of partial or complete replacement of amalgam fillings following a positive patch test reaction to ammoniated mercury, metallic mercury, or amalgam.

In group A (20 patients), the oral lesions were confined to areas in close contact with amalgam fillings.

In group B (20 patients), the lesions extended 1 cm beyond the area of contact with amalgam fillings.

In group C (20 patients), the oral lesions had no topographic relationship with amalgam fillings.

Partial or complete replacement of amalgam fillings was recommended if there was a positive patch test reaction to ammoniated mercurymetallic mercury,  or amalgam.

Control group D (20 patients) had signs of allergic contact dermatitis.

Amalgam fillings were replaced in 13 patients of group A, with significant improvement.

Dental amalgam was replaced in 8 patients of group B, with significant improvement.

In group C, amalgam replacement in 2 patients resulted in improvement in 1 patient.

These results were evaluated after 3 months.

No positive patch test reactions to mercury compounds were found in patients with concomitant cutaneous lichen planus and in group D.

Contact allergy to mercury compounds is important in the pathogenesis of oral lichen planus, especially if there is close contact with amalgam fillings and if no concomitant cutaneous lichen planus is present.

In cases of positive patch test reactions to mercury compounds, partial or complete replacement of amalgam fillings will lead to a significant improvement in nearly all patients.

See full free article by clicking on the following link:
Oral Lichen Planus and Allergy to Dental Amalgam Restorations

Laeijendecker R, Dekker SK, Burger PM, Mulder PG, Van Joost T, Neumann MH.

Department of Dermatology
Albert Schweitzer Hospital
Dordrecht, The Netherlands


Arch Dermatol.

See also:

Lichenoid amalgam reaction

Tuesday, January 18, 2011

Oral Lichen Planus Support Group

Less than two percent of the general population suffers from oral lichen planus, an uncomfortable and chronic condition characterized by lesions that form in the mouth and skin. Its not unusual for lichen planus sufferers to know no one else with the disease.

That's one reason for the popularity of Texas A&M Health Science Center Baylor College of Dentistry's online International Oral Lichen Planus Support Group, a web-based support group that brings together sufferers from throughout the world. The on-line organization serves as a resource for patients, family members and practitioners.

The site also features periodic live online discussions that link lichen planus sufferers with faculty in HSC-BCDs Stomatology Center and guest faculty from other dental schools around the world.

Saturday, January 15, 2011

Have You been Tested for Liver Problems with Oral Lichen Planus?

Lichen planus is fairly common skin disorder that last for months to years. Lichen planus affects about 1 or 2% of the U.S. population (approximate six million) and usually affects people between the ages of 30 and 70 years old and is slightly more prevalent in women than in men.

The exact cause of lichen planus is unknown, but it seems to be triggered by stress, genetics, allergic reactions to medicines, and by viral infections such as Hepatitis C.

The onset may be gradual or quick. There have been studies that have found a prevalence of Hepatitis C Virus in people with lichen planus from 3.5% to 60%. For this reason, it has been recommended that people with lichen planus (especially with elevated liver enzymes) should be tested for Hepatitis C Virus.

See the rest of this article free in PDF

Tuesday, January 11, 2011

Laser Versus Topical in Oral Lichen Planus

A Comparative Pilot Study of Low Intensity Laser versus Topical Corticosteroids in the Treatment of Erosive-Atrophic Oral Lichen Planus


Background and objective:
Treatment of oral lichen planus (OLP) remains a great challenge for clinicians. The aim of our study was to compare the effect of low intensity laser therapy (LILT) with topical corticosteroids in the treatment of oral erosive and atrophic lichen planus.

Materials and Methods:
Thirty patients with erosive-atrophic OLP were randomly allocated into two groups.

The experimental group consisted of patients treated with the 630nm diode laser. The control group consisted of patients who used Dexamethason mouth wash.

Response rate was defined based on changes in the appearance score and pain score (Visual Analogue Scale) of the lesions before and after each treatment.

Appearance score, pain score, and lesion severity was reduced in both groups. No significant differences were found between the treatment groups regarding the response rate and relapse.

Our study demonstrated that LILT was as effective as topical corticosteroid therapy without any adverse effects and it may be considered as an alternative treatment for erosive-atrophic OLP in the future.

Photomedicine and Laser Surgery

A Comparative Pilot Study of Low Intensity Laser versus Topical Corticosteroids in the Treatment of Erosive-Atrophic Oral Lichen Planus

Hasan Hoseinpour Jajarm, D.D.S., M.Sc.,1
Farnaz Falaki, D.D.S., M.Sc.,1 and
Omid Mahdavi, D.D.S., M.Sc.2
1Department of Oral Medicine and Dental Research Center,
Faculty of Dentistry,
Mashhad, Iran.

2Department of Oral Medicine and Dental Research Center,
Faculty of Dentistry,
Yazd, Iran.

Address correspondence to:
Dr. Farnaz Falaki
Department of Oral Medicine
Faculty of Dentistry and Dental, Research Center
Mashhad University of Medical Sciences
P.O. Box 91735-984
E-mail: farnazfalaki@yahoo.com

Online Ahead of Print: January 8, 2011

Monday, January 10, 2011

Oral lichen planus in childhood: A rare case report

Oral lichen planus is a cell-mediated immune condition and is infrequently encountered in children, with a prevalence of about 0.03 percent in childhood.

