Commentary

Bowers, Kathryn E.; Sexton, Daniel J.; Sugerman, Philip B.

doi:10.1016/s0738-081x(00)00139-5

Cited by 11 publications

(8 citation statements)

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“…OLP affects one to two percent of the general adult population and is the most common non-infectious oral mucosal disease in patients referred to Oral Medicine and Oral Pathology clinics (Axéll and Rundqvist, 1987;Bowers et al, 2000). OLP affects women more than men at a ratio of approximately 1.4:1 (Axéll and Rundqvist, 1987).…”

Section: Clinical Features Of Olpmentioning

confidence: 99%

The Pathogenesis of Oral Lichen Planus

Sugerman

Savage²,

Walsh³

et al. 2002

Critical Reviews in Oral Biology & Medicine

645

584

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Both antigen-specific and non-specific mechanisms may be involved in the pathogenesis of oral lichen planus (OLP). Antigen-specific mechanisms in OLP include antigen presentation by basal keratinocytes and antigen-specific keratinocyte killing by CD8 + cytotoxic T-cells. Non-specific mechanisms include mast cell degranulation and matrix metalloproteinase (MMP) activation in OLP lesions. These mechanisms may combine to cause T-cell accumulation in the superficial lamina propria, basement membrane disruption, intra-epithelial T-cell migration, and keratinocyte apoptosis in OLP. OLP chronicity may be due, in part, to deficient antigen-specific TGF-␤1-mediated immunosuppression. The normal oral mucosa may be an immune privileged site (similar to the eye, testis, and placenta), and breakdown of immune privilege could result in OLP and possibly other autoimmune oral mucosal diseases. Recent findings in mucocutaneous graft-versus-host disease, a clinical and histological correlate of lichen planus, suggest the involvement of TNF-␣, CD40, Fas, MMPs, and mast cell degranulation in disease pathogenesis. Potential roles for oral Langerhans cells and the regional lymphatics in OLP lesion formation and chronicity are discussed. Carcinogenesis in OLP may be regulated by the integrated signal from various tumor inhibitors (TGF-␤1, TNF-␣, IFN-␥, IL-12) and promoters (MIF,. We present our recent data implicating antigen-specific and non-specific mechanisms in the pathogenesis of OLP and propose a unifying hypothesis suggesting that both may be involved in lesion development. The initial event in OLP lesion formation and the factors that determine OLP susceptibility are unknown.

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Section: Clinical Features Of Olpmentioning

confidence: 99%

The Pathogenesis of Oral Lichen Planus

Sugerman

Savage²,

Walsh³

et al. 2002

Critical Reviews in Oral Biology & Medicine

645

584

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“…Oral lichen planus affects 1-2 per cent of the general adult population and is the most common non-infectious oral mucosal disease in patients referred to oral medicine and oral pathology clinics. 1,2 Oral lichen planus affects women more than men (1.4:1). Oral lichen planus occurs predominantly in adults over 40, although younger adults and children may be affected.…”

Section: Clinical Features Of Oral Lichen Planusmentioning

confidence: 99%

Oral lichen planus: Causes, diagnosis and management

Sugerman

Savage

2002

Australian Dental Journal

171

124

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Oral lichen planus (OLP) is a chronic inflammatory disease of unknown etiology. In this paper we review the clinical and histological features of OLP, process of OLP diagnosis, causes of OLP, management of OLP patients and medical treatment of OLP lesions. Approximately 0.2 per cent OLP patients develop intra-oral carcinoma each year compared with approximately 0.005 per cent Australian adults. Possible mechanisms of increased oral cancer risk in OLP patients are presented. The aims of current OLP therapy are to eliminate mucosal erythema and ulceration, alleviate symptoms and reduce the risk of oral cancer. Patient education may improve the outcomes of OLP therapy and further reduce the risk of oral cancer in OLP patients. Although OLP may be diagnosed clinically, appropriate specialist referral is required for: (i) histological diagnosis; (ii) assessment of causative/exacerbating factors, associated diseases and oral cancer risk; (iii) patient education and management; (iv) medical treatment; and (v) long-term review and re-biopsy as required.

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“…Oral lichen planus (OLP) is a chronic inflammatory disease presenting as bilateral white striations, papules or plaques with or without erythema, erosions, ulcers or blisters on the buccal mucosa, tongue and gingivae. OLP affects 1–2% of the adult population and is one of the more common oral mucosal diseases in patients attending oral pathology and oral medicine clinics (1). OLP is characterized histologically by a dense subepithelial T‐cell infiltrate, increased numbers of intraepithelial T cells and degeneration of basal keratinocytes.…”

mentioning

confidence: 99%