Evaluation of the Function of Vitamin D in Treating Oral Lichen Planus.

Objectives: The objective of the current research was to evaluate the role of vitamin D in the management of oral lichen planus. Materials and Method: Based on their vitamin D levels, 90 individuals with oral lichen planus were equally divided into three groups. Deficient subjects received oral vitamin D supplementation. Result: The majority of improvements were observed in patients who were taking vitamin D supplements. It was discovered that the data comparison was statistically considerable. Conclusion: It was determined that vitamin D was crucial for the management of oral lichen planus.

Ayurvedic management of a refractory skin disease clinically diagnosed as Cutaneous Lichen Planus-A case report.

This study reports the successful management of a recurrent, refractory skin disease diagnosed clinically as Cutaneous Lichen Planus (CLP) in a female patient with Ayurvedic treatment. A 42-year-old home maker from Coimbatore presented with blackish-red pigmented skin rashes and white streaks. Though mucous membranes were not affected, she did not respond to homoeopathic and biomedical treatment. The lesions were spread all over the body except for the face, scalp, axillary and genital region. In addition, she complained of dry skin, pain, and itching. The condition was treated as Kapha-Pitta dominant Tridoshaja Kushta based on Ayurvedic clinical assessment. The patient recovered after one year of conservative Ayurvedic intervention. After six years, there was a relapse, and the patient was admitted for a full course of Ayurvedic treatment and recovered within six months. Ayurvedic interventions should be considered an option in refractory skin diseases like Cutaneous Lichen Planus.

Oral lichen planus among patients from Lublin Region in relation to 25-hydroxy-vitamin D3 serum level.

INTRODUCTION AND OBJECTIVE: Lichen planus is a chronic inflammatory skin disease involving the mucous membrane of the oral cavity. It is postulated that different factors play a role in the occurrence of the disease and may activate the immune system, thus influencing the development of lichen planus. Vitamin D is a steroid prohormone with multiple systemic effects. OBJECTIVE: The aim of this study was to assess oral lichen planus against 25-hydroxy-vitamin D3 serum level. Vitamin D takes an active part in the pathogenesis of immunisation diseases, may have also a beneficial effect on oral health. MATERIAL AND METHODS: The clinical picture of lichen planus was analyzed according to the concentration of 25-hydroxy-vitamin D3. Patients were given a questionnaire interview which included questions about the co-existence of systemic diseases, subjective complaints, and information relating to the individual course of the disease. In the next stage of the study, patients were underwent a physical examination. Laboratory determinations of the concentration of 25-hydroxy-vitamin D3 were also performed. RESULTS: The mean vitamin D concentration in patients with lichen planus in the oral cavity was 14.37 ± 4.95 ng/ml. An insufficient level (10-30 ng/ml) was detected in 84.91% of the examined patients, whereas a deficiency (< 10 ng/ml) was observed in 15.09% of those patients. None of the analyzed patients had vitamin D level in the range of established clinical standards. A substantially lowered vitamin D level was found in patients reporting bleeding and pain of the gums. CONCLUSIONS: The study enhances relationship between reduced levels of vitamin D3 and lichen planus in patients with oral lesions. Thus, vitamin D3 control and supplementation may play an important role in the treatment of lichen planus.

Lichen pectin-containing polysaccharide from Xanthoria elegans and its ability to effectively protect LX-2 cells from H2O2-induced oxidative damage.

