Oral lichen planus: a clinical and morphometric study of oral lesions in relation to clinical presentation.

Oral lichen planus (OLP) is a chronic inflammatory disease with different clinical presentations that can be classified as reticular or atrophic-erosive. Sixty-two OLP patients were studied to evaluate the clinical-pathologic characteristics of their OLP lesions and to investigate possible differences in their biological behavior. The most common clinical presentation was the reticular type (62.9% vs 37.1%). Atrophic-erosive presentations showed significantly longer evolution (chi square=4.454; p=0.049), more extensive lesions (chi square=16.211; p=0.000) and more sites affected than reticular ones (chi square=10.048; p=0.002). Atrophic-erosive OLP was more frequently found on the tongue, gingiva and floor of the mouth. No statistically significant differences could be identified between reticular and atrophic-erosive clinical presentations in terms of age, sex, tobacco habit, plasma cortisol level and depth of inflammatory infiltrate. We concluded that the classification of OLP lesions as reticular vs atrophic-erosive is a simple, easy to use classification that can identify clinical presentations with different biological behavior.

Oral lichen planus: a clinical and morphometric study of oral lesions in relation to clinical presentation

O liquen plano oral (LPO) é uma doença inflamatória crónica com diferentes apresentações clínicas que podem ser classificadas como reticuladas ou atrófico-erosivas. Sessenta e dois pacientes com LPO foram estudados para avalidar as características clínicas/patológicas das suas lesões de LPO e investigar possíveis diferenças no seu comportamento biológico. A forma clínica mais comum foi a de tipo reticular (62,9% vs 37,1%). As formas atrófico-erosivas apresentaram um tempo de evolução significativamente maior (chi quadrado=4,454; p=0,049), lesões mais extensas (chi quadrado=16,211; p=0,000) e afetaram a mais localizações em comparação com as lesões reticulares (chi quadrado=10,048; p= 0,002). A forma atrófico-erosiva de LPO foi encontrada mais frequentemente na língua, gengiva e pavimento da boca. Não foram encontradas diferenças significativas entre as formas reticular e atrófico-erosivas em termos de idade, sexo, hábito tabágico, niveis plasmáticos de cortisol e profundidade de infiltrado inflamatório. Concluímos que a classificaçao de lesões de LPO como reticular vs atrófico-erosivo é uma classificaçao simples e facil de usar, que pode identificar apresentações clínicas com diferentes comportamentos biológicos.

Clinical and pathological characteristics of oral lichen planus in hepatitis C-positive and -negative patients.

The reported prevalence rate of anti-hepatitis C virus (HCV) antibodies in patients with oral lichen planus shows wide geographical variation and ranges from 0 to 65%. Certain characteristic clinical features have been attributed to oral lichen planus associated to HCV infection. The purpose of this investigation has been to assess hypothetical clinical differences, as well as differences in the intensity of the subepithelial inflammatory infiltrate between oral lichen planus-HCV +ve patients and oral lichen planus-HCV -ve patients. A total of sixty-two patients entered the study. Their mean age was 63.5 +/- 14.49 years, and 48.4% of them were men and 51.6% women. Patients were classified according to their serum HCV positivity. Age, sex, clinical presentation (reticular or atrophic-erosive), extension of the lesions, location of the lesions, number of locations affected, intensity of the inflammatory infiltrate and Candida albicans colonization were recorded for each patient. Reticular lichen planus was the most frequent clinical presentation in both HCV +ve (57.1%) and HCV -ve patients (63.6%). C. albicans colonization ranged from 42.8% in HCV +ve and 41.7% in HCV -ve patients. HCV + ve patients showed certain oral locations more frequently affected than HCV -ve ones: lip mucosa, 28.6% versus 7.3%; tongue, 57.1% versus 29.1%; and gingiva, 71.4% versus 23.6%. The number of affected intraoral locations was higher in HCV +ve patients (71.4%) than among HCV -ve ones (20.4%; chi2 = 8.34; P < 0.011). No statistically significant differences could be established in terms of density of subepithelial inflammatory infiltrate between the groups. Our results reinforce the need for liver examination in all patients with oral lichen planus, particularly those showing lesions on the gingiva with multiple intraoral locations affected, as no pathological differences could be identified between HCV + ve and HCV -ve patients.

Prevalencia de diabetes mellitus en pacientes con liquen plano oral (U0). Características clínico patológicas / Prevalence of diabetes mellitus amongst oral lichen planos patients. Clinical and pathological characteristics

Objetivos: La intención del presente estudio fue definir la prevalencia de diabetes mellitus en pacientes con liquen plano oral (LPO), siguiendo los criterios ADA-97, y estudiar las diferencias clínico-patológicas entre dos grupos de pacientes con LPO (asociados o no con diabetes mellitus). Diseño: Se han reunido 62 pacientes diagnosticados clínica y patológicamente de LPO. Se han considerado los criterios para el diagnóstico de diabetes mellitus establecidos por la Asociación Americana de Diabetes (ADA-1997). Lasvariables estudiadas para cada caso fueron edad, sexo, forma clínica, extensión de las lesiones, localización, número de localizaciones, colonización por Candida albicans y densidad del infiltrado inflamatorio subepitelial. Resultados: El 27,4 por ciento de los LPO se encuentran asociados a diabetes mellitus tipo 2 y el 17,7 por ciento se asocian a un metabolismo alterado de la glucosa (MAG). La edad media del grupo de LPO asociado a diabetes fue significativamente mayor que el grupo de no diabéticos. No se han evidenciado diferencias significativas entre las características clínicas y patológicas entre ambos grupos. Conclusión: La alta prevalencia de trastornos del metabolismo hidrocarbonado en pacientes con LPO justifica la utilización de la glucosa basal plasmática (GBP) para la selección de diabetes tipo 2 en pacientes con esta patología (AU)

Poorly differentiated oxyphilic (Hürthle cell) carcinoma arising in lingual thyroid: a case report and review of the literature.

Clinically significant lingual thyroid is an unusual developmental anomaly, and carcinoma arising in lingual thyroid, an extremely rare entity. Here we describe the cytologic, histologic, immunohistochemical, and ultrastructural findings of the first poorly differentiated oxyphilic (Hürthle cell) carcinoma described in lingual thyroid along with a review of the literature. Carcinoma arising in lingual thyroid was reported in 12 males and 21 females age 12 to 86 yr (mean age: 40). Because in nonneoplastic lingual thyroid there exists an intimate and irregular relationship of normal follicles with the surrounding skeletal muscle fibers, unequivocal infiltration, with desmoplastic response, and/or vascular invasion should be demonstrated before making a diagnosis of carcinoma. Immunostain for thyroglobulin is the most useful marker for the differential diagnosis. Although, in some older cases, the precise histologic type is difficult to determine, follicular carcinoma seems to be prevalent. This contrasts with the predominance of the papillary type in thyroglossal duct associated carcinoma. This fact is probably related to the history of hypothyroidism and compensatory hyperplasia secondary to the absence of the orthotopic gland, like that occurring in areas of endemic goiter.