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Oral lichenoid lesions - a review and update.

Kamath VV, Setlur K, Yerlagudda K - Indian J Dermatol (2015 Jan-Feb)

Bottom Line: In contrast to the idiopathic nature of OLP, OLLs are often associated with a known identifiable inciting factor.Associations with dental restorative materials, drugs, and medications have been conclusively proven in the etiology of this condition.Substantial differentiating features were uncovered to delineate OLLs as a separate entity with definite etiology, pathogenesis, and a high malignant transformation rate compared with OLP.

View Article: PubMed Central - PubMed

Affiliation: Department of Oral and Maxillofacial Pathology, Dr. Syamala Reddy Dental College, Hospital and Research Centre, Munnekolala, Marathalli, Bangalore, Karnataka, India.

ABSTRACT

Background: Oral lichenoid lesions or reactions (OLLs/OLRs) are clinical and histological contemporaries of the classical oral lichen planus (OLP) that have generated a lot of debate in literature. In contrast to the idiopathic nature of OLP, OLLs are often associated with a known identifiable inciting factor. A superficial examination of these lesions clinically and histologically often reveals many similarities with OLP, but recent data indicate that distinguishable features do exist and form the basis of most classifications.

Aims and objectives: This paper attempts to collate available data in English literature on OLLs, highlight distinguishing features clinically and histologically and reflect on the malignant transformation potential and treatment modalities of the condition.

Materials and methods: A comprehensive search of medical and dental databases including PubMed, Ovid, Cochrane, Pubget, Researchgate, and non-medical search engines were utilized for the review. The search words included "oral lichen planus", "oral lichenoid lesions", "oral drug reactions", "lichenoid dysplasia", and "adverse effects of dental materials".

Review results: OLLs seem to grossly underrated and most cases were clubbed as OLP. Definite clinical and histological features were uncovered to establish the identity of this lesion. Associations with dental restorative materials, drugs, and medications have been conclusively proven in the etiology of this condition. Specific markers are being utilized to diagnose the condition and monitor its progress.

Conclusion: Substantial differentiating features were uncovered to delineate OLLs as a separate entity with definite etiology, pathogenesis, and a high malignant transformation rate compared with OLP.

No MeSH data available.


Related in: MedlinePlus

Histopathological image of biopsy from case 1 showing a more OLP like presentation (H and E, ×10)
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Figure 4: Histopathological image of biopsy from case 1 showing a more OLP like presentation (H and E, ×10)

Mentions: The histological features of OLLs differ in several aspects. While the subepithelial infiltrate in OLP is limited to the lamina propria, it is more diffuse and penetrating in OLLs [Figure 3]. The nature of the infiltrate is also lymphohistiocytic compared with the mixed variety of OLP.[41] There is a tendency for perivascular congregration of the inflammatory cells, as seen in many allergic reactions, in OLLs [Figures 4 and 5]. Epithelial changes include focal parakeratosis, focal interruption of the granular layer, and presence of cytoid bodies in the granular and keratinized layers.[42] These features are uncommon in OLP. Degranulating mast cells form an integral feature of the histological presentation and etiopathogenesis of OLP. Mast cell presence in OLL is more subdued. Various other minor features like increased vascularity and increased positivity of periodic acid-schiff (PAS) material in the basement membrane of OLP are not usually found in OLLs.[43]


Oral lichenoid lesions - a review and update.

Kamath VV, Setlur K, Yerlagudda K - Indian J Dermatol (2015 Jan-Feb)

Histopathological image of biopsy from case 1 showing a more OLP like presentation (H and E, ×10)
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4318020&req=5

Figure 4: Histopathological image of biopsy from case 1 showing a more OLP like presentation (H and E, ×10)
Mentions: The histological features of OLLs differ in several aspects. While the subepithelial infiltrate in OLP is limited to the lamina propria, it is more diffuse and penetrating in OLLs [Figure 3]. The nature of the infiltrate is also lymphohistiocytic compared with the mixed variety of OLP.[41] There is a tendency for perivascular congregration of the inflammatory cells, as seen in many allergic reactions, in OLLs [Figures 4 and 5]. Epithelial changes include focal parakeratosis, focal interruption of the granular layer, and presence of cytoid bodies in the granular and keratinized layers.[42] These features are uncommon in OLP. Degranulating mast cells form an integral feature of the histological presentation and etiopathogenesis of OLP. Mast cell presence in OLL is more subdued. Various other minor features like increased vascularity and increased positivity of periodic acid-schiff (PAS) material in the basement membrane of OLP are not usually found in OLLs.[43]

Bottom Line: In contrast to the idiopathic nature of OLP, OLLs are often associated with a known identifiable inciting factor.Associations with dental restorative materials, drugs, and medications have been conclusively proven in the etiology of this condition.Substantial differentiating features were uncovered to delineate OLLs as a separate entity with definite etiology, pathogenesis, and a high malignant transformation rate compared with OLP.

View Article: PubMed Central - PubMed

Affiliation: Department of Oral and Maxillofacial Pathology, Dr. Syamala Reddy Dental College, Hospital and Research Centre, Munnekolala, Marathalli, Bangalore, Karnataka, India.

ABSTRACT

Background: Oral lichenoid lesions or reactions (OLLs/OLRs) are clinical and histological contemporaries of the classical oral lichen planus (OLP) that have generated a lot of debate in literature. In contrast to the idiopathic nature of OLP, OLLs are often associated with a known identifiable inciting factor. A superficial examination of these lesions clinically and histologically often reveals many similarities with OLP, but recent data indicate that distinguishable features do exist and form the basis of most classifications.

Aims and objectives: This paper attempts to collate available data in English literature on OLLs, highlight distinguishing features clinically and histologically and reflect on the malignant transformation potential and treatment modalities of the condition.

Materials and methods: A comprehensive search of medical and dental databases including PubMed, Ovid, Cochrane, Pubget, Researchgate, and non-medical search engines were utilized for the review. The search words included "oral lichen planus", "oral lichenoid lesions", "oral drug reactions", "lichenoid dysplasia", and "adverse effects of dental materials".

Review results: OLLs seem to grossly underrated and most cases were clubbed as OLP. Definite clinical and histological features were uncovered to establish the identity of this lesion. Associations with dental restorative materials, drugs, and medications have been conclusively proven in the etiology of this condition. Specific markers are being utilized to diagnose the condition and monitor its progress.

Conclusion: Substantial differentiating features were uncovered to delineate OLLs as a separate entity with definite etiology, pathogenesis, and a high malignant transformation rate compared with OLP.

No MeSH data available.


Related in: MedlinePlus