Oral Lichen Planus Successfully Treated With Upadacitinib.

With the rise of Janus kinase (JAK) and Signal Transducer and Activator of Transcription (STAT) inhibitor use in dermatologic conditions, there has been increasing hope in treating extensive and difficult-to-treat inflammatory cutaneous conditions. Today we report a case of oral lichen planus successfully treated with an oral JAK1 inhibitor, upadacitinib. This case had been unresponsive by several standard methods but responded with 70% improvement within 1 month when treated with upadacitinib.  J Drugs Dermatol. 2024;23(4):7859.     doi:10.36849/JDD.7859e  .

TYK2 inhibition with deucravacitinib ameliorates erosive oral lichen planus.

Erosive oral lichen planus (OLP) is a challenging disease. This T cell driven disorder frequently shows a treatment unresponsive course and strongly limits patients' quality of life. The disease lacks FDA or EMA approved drugs for its treatment and the efficacy of the commonly administered treatments (i.e. topical and systemic steroids, steroid sparing agents) is often only partial. Although the etiopathogenesis of the disease still needs to be fully elucidated, recent advances helped to identify interferon-É£ (IFN-É£) as a pivotal cytokine in OLP pathogenesis, thus making the interference with its signalling a therapeutic target. Janus kinase (JAK) inhibitors therefore gained relevance for their inhibitory effect on IFN-É£ signalling. While some drugs such as abrocitinib, upadacitinib, tofacitinib directly interfere with IFN-É£ signalling through blockade of JAK1 and/or JAK2, deucravacitinib, a selective TYK-2 inhibitor indirectly interferes on IFN-É£ activation through interference with interleukin (IL)-12, a potent promotor for Th1/IFN-É£ responses. This mechanism of action makes deucravacitinib a candidate drug for the treatment of OLP. Here we provide initial evidence that deucravacitinib 6 mg daily has a beneficial effect in three patients with oral OLP.

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.

Downregulation of salivary miR-3928 as a potential biomarker in patients with oral squamous cell carcinoma and oral lichen planus.

OBJECTIVES: Recent studies highlighted the role of miR expressed in saliva as reliable diagnostic and prognostic tools in the long-term monitoring of cancer processes such as oral squamous carcinoma (OSCC). Based on a few previous studies, it seems the miR-3928 can be considered a master regulator in carcinogenesis, and it can be therapeutically exploited. This is the first study that compared oral potentially malignant disorder (OLP) and malignant (OSCC) lesions for miR-3928 expression. MATERIALS AND METHODS: In this cross-sectional study, saliva samples from 30 healthy control individuals, 30 patients with erosive/atrophic oral lichen planus, and 31 patients with OSCC were collected. The evaluation of miR-3928 expression by q-PCR and its correlation with clinicopathological indices were analyzed by Shapiro-Wilk, Kruskal-Wallis, Pearson's χ2 , and Mann-Whitney tests. The p-value less than .05 indicated statistically significant results. RESULTS: Based on nonparametric Kruskal-Wallis test results, there was a statistically significant difference between the ages of three study groups (p < .05). This test demonstrated a statistically significant difference between the average of miR-3928 expression in three study groups (p < .05). The result of the χ2  test showed a statistically significant difference in miR-3928 expression between patients with OLP (p = .01) and also patients with OSCC (p < .0001) in comparison to the control group. CONCLUSIONS: The salivary miR-3928 can play a tumor suppressive role in the pathobiology of OSCC, and it is significantly downregulated in patients. According to the potential tumor suppressive role of miR-3928 in the OSCC process, we can consider this microRNA as a biomarker for future early diagnosis, screening, and potential target therapy.

Development of an immune-related diagnostic predictive model for oral lichen planus.

