Suppl.completo reimpag._4b_. 04/10/13 17:14 Pagina 46
Case Report
An unusual case of Oral Lichen Planus S. Decani, E. Varoni, S. Sutera, A. Trapani, A. Sardella UO Dentistry II - AO San Paolo Hospital Milan, Department of Biomedical, Surgical and Dental Sciences, University of Milan, Italy Introduction. Oral Lichen Planus (OLP) is an immune-mediated chronic inflammatory disease, with a plethora of clinical presentations (from atrophic to ulcerative forms). OLP in its ulcerative form is usually in differential diagnosis with pemphigus vulgaris (PV), pemphigoid of mucous membranes (PMM) and oral lichenoid lesions, including oral lupus erithematosus (OLE). Case details. We present the case of a 67-year-old female, who came to our attention for a palatal lesion. Intraoral clinical examination showed an ulceration of 3 cm of diameter, surrounded by an erythematous area, localized at the anterior third of the hard palate. The clinical diagnosis was OLE mainly because of the palatal collocation (suggestive of lichenoid lesion LE correlated), although OLP and PV were considered in the differential diagnosis. During the first visit, we decided to perform an incisional biopsy for both the histopathological and immunofluorescence exams. The histological exam was suggestive of OLP. The patient was then treated with clobetasol gel 0.05% associated with anti-fungal agents to prevent candidiasis. The treatment was effective, eliminating both symptoms and the palatal lesion. Conclusions. Ulcerative OLP may share clinical features with PMM, PV and OLE. The histopathological exam, together with direct immunofluorescence, can be necessary to confirm the diagnosis, particularly in case of less common clinical features. References • •
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Lodi G, Varoni E, Salis A, Franchini R. Lichen planus orale e lesioni lichenoidi. Una guida per l’odontoiatra. Dental Cadmos 2011; 79:675-93. Trucci VM, Salum FG, Figueiredo MA, Cherubini K. Interrelationship of dendritic cells, type 1 interferon system, regulatory T cells and toll-like receptors and their role in lichen planus and lupus erythematosus. Arch Oral Biol 2013; 8:211-2.
Annali di Stomatologia 2013; Suppl. 2: 1-48
Case Report
An unusual case of Oral Lichen Planus S. Decani, E. Varoni, S. Sutera, A. Trapani, A. Sardella UO Dentistry II - AO San Paolo Hospital Milan, Department of Biomedical, Surgical and Dental Sciences, University of Milan, Italy Introduction. Oral Lichen Planus (OLP) is an immune-mediated chronic inflammatory disease, with a plethora of clinical presentations (from atrophic to ulcerative forms). OLP in its ulcerative form is usually in differential diagnosis with pemphigus vulgaris (PV), pemphigoid of mucous membranes (PMM) and oral lichenoid lesions, including oral lupus erithematosus (OLE). Case details. We present the case of a 67-year-old female, who came to our attention for a palatal lesion. Intraoral clinical examination showed an ulceration of 3 cm of diameter, surrounded by an erythematous area, localized at the anterior third of the hard palate. The clinical diagnosis was OLE mainly because of the palatal collocation (suggestive of lichenoid lesion LE correlated), although OLP and PV were considered in the differential diagnosis. During the first visit, we decided to perform an incisional biopsy for both the histopathological and immunofluorescence exams. The histological exam was suggestive of OLP. The patient was then treated with clobetasol gel 0.05% associated with anti-fungal agents to prevent candidiasis. The treatment was effective, eliminating both symptoms and the palatal lesion. Conclusions. Ulcerative OLP may share clinical features with PMM, PV and OLE. The histopathological exam, together with direct immunofluorescence, can be necessary to confirm the diagnosis, particularly in case of less common clinical features. References • •
46
Lodi G, Varoni E, Salis A, Franchini R. Lichen planus orale e lesioni lichenoidi. Una guida per l’odontoiatra. Dental Cadmos 2011; 79:675-93. Trucci VM, Salum FG, Figueiredo MA, Cherubini K. Interrelationship of dendritic cells, type 1 interferon system, regulatory T cells and toll-like receptors and their role in lichen planus and lupus erythematosus. Arch Oral Biol 2013; 8:211-2.
Annali di Stomatologia 2013; Suppl. 2: 1-48
