Oral symptoms and salivary findings in oral lichen planus, oral lichenoid lesions and stomatitis

Abstract

BackgroundTo examine if patients with oral lichen planus, oral lichenoid lesions and generalised stomatitis and concomitant contact allergy have more frequent and severe xerostomia, lower unstimulated and chewing-stimulated saliva and citric-acid-stimulated parotid saliva flow rates, and higher salivary concentration of total protein and sIgA than cases without contact allergy and healthy controls.MethodsForty-nine patients (42 women, aged 61.0 ± 10.3 years) and 29 healthy age- and gender-matched subjects underwent a standardised questionnaire on general and oral health, assessment of xerostomia, clinical examination, sialometry, mucosal biopsy and contact allergy testing.ResultsNineteen patients had oral lichen planus, 19 patients had oral lichenoid lesions and 11 patients had generalised stomatitis. 38.8% had contact allergy. Xerostomia was significantly more common and severe in patients (46.9%) than in healthy controls, whereas the saliva flow rates did not differ. The patients had higher sIgA levels in unstimulated and chewing-stimulated saliva than the healthy controls. The total protein concentration in saliva was lower in the unstimulated saliva samples whereas it was higher in the chewing stimulated saliva samples from patients when compared to healthy controls. The differences were not significant and they were irrespective of the presence of contact allergy.ConclusionXerostomia is prevalent in patients with oral lichen planus, lichenoid lesions and generalised stomatitis, but not associated with salivary gland hypofunction, numbers of systemic diseases or medications, contact allergy, age, or gender. Salivary sIgA levels were higher in patients than in healthy controls, but did not differ between patient groups. The total salivary protein concentration was lower in unstimulated saliva samples and higher in chewing-stimulated saliva samples in patients than in healthy controls, but did not differ between patient groups. Our findings do not aid in the discrimination between OLP and OLL and these conditions with or without contact allergic reactions.

Novel Oral Lichen Planus Symptom Severity Measure for assessing patients’ daily symptom experience

“…Oral lichen planus (OLP), which affects the oral mucosa of 0.5%–2% of the adult population (Larsen et al, ; McCartan & Healy, ), is a chronic autoimmune disease associated with cell‐mediated immunological dysfunction (Thongprasom, Carrozzo, Furness, & Lodi, ). Oral lichen planus can present with a range of clinical appearances: a lacy white pattern (striations or reticulations), erythema, erosions, superficial ulceration, plaques, desquamate gingivitis and blistering of the oral mucosa.…”

“…Oral lichen planus can present with a range of clinical appearances: a lacy white pattern (striations or reticulations), erythema, erosions, superficial ulceration, plaques, desquamate gingivitis and blistering of the oral mucosa. Patients may have a combination of these oral mucosal changes (Larsen et al, ). Lesions typically occur bilaterally, and patients may be asymptomatic.…”

“…Lesions typically occur bilaterally, and patients may be asymptomatic. However, in most erythematous or erosive cases normal daily oral activities are adversely affected by the disease (Larsen et al, ; Yiannias, el‐Azhary, Hand, Pakzad, & Rogers, ). Moreover, as the disease is often triggered or worsened by particular foods and drinks, patients with OLP are often unable to enjoy these without discomfort (Chen, Yount, & Culton, ).…”

Serum cytokine profile and clinicopathological findings in oral lichen planus, oral lichenoid lesions and stomatitis

“…Data on alcohol consumption was used to pool the participants in groups of never consuming alcohol, occasionally, or daily consumption of alcohol. They were also being questioned about symptoms of the oral mucosa such as itching, burning and roughness, dysgeusia, and xerostomia (Larsen, Johansen, Reibel, Zachariae, & Pedersen, ). Additionally, measurements of unstimulated and paraffin‐chewing‐stimulated whole saliva flow rates and stimulated parotid saliva flow rates were performed (Larsen, Johansen, Reibel, Zachariae, & Pedersen, ).…”

Salivary proteomics in lichen planus: A relationship with pathogenesis?

“…The decrease in salivary flow raises the proliferation potential of commensal micro‐organisms and mucosal alterations, and may lead to a multiplication of tooth decay and a decrease in mucosal adhesiveness. The changes in saliva composition affect the lubrication capacity, prejudicing the food mastication and swallowing, challenging the digestion and feeding process itself (Larsen et al., ).…”