Oral lichen planus (OLP) was a chronic inflammatory disease of unknown etiology with a 1.4% chance of progressing to malignancy. However, it has been suggested in several studies that immune system disorders played a dominant role in the onset and progression of OLP. Therefore, this experiment aimed to develop a diagnostic prediction model for OLP based on immunopathogenesis to achieve early diagnosis and treatment and prevent cancer. In this study, 2 publicly available OLP datasets from the gene expression omnibus database were filtered. In the experimental group (GSE52130), the level of immune cell infiltration was assessed using MCPcounter and ssGSEA algorithms. Subsequently, differential expression analysis and gene set enrichment analysis were performed between the OLP and control groups. The resulting differentially expressed genes were intersected with immunologically relevant genes provided on the immunology database and analysis portal database (ImmPort) website to obtain differentially expressed immunologically relevant genes (DEIRGs). Furthermore, the gene ontology and kyoto encyclopedia of genes and genomes analyses were carried out. Finally, protein-protein interaction network and least absolute shrinkage and selection operator regression analyses constructed a model for OLP. Receiver operating characteristic curves for the experimental and validation datasets (GSE38616) were plotted separately to validate the model's credibility. In addition, real-time quantitative PCR experiment was performed to verify the expression level of the diagnostic genes. Immune cell infiltration analysis revealed a more significant degree of inflammatory infiltration in the OLP group compared to the control group. In addition, the gene set enrichment analysis results were mainly associated with keratinization, antibacterial and immune responses, etc. A total of 774 differentially expressed genes was obtained according to the screening criteria, of which 65 were differentially expressed immunologically relevant genes. Ultimately, an immune-related diagnostic prediction model for OLP, which was composed of 5 hub genes (BST2, RNASEL, PI3, DEFB4A, CX3CL1), was identified. The verification results showed that the model has good diagnostic ability. There was a significant correlation between the 5 hub diagnostic biomarkers and immune infiltrating cells. The development of this model gave a novel insight into the early diagnosis of OLP.

Inflammatory cytokines mediating the effect of oral lichen planus on oral cavity cancer risk: a univariable and multivariable mendelian randomization study.

BACKGROUND: While observational studies and experimental data suggest a link between oral lichen planus (OLP) and oral cavity cancer (OCC), the causal relationship and the role of inflammatory cytokines remain unclear. METHODS: This study employed a univariable and multivariable Mendelian Randomization (MR) analysis to investigate the causal relationship between OLP and the risk of OCC. Additionally, the potential role of inflammatory cytokines in modulating this association was explored. Instrumental variables were derived from genetic variants associated with OLP (n = 377,277) identified in Finngen R9 datasets, with 41 inflammatory cytokines as potential mediators, and OCC (n = 4,151) as the outcome variable. Analytical methods including Inverse Variance Weighted (IVW), Weighted Median, MR-Egger, and MR-PRESSO were utilized to assess the causal links among OLP, inflammatory cytokines, and OCC risk. Multivariable MR (MVMR) was then applied to quantify the mediating effects of these cytokines in the relationship between OLP and increased OCC risk. RESULTS: MR analysis provided strong evidence of a causal relationship between OLP (OR = 1.417, 95% CI = 1.167-1.721, p < 0.001) and the risk of OCC. Furthermore, two inflammatory cytokines significantly influenced by OLP, IL-13 (OR = 1.088, 95% CI: 1.007-1.175, P = 0.032) and IL-9 (OR = 1.085, 95% CI: 1.005-1.171, P = 0.037), were identified. Subsequent analysis revealed a significant causal association only between IL-13 (OR = 1.408, 95% CI: 1.147-1.727, P = 0.001) and higher OCC risk, establishing it as a potential mediator. Further, MVMR analysis indicated that IL-13 (OR = 1.437, 95% CI = 1.139-1.815, P = 0.002) mediated the relationship between OLP and OCC, accounting for 8.13% of the mediation. CONCLUSION: This study not only elucidates the potential causal relationship between OLP and the risk of OCC but also highlights the pivotal mediating role of IL-13 in this association.