Reports of oral lichen planus affecting children are scarce in the literature.

The purpose of this article is to present a rare case of oral lichen planus affecting a seven-year-old child without concomitant cutaneous lesions.

Intraoral lesions and associated mild discomfort treated with topical corticosteroid therapy and a plaque control regime resulted in a favorable result.

continue to read full article here>>>

Dermatology Online Journal
Volume 16 Number 8
August 2010

Oral lichen planus in childhood: A rare case report

M GunaShekhar MDS,
Reddy Sudhakar MDS,
Mohammad Shahul MDS,
John Tenny MDS,
Manyam Ravikanth MDS,
N Manikyakumar BDS

Vishnu Dental College & Hospital,

Sunday, January 9, 2011

The Pathogenesis of Oral Lichen Planus


Both antigen-specific and non-specific mechanisms may be involved in the pathogenesis of oral lichen planus (OLP). Antigen-specific mechanisms in OLP include antigen presentation by basal keratinocytes and antigen-specific keratinocyte killing by CD8+ cytotoxic T-cells.

Non-specific mechanisms include mast cell degranulation and matrix metalloproteinase (MMP) activation in OLP lesions.

These mechanisms may combine to cause T-cell accumulation in the superficial lamina propria, basement membrane disruption, intra-epithelial T-cell migration, and keratinocyte apoptosis in OLP.

OLP chronicity may be due, in part, to deficient antigen-specific TGF-β1-mediated immunosuppression.

The normal oral mucosa may be an immune privileged site (similar to the eye, testis, and placenta), and breakdown of immune privilege could result in OLP and possibly other autoimmune oral mucosal diseases.

Recent findings in mucocutaneous graft-versus-host disease, a clinical and histological correlate of lichen planus, suggest the involvement of TNF-α, CD40, Fas, MMPs, and mast cell degranulation in disease pathogenesis.

Potential roles for oral Langerhans cells and the regional lymphatics in OLP lesion formation and chronicity are discussed. Carcinogenesis in OLP may be regulated by the integrated signal from various tumor inhibitors (TGF-β1, TNF-α, IFN-γ, IL-12) and promoters (MIF, MMP-9).

We present our recent data implicating antigen-specific and non-specific mechanisms in the pathogenesis of OLP and propose a unifying hypothesis suggesting that both may be involved in lesion development.

The initial event in OLP lesion formation and the factors that determine OLP susceptibility are unknown.

The complete free article is available 

Critical Reviews of Oral Biology and Medicine 
July 2002 vol. 13 no. 4 350-365

P.B. Sugerman  
N.W. Savage
L.J. Walsh
Z.Z. Zhao
X.J. Zhou
A. Khan
G.J. Seymour
M. Bigby

AstraZeneca R&D Boston,
35 Gatehouse Drive,
Waltham, MA 02451, USA     

Oral Biology and Pathology,
The University of Queensland,
St Lucia, Brisbane,
Queensland, Australia,

Department of Dermatology,
Beth Israel Deaconess Medical Center,
Brookline, MA, USA

Peripheral sensory neuropathy associated with short-term oral acitretin therapy

A 57-year-old female patient with widespread chronic plaque psoriasis and a 32-year-old male patient with severe oral lichen planus are reported, who developed sensory symptoms in the extremities 3 and 4 months after the onset of oral acitretin (trade name Soriatane) therapy, respectively. 

Both patients showed clinical and electrophysiological evidence of a sensory peripheral neuropathy, which completely resolved 2 and 2.5 years after discontinuation of oral acitretin administration, respectively.
2003 Jan-Feb;16(1):46-9.

Department of Dermatology, 
University of Patras, 

Copyright 2003 S. Karger AG, Basel
PMID: 12566828 [PubMed - indexed for MEDLINE] 

The full free article is supposed to be available through Karger, but I could not find it.

Wednesday, January 5, 2011

Resolution of Oral Lichen Planus

It has been nearly two months since I went off the Cellcept and I still have very little signs of Oral Lichen Planus. The cold that I had stayed for a very long time, though, and eventually because it aggravated my asthma, I needed to take some Prednisone to get it under control. Presently, the cold is gone, my asthma is under control and I am titering down from the Prednisone.

Still no sign of the Oral Lichen Planus. The few times in this last six weeks that I thought I might have some signs, I have used my Clobetasol ointment, and it has been enough. Let it be understood that my mouth is not entirely perfect looking. I still have some redness, a little bit of lace appearance on the inside of the cheeks, and some thinning of the tissue on top of the tongue, but the pain is gone and I am able to consume most foods that I would have eaten in the past before the OLP with the exception of highly spiced foods. I still have some permanent scarring inside, and swelling on the outside edge of my chin.

I have now been able to appropriately take care of my dental health. I am using a sonic toothbrush and Biotene toothpaste. I can floss well, though I do not use a mint or cinnamon flavored floss. Mint and cinnamon are not recommended for people with Oral Lichen Planus. I also use a Waterpik. All of these methods for good oral health were difficult to perform when my mouth was so flared up in the past.

Needless to say, I am very happy!

Always seek the advice and supervision of a qualified licensed medical professional!

The information provided on this site has been created as an online journal only. The author is writing from her personal viewpoint and cannot guarantee the completeness or accuracy of the information displayed.

Comments to any of the entries are appreciated.