The significance of oral and systemic factors in Australian and Croatian patients with oral lichen planus.

Oral lichen planus (OLP) is an immunologically T cell-mediated disease caused by an unknown stimulus. Despite intensive investigation its pathogenesis still remains unknown. A few possible associations between OLP and certain diseases such as thyroid and malignant diseases as well as specific medication intake have been proposed in the literature with inconsistent findings. We aimed to investigate the profile of 163 Australian and 163 Croatian OLP patients with special regard to their systemic diseases, medication intake (with special regard to the drugs that metabolize through Cytochrome P450), OLP type and localization, as well as involvement of other body surfaces with lichen. We did not find any statistical significance with regard to the OLP presence and thyroid and malignant diseases. As expected, the reticular type of OLP was most prevalent, as well as involvement of the both buccal mucosas. There was no significant association with other oral diseases such as labial herpes. Simultaneous involvement of other body surfaces in patients with OLP does not seem to be prevalent. None of the medical conditions which were investigated had significant correlation with OLP neither in Australian nor in Croatian patients with OLP. Furthermore, the use of drugs which metabolize through Cytochrome P450 (CYP450) was not significantly correlated with OLP in either studied population. Therefore, we conclude that patients with OLP are not to be routinely screened for any systemic conditions.

The influence of psychological state on oral lichen planus.

Oral lichen planus (OLP) is a T-cell mediated disease directed to a still unknown antigen, which may affect oral mucosa. The aim of this study was to determine whether differences in anxiety, depression and stress could be seen in patients with OLP in acute stage and in remission, as well as in comparison with healthy control subjects. The study included 50 OLP patients aged 22-79 (mean age 61.04) years and 50 control subjects who had healthy oral mucosa aged 38-80 (mean age 58.70) years. Patients with OLP filled out the State-Trait Anxiety Inventory for Adults and Beck Depression Inventory II test in acute stage and in remission. Control subjects also filled out the same tests. On detailed medical history, study subjects were asked about the possible stressors, which might have happened in the previous year. Statistical analysis was performed by use of descriptive statistics and t-test. There were no differences in the level of anxiety, depression and stress between the two stages of OLP disease (acute vs. remission period). Patients with OLP were significantly more anxious, depressed and stressed in both OLP stages as compared with healthy controls. It might be that psychological disturbances precede OLP development rather than worsening the disease process itself.