Clinical diagnosis of oral erosive lichen planus by direct oral microscopy

Drogoszewska, Barbara; Chomik, Piotr; Polcyn, Adam; Michcik, Adam

doi:10.5114/pdia.2014.40926

Cited by 20 publications

(20 citation statements)

References 16 publications

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“…Lichen planus is a chronic inflammatory disease that affects the skin, genitalia, mucous membranes, and appendages [ 1 , 7 ]. An immune-mediated mechanism may play a role in the pathogenesis of LP.…”

Section: Discussionmentioning

confidence: 99%

Assessment of systemic inflammation with neutrophil-lymphocyte ratio in lichen planus

Ataş

Cemil

Kurmuş

et al. 2016

pdia

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IntroductionLichen planus (LP) is a papulosquamous eruption of the skin and mucous membranes. Although the exact pathogenesis of the disease remains unclear, it is believed that LP represents an inflammatory disorder. Neutrophil-lymphocyte (N/L) ratio is considered a systemic inflammatory marker that correlated with severity of the diseases.AimTo investigate whether N/L ratio increases in LP and may be an independent severity marker for LP lesions.Material and methodsWhite blood cell (WBC), neutrophil and lymphocyte counts, N/L ratio, erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) were statistically compared between the patient (n = 55) and the control group (n = 48). The relationship of N/L ratio and the body surface area (BSA) was assessed.ResultsErythrocyte sedimentation rate and CRP were statistically higher in patients with LP than in controls (p < 0.0001). Our analysis revealed a significantly higher level of N/L ratio in patients with LP compared with controls, respectively (2.5 ±1.1 (1.2–7.3) vs. 1.4 ±0.4 (0.8–2.7), p < 0.0001). Body surface area (p = 0.001), CRP (p = 0.006), and ESR (p = 0.003) were identified as possible predictors of N/L ratio, but only BSA (p = 0.002) and ESR (p = 0.003) were found as significant independent predictors in a multiple linear regression model.ConclusionsThe inflammatory process in LP was supported by our results. N/L ratio may have an impact to show the inflammatory status in patients with LP as an inexpensive, simple and effective predictor. It may be used for the severity and treatment option of LP. But, N/L ratio and LP relationship could be confirmed by other large prospective studies.

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Section: Discussionmentioning

confidence: 99%

Assessment of systemic inflammation with neutrophil-lymphocyte ratio in lichen planus

Ataş

Cemil

Kurmuş

et al. 2016

pdia

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“…Angiogenesis was interpreted as an increase in capillary density, diameter and tortuosity, total vascular caliber, and branched loops, indicating the angiogenic phenomenon of OLP in vivo, was significantly increased compared to normal mucosa [16,27]. However, in recent years, Drogoszewska used direct oral microscopy for OLP to observe surface pattern, color tone, borders of the lesion and subepithelial mucosal vessels [28]. Twenty percent erosive OLP showed visible numerous thin, elongated subepithelial hairpin capillaries under green filter [26].…”

Section: Evaluation Of Average Areas and Ipcl Anglesmentioning

confidence: 99%

Histomorphometric Evaluation of Intraepithelial Papillary Capillaries in Oral Lichen Planus: A Histopathological Study

Hara¹,

Sakamaki²,

Higuchi³

et al. 2018

J Dermatol Res Ther

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Background: Definitive diagnosis of oral lichen planus (OLP) is important for planning treatment. The problems and difficulties of diagnosing OLP based on histopathological features were showing inter-and intra-observer variability. In terms of pathological diagnosis on OLP, microvascular appearance was not highly valued. Comparative histomorphometric analysis of intraepithelial papillary capillary loops (IPCLs) of OLP was performed to investigate the potential for use as diagnostic criteria. Methods: Immunohistochemical and histopathological evaluations of microvascular morphology were performed in 42 cases diagnosed as OLP clinico-histopathologically. Average areas and capillary loop angles at the sites adjacent to the lesion and most prominent and erosive areas of OLP were measured using image analysis software under microscopic observation. Results: Area of IPCLs in sites adjacent to the lesion was larger than those in prominent areas of OLP (p < 0.001). Capillary loop angles were 26.6 ± 19.3*, 84.5 ± 17.8*, 30.2 ± 2.4* and 34.4 ± 19.3* for normal mucosa, sites adjacent to the lesion, prominent areas of OLP, and erosive areas, respectively. Significant differences were observed between the prominent areas and adjacent sites to the lesion (p < 0.001). Conclusions: Characteristic IPCL patterns were identified in the present study despite reticular/erosive type. This research thus suggested the utility of these patterns in pathological diagnostic criteria.

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“…Direct oral microscopy constitutes a novel, as yet sporadically utilised, non-invasive diagnostic technique, which aids clinical examination of the oral cavity [ 1 ]. The basic principles of this method derive from colposcopy, a common diagnostic tool in gynaecology, and dermoscopy, which is utilised in clinical evaluations of skin lesions.…”

Section: Introductionmentioning

confidence: 99%

Application of direct oral microscopy in evaluating mucosal margins around invasive oral squamous cell carcinoma

Chomik

Michcik

Michajłowski

et al. 2015

pdia

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IntroductionDirect oral microscopy constitutes a novel, non-invasive diagnostic technique, which aids clinical examination of the oral cavity. The oral mucosa is examined at multiple magnifications and features such as sub-epithelial mucosal vessels, surface patterns, colour tone, transparency and the exact demarcation of mucosal lesions are estimated. The incidence of oral squamous cell carcinoma (OSCC) oscillates between 1.9% and 3.5%, which makes it the eighth most common carcinoma occurring around the world and in Poland. The 5-year survival rates oscillate between 20% and 30%.AimThe aim of the study was to evaluate clinically unchanged mucosal margins around OSCC by direct oral microscopy. The authors approached the question whether the borders of mucosal margins around OSCC established via direct oral microscopy differ from those established based on clinical examination.Material and methodsFifteen patients diagnosed with OSCC were enrolled. Patients were first clinically examined to evaluate the extent of the tumour and to plan resection margins. Eventually, direct oral microscopy was performed to establish the width of the subclinically unchanged mucosal margins based on a standard picture of healthy oral mucosae, followed by comparison with those established by clinical evaluation.ResultsHistopathologic results of biopsies from areas indicated by direct oral microscopy revealed dysplasia in 86.7% of patients, whereas biopsies from areas indicated by clinical examination revealed dysplasia only in 40% of individuals, resulting in the need for widening of mucosal margins.ConclusionsDirect oral microscopy enables detection of dysplasia within clinically unaltered mucosal margins around OSCC, which results in more precise establishing of resection boundaries, contributing to improvement of resection totality.

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Clinical diagnosis of oral erosive lichen planus by direct oral microscopy

Cited by 20 publications

References 16 publications

Assessment of systemic inflammation with neutrophil-lymphocyte ratio in lichen planus

Assessment of systemic inflammation with neutrophil-lymphocyte ratio in lichen planus

Histomorphometric Evaluation of Intraepithelial Papillary Capillaries in Oral Lichen Planus: A Histopathological Study

Application of direct oral microscopy in evaluating mucosal margins around invasive oral squamous cell carcinoma

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