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Oral lichen planus - Differential diagnoses, serum autoantibodies, hematinic deficiencies, and management.
J Formos Med Assoc. 2018 Sep; 117(9):756-765.JF

Abstract

Oral lichen planus (OLP) is a chronic inflammatory oral mucosal disease that occurs more frequently in middle-aged and elderly female patients. Previous studies indicate that OLP is a T-cell dysfunction-induced localized autoimmune disease. Clinically, six types of OLP, namely reticular, papular, plaque-like, atrophic/erosive, ulcerative, and bullous types, can be identified. OLP more commonly affects buccal mucosa, tongue, and gingiva. It always has a bilateral and symmetric distribution of the oral lesions. Plaque-like and atrophic/erosive OLP may be misdiagnosed as oral leukoplakia and oral erythroleukoplakia, respectively. Our previous study found serum autoantibodies in 195 (60.9%) of the 320 OLP patients. Specific serum anti-nuclear, anti-smooth muscle, anti-mitochondrial, gastric parietal cell, thyroglobulin, and thyroid microsomal autoantibodies are present in 28.1%, 8.4%, 1.6%, 26.3%, 21.3%, and 24.4% of 320 OLP patients, respectively. Furthermore, we also discovered that 21.9%, 13.6%, 7.1%, 0.3%, and 14.8% of 352 OLP patients have hemoglobin, iron, vitamin B12, and folic acid deficiencies, and abnormally high serum homocysteine level, respectively. Therefore, it is very important to examine the serum autoantibody, hematinic and homocysteine levels in OLP patients before starting the treatments for OLP patients. Because OLP is an immunologically-mediated disease, corticosteroids are the drugs of choice for treatment of OLP.

Authors+Show Affiliations

Department of Dentistry, Far Eastern Memorial Hospital, New Taipei City, Taiwan; Graduate Institute of Clinical Dentistry, School of Dentistry, National Taiwan University, Taipei, Taiwan; Department of Dentistry, National Taiwan University Hospital, College of Medicine, National Taiwan University, Taipei, Taiwan; Graduate Institute of Oral Biology, School of Dentistry, National Taiwan University, Taipei, Taiwan.Graduate Institute of Clinical Dentistry, School of Dentistry, National Taiwan University, Taipei, Taiwan; Department of Dentistry, National Taiwan University Hospital, College of Medicine, National Taiwan University, Taipei, Taiwan; Graduate Institute of Oral Biology, School of Dentistry, National Taiwan University, Taipei, Taiwan.Graduate Institute of Clinical Dentistry, School of Dentistry, National Taiwan University, Taipei, Taiwan; Department of Dentistry, National Taiwan University Hospital, College of Medicine, National Taiwan University, Taipei, Taiwan; Graduate Institute of Oral Biology, School of Dentistry, National Taiwan University, Taipei, Taiwan.Department of Dentistry, Far Eastern Memorial Hospital, New Taipei City, Taiwan; Graduate Institute of Clinical Dentistry, School of Dentistry, National Taiwan University, Taipei, Taiwan.Oral Pathology and Family Dentistry Section, Department of Dentistry, Chang Gung Memorial Hospital, Kaohsiung Medical Center, Chang Gung University College of Medicine, Kaohsiung, Taiwan.Graduate Institute of Clinical Dentistry, School of Dentistry, National Taiwan University, Taipei, Taiwan; Department of Dentistry, National Taiwan University Hospital, College of Medicine, National Taiwan University, Taipei, Taiwan. Electronic address: andysun7702@yahoo.com.tw.

Pub Type(s)

Journal Article
Review

Language

eng

PubMed ID

29472048

Citation

Chiang, Chun-Pin, et al. "Oral Lichen Planus - Differential Diagnoses, Serum Autoantibodies, Hematinic Deficiencies, and Management." Journal of the Formosan Medical Association = Taiwan Yi Zhi, vol. 117, no. 9, 2018, pp. 756-765.
Chiang CP, Yu-Fong Chang J, Wang YP, et al. Oral lichen planus - Differential diagnoses, serum autoantibodies, hematinic deficiencies, and management. J Formos Med Assoc. 2018;117(9):756-765.
Chiang, C. P., Yu-Fong Chang, J., Wang, Y. P., Wu, Y. H., Lu, S. Y., & Sun, A. (2018). Oral lichen planus - Differential diagnoses, serum autoantibodies, hematinic deficiencies, and management. Journal of the Formosan Medical Association = Taiwan Yi Zhi, 117(9), 756-765. https://doi.org/10.1016/j.jfma.2018.01.021
Chiang CP, et al. Oral Lichen Planus - Differential Diagnoses, Serum Autoantibodies, Hematinic Deficiencies, and Management. J Formos Med Assoc. 2018;117(9):756-765. PubMed PMID: 29472048.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Oral lichen planus - Differential diagnoses, serum autoantibodies, hematinic deficiencies, and management. AU - Chiang,Chun-Pin, AU - Yu-Fong Chang,Julia, AU - Wang,Yi-Ping, AU - Wu,Yu-Hsueh, AU - Lu,Shin-Yu, AU - Sun,Andy, Y1 - 2018/02/19/ PY - 2018/01/19/received PY - 2018/01/26/revised PY - 2018/01/30/accepted PY - 2018/2/24/pubmed PY - 2018/11/28/medline PY - 2018/2/24/entrez KW - Autoantibody KW - Gastric parietal cell antibody KW - Hematinic deficiency KW - Oral lichen planus KW - Thyroglobulin antibody KW - Thyroid microsomal antibody SP - 756 EP - 765 JF - Journal of the Formosan Medical Association = Taiwan yi zhi JO - J Formos Med Assoc VL - 117 IS - 9 N2 - Oral lichen planus (OLP) is a chronic inflammatory oral mucosal disease that occurs more frequently in middle-aged and elderly female patients. Previous studies indicate that OLP is a T-cell dysfunction-induced localized autoimmune disease. Clinically, six types of OLP, namely reticular, papular, plaque-like, atrophic/erosive, ulcerative, and bullous types, can be identified. OLP more commonly affects buccal mucosa, tongue, and gingiva. It always has a bilateral and symmetric distribution of the oral lesions. Plaque-like and atrophic/erosive OLP may be misdiagnosed as oral leukoplakia and oral erythroleukoplakia, respectively. Our previous study found serum autoantibodies in 195 (60.9%) of the 320 OLP patients. Specific serum anti-nuclear, anti-smooth muscle, anti-mitochondrial, gastric parietal cell, thyroglobulin, and thyroid microsomal autoantibodies are present in 28.1%, 8.4%, 1.6%, 26.3%, 21.3%, and 24.4% of 320 OLP patients, respectively. Furthermore, we also discovered that 21.9%, 13.6%, 7.1%, 0.3%, and 14.8% of 352 OLP patients have hemoglobin, iron, vitamin B12, and folic acid deficiencies, and abnormally high serum homocysteine level, respectively. Therefore, it is very important to examine the serum autoantibody, hematinic and homocysteine levels in OLP patients before starting the treatments for OLP patients. Because OLP is an immunologically-mediated disease, corticosteroids are the drugs of choice for treatment of OLP. SN - 0929-6646 UR - https://www.unboundmedicine.com/medline/citation/29472048/Oral_lichen_planus___Differential_diagnoses_serum_autoantibodies_hematinic_deficiencies_and_management_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0929-6646(18)30052-4 DB - PRIME DP - Unbound Medicine ER -