Xanthoria elegans, a drought-tolerant lichen, is the original plant of the traditional Chinese medicine "Shihua" and effectively treats a variety of liver diseases. However, thus far, the hepatoprotective effects of polysaccharides, the most important chemical constituents of X. elegans, have not been determined. The aim of this study was to screen the polysaccharide fraction for hepatoprotective activity by using free radical scavenging assays and a H2O2-induced Lieming Xu-2 cell (LX-2) oxidative damage model and to elucidate the chemical composition of the bioactive polysaccharide fraction. In the present study, three polysaccharide fractions (XEP-50, XEP-70 and XEP-90) were obtained from X. elegans by hot-water extraction, DEAE-cellulose anion exchange chromatography separation and ethanol gradient precipitation. Among the three polysaccharide fractions, XEP-70 exhibited the best antioxidant activity in free radical scavenging capacity and reducing power assays. Structural studies showed that XEP-70 was a pectin-containing heteropolysaccharide fraction that was composed mainly of (1 â†’ 4)-linked and (1 â†’ 4,6)-linked α-D-Glcp, (1 â†’ 4)-linked α-D-GalpA, (1 â†’ 2)-linked, (1 â†’ 6)-linked and (1 â†’ 2,6)-linked α-D-Manp, and (1 â†’ 6)-linked and (1 â†’ 2,6)-linked ß-D-Galf. Furthermore, XEP-70 exhibited effectively protect LX-2 cells against H2O2-induced oxidative damage by enhancing cellular antioxidant capacity by activating the Nrf2/Keap1/ARE signaling pathway. Thus, XEP-70 has good potential to protect hepatic stellate cells against oxidative damage.

Photobiomodulation versus corticosteroid in the management of erosive oral lichen planus: a randomized controlled clinical trial.

BACKGROUND: Oral lichen planus (OLP) is a chronic illness of immune origin that is typically treated with corticosteroids as a gold standard therapy. Photobiomodulation (PBM) may represent an alternative remedy that has the potential to treat a variety of pathological conditions by alleviating pain, reducing inflammation, and promoting tissue healing without the drawbacks of steroid therapies. Thus, the aim of the current study was to compare the effect of photobiomodulation to topical 0.1% triamcinolone acetonide on erosive oral lichen planus. METHODS: This randomized controlled clinical trial involved 44 patients complaining of erosive oral lichen planus. Patients were assigned to one of two groups: control group (n = 22) received 0.1% topical triamcinolone acetonide three times daily with miconazole oral gel once daily for 4 weeks, and photobiomodulation group (n = 22) received laser therapy by 980 nm diode laser utilizing output power 300 mW twice weekly for 5 weeks (a total of 10 sessions). The evaluation of patients was performed at baseline, 6 weeks, and 12 weeks postoperatively in terms of pain, clinical scores, and biochemical evaluation of salivary malondialdehyde levels. All recorded data were analyzed using Mann-Whitney test to compare the two studied groups regarding pain, lesion size, and salivary levels of malondialdehyde. Friedman test, followed by post hoc test, was used for comparison of the data within the same group along the 3 periods at baseline, 6 weeks, and 12 weeks. RESULTS: Both groups showed significant improvement in pain and clinical scores, with no statistical difference between them. Moreover, there was a significant improvement in salivary malondialdehyde levels for both groups, with no significant difference between them. CONCLUSIONS: Photobiomodulation could be a promising therapeutic modality for management of erosive oral lichen planus without the side effects of steroid therapy. The salivary malondialdehyde level could be used as a biomarker to evaluate the disease severity and its response to the treatment. TRIAL REGISTRATION: The study has been registered at ClinicalTrials.gov (NCT05951361) (19/07/2023).

Effects of Curcumin on the treatment of oral lichen planus symptoms: a systematic review and meta-analysis study.

BACKGROUND AND OBJECTIVES: Oral lichen planus (OLP) is a relatively common chronic T-cell-mediated disease that can cause significant pain, particularly in its erosive or ulcerative forms. This study aimed to examine the therapeutic impact of curcumin on symptoms of OLP. MATERIALS AND METHODS: This meta-analysis was performed according to the PRISMA guidelines. All related English documents indexed in electronic databases (including PubMed, Web of Science, Scopus, Embase, Wiley, Cochrane, and ProQuest databases [updated to August 15, 2023]) were retrieved. Data were double-extracted into a predefined worksheet, and quality analysis was performed using the Joanna Briggs Institute (JBI) scale. We carried out meta-analyses, and the random effects model was used to estimate the differences in erythema, lesion size, and pain between the curcumin control groups. RESULTS: The search identified 289 studies, of which 10 were found to meet the inclusion criteria. The overall findings of the meta-analysis revealed that curcumin did not have a significant effect on erythema of OLP (standardized mean difference [SMD] = -0.14; 95% CI, -0.68 to 0.40; P = 0.61; I2 = 57.50%), lesion size of OLP (SMD = -0.15; 95% CI, -0.45 to 0.15; P = 0.33; I2 = 28.42%), and pain of OLP (SMD = -0.38; 95% CI, -0.97 to 0.22; P = 0.22; I2 = 86.60%). However, subgroup analysis based on treatment duration indicated that 2-week treatment duration was significantly associated with a reduction in OLP pain (n = 3; SMD = -1.21; 95% CI, -2.19 to -0.23; P = 0.01). CONCLUSIONS: Curcumin had no significant effect on erythema, lesion size, and pain of OLP compared to the control groups. However, subgroup analysis revealed that curcumin was more effective in reducing pain in non-randomized trials and in trials with a treatment duration of 2 weeks.

