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Oral Lichen Planus and Oral Lichenoid Lesion: Diagnosis and Assessment of Direct Immunofluorescence

  • Lee, Kyung-Eun (Department of Oral Medicine, School of Dentistry, Chonbuk National University, Institute of Oral Bioscience, Chonbuk National University)
  • Received : 2016.08.22
  • Accepted : 2016.09.19
  • Published : 2016.09.30

Abstract

Purpose: Oral lichen planus (OLP) has generated many discussions and been associated with much controversy for a long time. A reliable diagnosis of OLP has proven challenging and significant disagreements concerning its diagnosis has continued. Therefore, the aim of this study was to apprehend newly proposed diagnostic criteria of OLP and oral lichenoid lesion (OLL) and to evaluate difference of final diagnosis of OLP and OLL in accordance with type of diagnostic criteria. Also, direct immunofluorescence (DIF) was compared to evaluate the value of DIF between two groups. Methods: Fifty-two patients with DIF result were retrospectively reviewed. The selected patients were classified by the modified World Health Organization (WHO) diagnostic criteria of OLP and OLL and by criteria proposed by American Academy of Oral and Maxillofacial Pathology (AAOMP). Results of DIF in OLP and OLL were classified by deposition intensity or pattern of fibrinogen. The classification of fluorescence pattern in each specimen was graded as positive, possibly positive or negative. Results: Patients diagnosed as OLP were a few more when the modified WHO diagnostic criteria were used than when criteria proposed by AAOMP were used. There was no statistical difference of DIF between OLP and OLL by applying the WHO modification criteria or criteria proposed by AAOMP. Conclusions: The final diagnosis of OLP could be changed in accordance with type of diagnostic criteria and difference of DIF between OLP and OLL was not found.

