WARNING!

WARNING! THIS SITE HAS PICTURES AND CONTENT OF A MEDICAL NATURE AND MAY NOT BE SUITABLE FOR EVERYONE. VIEW AT YOUR OWN DISCRETION.

Saturday, April 23, 2011

Oral Lichen Planus Three Year Comparison





Please note: The top photo was taken in 2008 when I had a very bad flare up of Erosive OLP ulcers. I was in bad pain at the time and could barely swallow water. If you ever get like that, pay attention to your water intake so that you don't get dehydrated.
The second photo was taken in January of this year. My OLP was much improved at that time, after having been taking Cellcept for over a year. My mouth was almost completely clear when I went off the Cellcept. After this little bout in January, it cleared up again. I continue to use Clobetasol ointment.

Sunday, April 17, 2011

Update on Oral Luchen Planus - Abstract and Link

Update on oral lichen planus: etiopathogenesis and management.
  
Abstract
Lichen planus (LP) is a relatively common disorder of the stratified squamous epithelia, which is, in many ways, an enigma.

This paper is the consensus outcome of a workshop held in Switzerland in 1995, involving a selection of clinicians and scientists with an interest in the condition and its management.

The oral (OLP) eruptions usually have a distinct clinical morphology and characteristic distribution, but OLP may also present a confusing array of patterns and forms, and other disorders may clinically simulate OLP. Lesions may affect other mucosae and/or skin. 

Lichen planus is probably of multifactorial origin, sometimes induced by drugs or dental materials, often idiopathic, and with an immunopathogenesis involving T-cells in particular. 

The etiopathogenesis appears to be complex, with interactions between and among genetic, environmental, and lifestyle factors, but much has now been clarified about the mechanisms involved, and interesting new associations, such as with liver disease, have emerged. 

The management of lichen planus is still not totally satisfactory, and there is as yet no definitive treatment, but there have been advances in the control of the condition. 

There is no curative treatment available; immunomodulation, however, can control the condition. Based on the observed increased risk of malignant development, OLP patients should be offered regular follow-up examination from two to four times annually and asked to report any changes in their lesions and/or symptoms. 

Follow-up may be particularly important in patients with atrophic/ulcerative/erosive affections of the tongue, the gingiva, or the buccal mucosa. 

Much more research is required into the genetic and environmental aspects of lichen planus, into the premalignant potential, and into the possible associations with chronic liver, and other disorders. 

More clinical studies are required into the possible efficacy of immunomodulatory drugs such as pentoxifylline and thalidomide.

Click on this link for full PDF article
Note: it's a little slow to upload so be patient

From:
Critical reviews in oral biology and medicine
1998;9(1):86-122.

Eastman Dental Institute for Oral Health Care Sciences,
University of London,
United Kingdom.

Authors:
Scully C, Beyli M, Ferreiro MC, Ficarra G, Gill Y, Griffiths M, Holmstrup P, Mutlu S, Porter S, Wray D.


Please note: although this article was published in 1998, I think the information is still valuable for gaining understanding. ~~~Elizabeth Munroz

Thursday, April 14, 2011

Lichen Planus and Eyes

Isolated lichen planus of the conjunctiva





Abstract:
 
Lichen planus is an autoimmune condition of unknown aetiology affecting the skin and mucous membranes. 

Classic lesions appear as recurrent, small, discrete, polygonal, flat topped, violaceous, pruritic papules distributed symmetrically on the flexor surfaces of the extremities and trunk. 

These lesions are often accompanied by lesions of the oral, genital, and rarely, ocular mucosa. 

Conjunctival lichen planus can lead to irreversible damage to the ocular surface and loss of vision from corneal scarring.

We report two patients with isolated lichen planus of the conjunctiva. 

The referring ophthalmologists had attributed these ocular findings to a severe dry eye state. 

The correct diagnosis was made by conjunctival biopsy.

Treatment with topical ciclosporin A resulted in suppression of the inflammation and arrest of the progressive cicatrisation. 

From:
British Journal of Ophthalmology  
2006;90:1325-1326  
doi:10.1136/bjo.2006.096263
  1. M Pakravan,
  2. T R Klesert,
  3. E K Akpek
+ Author Affiliations
  1. The Ocular Surface Diseases and Dry Eye Clinic, The Wilmer Eye Institute, Johns Hopkins School of Medicine, Baltimore, MD, USA

Correspondence to:
Esen Karamursel Akpek MD, Director 
Ocular Surface Diseases and Dry Eye Clinic
The Wilmer Eye Institute
600 North Wolfe Street
Maumenee Building No 321
Baltimore, MD 21287-9238, USA




Palate Oral Lichen Planus

Distribution of mucosal pH on the bucca, tongue, lips and palate.
A study in healthy volunteers and patients with lichen planus, Behçet's disease and burning mouth syndrome.

Abstract

Saliva coating all oral surfaces has a buffering capacity that neutralizes bacterial and cariogenic acids.