WNL we never looked: vulvar carcinoma incidence after screening cutoff.

The incidence of vulvar carcinoma increases with age, though elderly women receive less aggressive cancer therapies and fewer strategies aimed at cancer prevention. Furthermore, elderly women dual enrolled in Medicaid-Medicare experience poor survival rates for vulvar carcinoma. Herein, we provide recommendations for the prevention of and guidelines for the multidisciplinary care of vulvar carcinoma. Prevention of vulvar carcinoma can be categorized into primary, secondary, and tertiary prevention. Primary prevention consists of vaccination, secondary prevention consists of screening, and tertiary prevention is aimed at the management of premalignant and early-stage lesions.

Use of new Indices for the Assessment of Air Quality in the Safi Region (Morocco) using Lichen Biomonitoring of Air Contamination by Trace Elements.

This study aims to use environmental indices as complementary tools to other air quality biomonitoring techniques. The concentrations of trace elements Hg, Se, V, Mo, and Ba were analyzed by ICP-MS in four lichens: Xanthoria calcicola, Xanthoria parietina, Ramalina pollinaria, and Ramalina lacera. To assess the contamination of lichens by trace elements, different environmental indices were calculated: Contamination Index (Ic), Contamination Factor (CF), Pollution Load Index (PLI) and Enrichment Factor (EF). The results revealed that the genus Ramalina has a low tolerance to polymetallic pollution with a PLI not exceeding 0.44. The genus Xanthoria seems more resistant to polymetallic pollution with a maximum PLI of 2.58. The calculation of the enrichment factor revealed a very strong enrichment of the lichens in Mo, Hg and Se with a maximum content in Ba which reflects a strong metallic contamination of various origins especially in the urban and industrial areas of the region.

Isolation of Mycosporine-like Amino Acids from Red Macroalgae and a Marine Lichen by High-Performance Countercurrent Chromatography: A Strategy to Obtain Biological UV-Filters.

Marine organisms have gained considerable biotechnological interest in recent years due to their wide variety of bioactive compounds with potential applications. Mycosporine-like amino acids (MAAs) are UV-absorbing secondary metabolites with antioxidant and photoprotective capacity, mainly found in organisms living under stress conditions (e.g., cyanobacteria, red algae, or lichens). In this work, five MAAs were isolated from two red macroalgae (Pyropia columbina and Gelidium corneum) and one marine lichen (Lichina pygmaea) by high-performance countercurrent chromatography (HPCCC). The selected biphasic solvent system consisted of ethanol, acetonitrile, saturated ammonium sulphate solution, and water (1:1:0.5:1; v:v:v:v). The HPCCC process for P. columbina and G. corneum consisted of eight separation cycles (1 g and 200 mg of extract per cycle, respectively), whereas three cycles were performed for of L. pygmaea (1.2 g extract per cycle). The separation process resulted in fractions enriched with palythine (2.3 mg), asterina-330 (3.3 mg), shinorine (14.8 mg), porphyra-334 (203.5 mg) and mycosporine-serinol (46.6 mg), which were subsequently desalted by using precipitation with methanol and permeation on a Sephadex G-10 column. Target molecules were identified by HPLC, MS, and NMR.

Characteristics, comorbidities, and treatment practices of lichen planus in Northern Finland: A register-based study among 619 subjects.