Keywords

References

  1. Sugerman PB, Savage NW, Walsh LJ, et al. The pathogenesis of oral lichen planus. Crit Rev Oral Biol Med 2002;13:350-365. https://doi.org/10.1177/154411130201300405
  2. Nico MM, Fernandes JD, Lourenco SV. Oral lichen planus. An Bras Dermatol 2011;86:633-641. https://doi.org/10.1590/S0365-05962011000400002
  3. Kramer IR, Lucas RB, Pindborg JJ, Sobin LH. Definition of leukoplakia and related lesions: an aid to studies on oral precancer. Oral Surg Oral Med Oral Pathol 1978;46:518-539. https://doi.org/10.1016/0030-4220(78)90383-3
  4. Cheng YS, Gould A, Kurago Z, Fantasia J, Muller S. Diagnosis of oral lichen planus: a position paper of the American Academy of Oral and Maxillofacial Pathology. Oral Surg Oral Med Oral Pathol Oral Radiol 2016;122:332-354. https://doi.org/10.1016/j.oooo.2016.05.004
  5. van der Meij EH, Schepman KP, Plonait DR, Axell T, van der Waal I. Interobserver and intraobserver variability in the clinical assessment of oral lichen planus. J Oral Pathol Med 2002;31:95-98. https://doi.org/10.1046/j.0904-2512.2001.00174.x
  6. van der Meij EH, Reibel J, Slootweg PJ, van der Wal JE, de Jong WF, van der Waal I. Interobserver and intraobserver variability in the histologic assessment of oral lichen planus. J Oral Pathol Med 1999;28:274-277.
  7. van der Meij EH, van der Waal I. Lack of clinicopathologic correlation in the diagnosis of oral lichen planus based on the presently available diagnostic criteria and suggestions for modifications. J Oral Pathol Med 2003;32:507-512. https://doi.org/10.1034/j.1600-0714.2003.00125.x
  8. Rad M, Hashemipoor MA, Mojtahedi A, et al. Correlation between clinical and histopathologic diagnoses of oral lichen planus based on modified WHO diagnostic criteria. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2009;107:796-800. https://doi.org/10.1016/j.tripleo.2009.02.020
  9. Laskaris G, Sklavounou A, Angelopoulos A. Direct immunofluorescence in oral lichen planus. Oral Surg Oral Med Oral Pathol 1982;53:483-487. https://doi.org/10.1016/0030-4220(82)90461-3
  10. Firth NA, Rich AM, Radden BG, Reade PC. Assessment of the value of immunofluorescence microscopy in the diagnosis of oral mucosal lichen planus. J Oral Pathol Med 1990;19:295-297. https://doi.org/10.1111/j.1600-0714.1990.tb00847.x
  11. Anuradha Ch, Malathi N, Anandan S, Magesh K. Current concepts of immunofluorescence in oral mucocutaneous diseases. J Oral Maxillofac Pathol 2011;15:261-266. https://doi.org/10.4103/0973-029X.86673
  12. Raghu AR, Nirmala NR, Sreekumaran N. Direct immunofluorescence in oral lichen planus and oral lichenoid reactions. Quintessence Int 2002;33:234-239.
  13. Lee KE, Suh BJ. Direct immunofluorescence in clinically diagnosed oral lichen planus. J Oral Med Pain 2016;41:16-20. https://doi.org/10.14476/jomp.2016.41.1.16
  14. Eisen D, Carrozzo M, Bagan Sebastian JV, Thongprasom K. Number V Oral lichen planus: clinical features and management. Oral Dis 2005;11:338-349. https://doi.org/10.1111/j.1601-0825.2005.01142.x
  15. Scully C, Eisen D, Carrozzo M. Management of oral lichen planus. Am J Clin Dermatol 2000;1:287-306. https://doi.org/10.2165/00128071-200001050-00004
  16. Thornhill MH, Sankar V, Xu XJ, et al. The role of histopathological characteristics in distinguishing amalgam-associated oral lichenoid reactions and oral lichen planus. J Oral Pathol Med 2006;35:233-240. https://doi.org/10.1111/j.1600-0714.2006.00406.x
  17. Karatsaidis A, Schreurs O, Helgeland K, Axell T, Schenck K. Erythematous and reticular forms of oral lichen planus and oral lichenoid reactions differ in pathological features related to disease activity. J Oral Pathol Med 2003;32:275-281. https://doi.org/10.1034/j.1600-0714.2003.00134.x
  18. Greenberg MS. AAOM Clinical Practice Statement: Subject: Oral lichen planus and oral cancer. Oral Surg Oral Med Oral Pathol Oral Radiol 2016;122:440-441. https://doi.org/10.1016/j.oooo.2016.05.015
  19. Issa Y, Duxbury AJ, Macfarlane TV, Brunton PA. Oral lichenoid lesions related to dental restorative materials. Br Dent J 2005;198:361-366; disussion 549; quiz 372. https://doi.org/10.1038/sj.bdj.4812176
  20. Potts AJ, Hamburger J, Scully C. The medication of patients with oral lichen planus and the association of nonsteroidal antiinflammatory drugs with erosive lesions. Oral Surg Oral Med Oral Pathol 1987;64:541-543. https://doi.org/10.1016/0030-4220(87)90029-6
  21. Robertson WD, Wray D. Ingestion of medication among patients with oral keratoses including lichen planus. Oral Surg Oral Med Oral Pathol 1992;74:183-185. https://doi.org/10.1016/0030-4220(92)90380-9
  22. Thompson DF, Skaehill PA. Drug-induced lichen planus. Pharmacotherapy 1994;14:561-571.
  23. Basara N, Blau WI, Romer E, et al. Mycophenolate mofetil for the treatment of acute and chronic GVHD in bone marrow transplant patients. Bone Marrow Transplant 1998;22:61-65. https://doi.org/10.1038/sj.bmt.1701281
  24. Woo SB, Lee SJ, Schubert MM. Graft-vs.-host disease. Crit Rev Oral Biol Med 1997;8:201-216. https://doi.org/10.1177/10454411970080020701
  25. Al-Hashimi I, Schifter M, Lockhart PB, et al. Oral lichen planus and oral lichenoid lesions: diagnostic and therapeutic considerations. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2007;103(Suppl):S25.e1-e12.
  26. Crincoli V, Di Bisceglie MB, Scivetti M, Lucchese A, Tecco S, Festa F. Oral lichen planus: update on etiopathogenesis, diagnosis and treatment. Immunopharmacol Immunotoxicol 2011;33:11-20. https://doi.org/10.3109/08923973.2010.498014
  27. Helander SD, Rogers RS 3rd. The sensitivity and specificity of direct immunofluorescence testing in disorders of mucous membranes. J Am Acad Dermatol 1994;30:65-75. https://doi.org/10.1016/S0190-9622(94)70010-9
  28. Buajeeb W, Okuma N, Thanakun S, Laothumthut T. Direct Immunofluorescence in oral lichen planus. J Clin Diagn Res 2015;9:ZC34-ZC37. https://doi.org/10.1111/crj.12101
  29. Jordan RC, Daniels TE, Greenspan JS, Regezi JA. Advanced diagnostic methods in oral and maxillofacial pathology. Part II: immunohistochemical and immunofluorescent methods. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2002;93:56-74. https://doi.org/10.1067/moe.2002.119567