The aim of our study was to determine the surface pH in different regions of the oral cavity in healthy volunteers and in patients with diseases affecting the oral mucosa.

Oral pH was measured with a flat glass electrode on the anterior third of the ventral surface of the tongue, middle hard palate, buccal mucosa and inner lips in 32 healthy volunteers, 12 patients with Behçet's disease, 23 patients with oral lichen planus, and 11 patients with burning mouth syndrome. The present study showed that there was an uneven distribution of oral surface pH. The palate had a higher pH than most other sites in all groups, and in patients with lichen planus, the palate pH was higher than that in healthy controls.

Those with dentures had lower pH values in the hard palate than dentate patients. The relatively high pH in the palate region in all patient groups as well as healthy volunteers needs to be further studied to clarify its mechanisms and clinical relevance.

Acta Derm Venereol. 
2001 Jun-Jul;81(3):178-80.

Yosipovitch G, Kaplan I, Calderon S, David M, Chan YH, Weinberger A.

Department of Dermatology,
Rabin Medical Center,
Petah Tiqva, Israel.
gil@nsc.gov.sg

PMID: 11558872 [PubMed - indexed for MEDLINE]

NOTE: The complete article can be found by clicking here.

Wednesday, April 13, 2011

Lichen Planus and Oral Cancer Study



    * Are you a patient with oral cancer or Oral Lichen Planus?
    * If so, you may be eligible for a research study!


What is the purpose of the study?

This study is to explore the possibility of using saliva in an early cancer detection method for certain patients who may be at risk for developing oral cancer.

We will need to collect saliva samples from two types of people; those who have oral squamous cell carcinoma and those who have lichen planus. Analysis of the saliva samples for several particular proteins and chemicals will be performed and the results will be compared among these two groups and a group of normal controls (people who have neither oral cancer nor lichen planus).

For the rest of this information click here.

NOTE: The photo DOES NOT represent oral cancer

Monday, April 11, 2011

Do Medications cause Oral Lichen Planus?


Abstract
Objectives: To investigate whether daily systemic and/or topical medication contributes to the development of oral
lichen planus (OLP) lesions.

Study Design:
The study involved 110 OLP patients and 76 control subjects, matched by age, race and sex. The analyzed data included medical records, drug intake and topical medication.

Results:
No statistical difference was found between the two groups in terms of systemic diseases, number of medicated individuals in the categories of mono- and polypharmacy,

Regarding the clinical forms and site of involvement, a statistically significant difference was only found for the clinical erosive form of OLP

Conclusions:
It seems that the use of systemic medication does not lead to a significant increase in the incidence of OLP lesions. For their part, lichenoid drug reactions are likely to occur only in a very low percentage of patients.

Please note: I have paraphrased this abstract. To see the complete article, go here.

Successful Treatment of Erosive Lichen Planus



I came across this medical article called, Successful Treatment of Erosive Lichen Planus With Topical Tacrolimus

It was co-published by researchers through Northwestern University Medical School and Mayo Clinic

There was a patient who had Oral Lichen Planus but also had some other diseases that made treating her with steroids not a good idea, so they tried out Tacrolimus on her and after a year she had good results.

I didn't have such good results with the Tacrolimus. For me, it intensified the burning sensations in my mouth the instant I used it, so I was reluctant to use it long enough to get good results. I'm am sure everyone has their own experience.

Click HERE for the article.

Note: The photo above was not taken recently. I show it here for educational purposes.

Friday, April 1, 2011

674 patients with oral lichen planus

These are notes from an abstract to see the full abstract go here.

Oral lichen planus (OLP) is a chronic inflammatory disease with different clinical presentations that can be classified as:

reticular
atrophic
erosive

Although OLP is a relatively common disorder, the reports comprising large numbers of OLP patients with specific character are lacking in the literature. 

Of the 674 patients, 65% were women and 34% were men. The most common clinical presentation was the reticular type, and symptomatic OLP was noted in 67% of the patients, mainly in those with the erosive form. 

The erosive presentations showed significantly longer duration, more sites affected and a much greater older patients predominance than reticular or atrophic ones.

No statistically significant differences could be identified between OLP and diabetes, cardiovascular disease, smoking or alcohol use. 

Precipitating factors that resulted in an exacerbation of the disease were frequently noted and included: 


foods
stress
dental cusp (biting surfaces of the teeth)
poor oral hygiene. 

The transformation of OLP into malignancy was observed in four patients at sites previously diagnosed by clinical examination as erosive or atrophic lichen planus.

A long time follow up is of utmost importance to detect its malignant transformation.

From: 
 

A clinical study of 674 patients with oral lichen planus in China.

Journal of Oral Pathol Med. 2005 Sep;34(8):467-72.

Xue JL, Fan MW, Wang SZ, Chen XM, Li Y, Wang L.

Source

Key Lab for Oral Biochemical Engineering 
Ministry of Education, 
Stomatological College of Wuhan University, 
Luoyu Road 65, 430079 Wuhan, Hubei, China.
PMID:
16091113
[PubMed - indexed for MEDLINE]


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