Background and Aims: Lichen planus (LP) is a common itching skin disease where lesions appear on the skin and mucous membranes. However, the epidemiology of LP is not yet sufficiently understood. The aim of this study was to retrospectively map out the characteristics, comorbidities and treatments of patients diagnosed with LP. Methods: This is a retrospective hospital patient registry-based study performed between 2009 and 2021 in a secondary care hospital (Oulu University Hospital) in Northern Finland. All patients with recorded diagnosis of LP were included in the study. Characteristics, comorbidities, and treatments of LP patients were studied. Results: In total, 619 patients were verified from the hospital health records. The mean age of patients was 54.2 years and the majority were female (58.3%). Most of the patients had symptoms in more than two skin areas (mean 2.7 skin areas), lower limbs being the most common site (74.0%). A third of patients (34.7%) had oral LP lesions. Nearly fifth (19.4%) of the subjects had a history of previous LP. Of comorbidities found among LP subjects, obesity (22.5%), malignancies (19.4%), depression (12.8%), and thyroiditis (12.4%) were seen more often than in general Finnish population. The most used form of treatment was topical corticosteroids (97.6%), followed by phototherapy 26.8%. Systemic treatments such as prednisolone and methotrexate had been used in 7.6% and 1.1% of the patients, respectively. Conclusion: LP patients had a heightened risk for several comorbidities, which should be considered when managing patients with LP.

Comparative Efficacy and Safety of Interventions for the Treatment of Oral Lichen Planus: A Systematic Review and Network Meta-Analysis.

BACKGROUND: This systematic review and network meta-analysis aimed to assess comparative efficacy and safety of interventions to treat symptomatic, biopsy-proven oral lichen planus (OLP). METHODS: Search was conducted for trials published in Medline, Embase and Cochrane Central Register of Controlled Trials. Network meta-analysis was performed on data from randomized controlled trials that assessed efficacy and safety of interventions used in the treatment of OLP. Agents were ranked according to their effectiveness in treatment of OLP based on outcomes using surface under the cumulative ranking [SUCRA]. RESULTS: In total, 37 articles were included in the quantitative analysis. Purslane was clinically significant and ranked first in improving clinical symptoms [RR = 4.53; 95% CI: 1.45, 14.11], followed by aloe vera [RR = 1.53; 95% CI: 1.05, 2.24], topical calcineurin [RR = 1.38; 95% CI: 1.06, 1.81] and topical corticosteroid [RR = 1.35 95% CI: 1.05, 1.73]. Topical calcineurin demonstrated the highest incidence of adverse effects [RR, 3.25 [95% CI: 1.19, 8.86. Topical corticosteroids were significant in achieving clinical improvement of OLP with RR1.37 [95% CI: 1.03, 1.81]. PDT [MD = -5.91 [95% CI: -8.15, -3.68] and showed statistically significant improvement in the clinical score for OLP. CONCLUSIONS: Purslane, aloe vera and photodynamic therapy appear promising in treatment of OLP. More high-quality trials are recommended for strengthening the evidence. Although topical calcineurin is significantly efficacious in the treatment of OLP, significant adverse effects are a concern for clinical use. Based on the current evidence, topical corticosteroids are recommended for treatment of OLP owing to their predictable safety and efficacy.

Emerging potential of phototherapy in management of symptomatic oral lichen planus: A systematic review of randomised controlled clinical trials.

Phototherapy incorporating photobiomodulation therapy and antimicrobial photodynamic therapy has been utilised as antioxidants in symptomatic oral lichen planus (OLP) management; however, its role of intervention remains controversial. The aim of this systematic review of CRD42021227788 PROSPERO (an international prospective register of systematic reviews in health and social care) registration number was to oversee and determine phototherapy efficacy in patients with symptomatic OLP, identifying and bridging the literature gaps by proposing recommendations for future studies. A search strategy was developed in consistent with Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Various electronic databases were exercised to search for randomised controlled clinical trials (RCTs). Several search engines were employed to analyse a total of 177 studies of which nine included. A wide range of utilised laser and light-emitted diode wavelengths between 630 and 808 nm and irradiance ranged between 10 and 13 mW/cm2 were noted. 67% of studies reported a high risk of bias and a high heterogeneity obtained from numerical data for quantitative analysis, therefore meta-analysis was impossible to conduct. Despite inconsistency and diversity in phototherapy parameters, treatment protocols, photosensitiser (type, concentration and method of application) and outcome assessment tools, the majority of the studies showed positive results compared with standard care treatments. Hence, a necessity to perform well-designed RCTs with robust methodology is warranted, after acknowledging the current drawbacks and addressing the suggested recommendations highlighted in our review. Moreover, advanced knowledge in understanding further phototherapy-antioxidants molecular mechanistic in symptomatic OLP is required.

Molecular docking and dynamics supported investigation of antiviral activity of Lichen metabolites of Roccella montagnei: an in silico and in vitro study.

Lichens are symbiotic organisms that have been traditionally used for treating different kinds of ailments. As there are only a few reports on the antiviral activity of lichens, we thought of evaluating the anti-Herpes simplex virus-1 (HSV-1) activity of methanolic extract of Roccella montagnei and their isolated compounds. Fractionation of crude methanolic extract of Roccella montagnei by column chromatography isolated two pure compounds. Antiviral activity was assessed using a CPE inhibition assay at non-cytotoxic concentrations on Vero cells. Molecular docking and dynamics studies were carried out against Herpes simplex type-1 thymidine kinase to understand the binding interactions of the isolated compounds with reference to acyclovir. Isolated compounds were characterized as methyl orsellinate and montagnetol by spectral methods. Methanolic extract of Roccella montagnei exhibited an EC50 value of 56.51 µg/ml, while the compounds methyl orsellinate and montagnetol offered EC50 values of 13.50 µg/ml and 37.52 µg/ml, respectively, against HSV-1 viral infection on Vero cell lines. The selectively index (SI) of montagnetol (10.93) was found to be higher when compared to that of methyl orsellinate (5.55), indicating its better anti-HSV-1 activity. The docking and dynamics studies showed montagnetol was stable throughout the 100 ns, having better interactions and docking scores with HSV-1 thymidine kinase than methyl orsellinate, as well as the standard. To understand the mechanism of montagnetol's anti-HSV-1 activity, more research is required, and this could lead to the discovery of new and effective antiviral agents.Communicated by Ramaswamy H. Sarma.

Eumitrins I-K: three new xanthone dimers from the lichen Usnea baileyi.

In the continuing discovery and structure elucidation of natural xanthone dimers, which are still rarely reported in absolute configuration, three new xanthone dimers, eumitrins I-K (1-3) were isolated from the lichen Usnea baileyi, a rich source of natural xanthone dimers. Their structures were elucidated unambiguously by spectroscopic analyses, including high-resolution electrospray ionization mass spectrometry (HRESIMS), 1D and 2D nuclear magnetic resonance spectroscopy (1D and 2D NMR). The absolute configuration of all three compounds was established through DP4 probability and ECD calculation. All compounds revealed weak activity for their enzymatic inhibition against α-glucosidase and tyrosinase, as well as antibacterial activity.

Different Treatment Modalities of Oral Lichen Planus-A Narrative Review.

Oral lichen planus (OLP) is a chronic inflammatory disease of unknown etiology which affects the oral mucosa. OLP varies in its clinical features from a reticular form that is, in most cases, asymptomatic, to atrophic-erosive, and is accompanied by symptoms of burning sensation and pain followed by difficulty in eating. Given the fact that OLP is a disease of unknown etiology, the treatment is symptomatic and involves suppressing the signs and symptoms of the disease using various topical and systemic drugs. The first line of therapy for treating symptomatic OLP is topical corticosteroids, whereas systemic corticosteroids are used for treating persistent lesions that do not respond to local treatment. However, the lack of convincing evidence on the efficacy of previous therapies, including topical corticosteroids, and numerous side effects that have appeared over recent years has resulted in the emergence and development of new therapeutic options. Some of the therapies mentioned are tacrolimus, efalizumab, dapson, interferon, retinoic acid, photochemotherapy with psoralen and ultraviolet A rays (PUVA), aloe vera, antimalarials, antibiotics and others. These therapies only partially meet the properties of efficacy and safety of use, thus justifying the continuous search and testing of new treatment methods.

Single session of laser photobiomodulation for symptom management of oral lichen planus: a retrospective study.

This study aimed to evaluate the effectiveness of a single session of laser photobiomodulation (PBM) with flat top handpiece in reducing painful symptoms in patients with Oral Lichen Planus (OLP). The clinical charts of 20 patients of the Dental Clinic of University of Padua (Italy) who underwent a single laser PBM to manage OLP symptomatology were retrospectively analyzed. A 980 nm diode laser and a flat top handpiece with a 1-cm2 spot area were employed to perform the PBM with a single session protocol. VAS pain scores were assessed before and after the laser PBM, the day after, and on the 7th and 30th days after the treatment. No adverse effects occurred within 30 days after treatment. The mean VAS-pain score was 3.8 (SD 2.3) before PBM; 2.6 (SD 2.0) after PBM; 1.9 (SD 2.2) on day 1; 2.0 (SD 2.3) on day 7; and 1.5 (SD 2.2) on day 30. VAS pain decreased significantly over time (p < 0.0001). A single session of laser PBM may be safe and effective in reducing pain for symptomatic OLP patients. Further investigations are required to include placebo or topical corticosteroids as comparators.

Antioxidant Activity of Usnic Acid Compound from Methanol Extract of Lichen Usnea sp.

Lichen Usnea sp. is one of the sources of natural bioactive compounds which are currently being developed as medicinal ingredients. The purpose of this study was the isolation and identification of secondary metabolites from methanol extract, toxicity test and antioxidant activity of Usnea sp. Lichen was isolated by maceration using methanol solvent, then separated by liquid-liquid partition and separation using vacuum chromatography. Based on the results of the study, NMR-1D spectral data and FTIR spectrum is the presence of functional groups showed the presence of F15 compound is usnic acid consisting of 18 carbons with 3 carbons from the C=O carbonyl group. The results of the toxicity test showed that all of them were active against Artemia salina L. shrimp larvae with LC50 values of 0.820 µg/mL (Usnea sp.), 1.030 µg/mL (n-hexane), 1.056 µg/mL (ethyl acetate), and 1.236 µg/mL (methanol extract). The results of the antioxidant activity test showed that the inhibitory activity of usnic acid isolate was very active with an IC50 value of 11.696 µg/mL. Meanwhile, methanol extracts and ethyl acetate showed antioxidant activity with IC50 values of 18.098 and 26.917 µg/mL, respectively.

Plant Extracts and Phytochemicals, a Promising Strategy Against Oral Lichen Planus: A Review on Clinical Trials.

BACKGROUND: Oral lichen planus (OLP) is an autoimmune disease that distress keratinized cells of the oral epithelium. Topical corticosteroids and other potential therapies like immunosuppressives, hydroxychloroquine, azathioprine, mycophenolate, dapsone, retinoids, biologic agents are used for the management of OLP. However, their effectiveness, best dose, duration of treatment and safety remain mostly unidentified. Moreover, recurrence of disease and dose-related side effects are the other issues. OBJECTIVE: The primary objective of the review is to explore the existing clinical trials for the efficacy of phytochemicals in treating OLP in comparison to corticosteroids. A comprehensive information about their mode of action is also discussed. METHODS: We have discussed different clinical trials conducted on various phytochemicals and plant extracts/formulations like curcumin, lycopene, quercetin, glycyrrhizin, purslane, raspberry, aloe vera gel and aloe vera mouthwash for the treatment of OLP. RESULTS: The current therapy for the management of OLP has numerous adverse effects and requires a long-term treatment. Phytochemicals can be a very good alternative in overcoming these side effects and reducing the course of treatment. CONCLUSION: Herbal extracts and their formulations can be an effective alternative to the current therapy due to their proven therapeutic effects, reduced side effects, long-term applicability, prevention of recurrence as well as progression into cancer.