Oral lichen planus in children: A systematic review / Liquen plano oral en niños: una revisión sistemática

Background: Oral Lichen Planus is a common chronic inflammatory disease of the oral mucosa. The prevalencein adults ranges between 0.5% and 2%, while in children is reported to be about 0,03%. Clinical features of OralLichen Planus could be variable in both adults and children, ranging from painless white hyperkeratotic lesions topainful erythematous atrophic ones.Actually, there are no systematic reviews in the literature on OLP in children, whereby this paper aims to sum-marize all the pathophysiological aspects and identify all cases described in the literature of Oral Lichen Planusin children, reporting their clinical characteristics.Material and Methods: A systematic review of the literature was performed in online databases including PubMed,Scopus, Web of Science, Science Direct, EMBASE. In addition, in order to identify reports not otherwise identifi-able, an analysis of the gray literature was performed on google scholar and in Open Gray.Results: By literature analysis, it emerged that most cases were reported from India. The mean age at time of diag-nosis of the disease was 11 years, ranging from 3 to 17 years. The most frequent pattern was the reticular patternfollowed by plaque-like, erosive, atrophic, sclerosus, and bullous. The buccal mucosa was the most involved oralsite, followed by the tongue, lips and gingiva.Conclusions: Although Oral Lichen Planus in children is rare, it may cause oral discomfort and need to be dif-ferentiated from other oral white lesions and/or chronic ulcers.(AU)

What can we learn from treatments of oral lichen planus?

Oral lichen planus (OLP), a T-lymphocyte-mediated disease of the oral mucosa, has a complex pathogenesis that involves a number of factors. The disease is characterized by recurrent episodes and requires continuous follow up, and there is no curative treatment available. Erosive lichen planus, among others, has a risk of malignant transformation and requires standardized treatment to control its progression. Different clinical subtypes of oral lichen planus require appropriate treatment. Pharmacological treatments are the most widely available and have the greatest variety of options and a number of novel pharmacological treatments are presented as highlights, including JAK enzyme inhibitors. The second is photodynamic therapy, which is the leading physiological treatment. In addition, periodontal treatment and psychological treatment should not be neglected. In this review, we briefly discuss the most recent developments in therapies for oral lichen planus after summarizing the most widely used clinical treatments, aiming to provide different proposals for future clinical treatment.

Immunophenotypic and Gene Expression Analyses of the Inflammatory Microenvironment in High-Grade Oral Epithelial Dysplasia and Oral Lichen Planus.

BACKGROUND: Oral lichen planus (OLP) and oral epithelial dysplasia (OED) present diagnostic challenges due to clinical and histologic overlap. This study explores the immune microenvironment in OED, hypothesizing that immune signatures could aid in diagnostic differentiation and predict malignant transformation. METHODS: Tissue samples from OED and OLP cases were analyzed using immunofluorescence/immunohistochemistry (IF/IHC) for CD4, CD8, CD163/STAT1, and PD-1/PDL-1 expression. RNA-sequencing was performed on the samples, and data was subjected to CIBERSORTx analysis for immune cell composition. Gene Ontology analysis on the immune differentially expressed genes was also conducted. RESULTS: In OED, CD8 + T-cells infiltrated dysplastic epithelium, correlating with dysplasia severity. CD4 + lymphocytes increased in the basal layer. STAT1/CD163 + macrophages correlated with CD4 + intraepithelial distribution. PD-1/PDL-1 expression varied. IF/IHC analysis revealed differential immune cell composition between OED and OLP. RNA-sequencing identified upregulated genes associated with cytotoxic response and immunosurveillance in OED. Downregulated genes were linked to signaling, immune cell recruitment, and tumor suppression. CONCLUSIONS: The immune microenvironment distinguishes OED and OLP, suggesting diagnostic potential. Upregulated genes indicate cytotoxic immune response in OED. Downregulation of TRADD, CX3CL1, and ILI24 implies dysregulation in TNFR1 signaling, immune recruitment, and tumor suppression. This study contributes to the foundation for understanding immune interactions in OED and OLP, offering insights into future objective diagnostic avenues.

Inflammatory cytokines and oral lichen planus: a Mendelian randomization study.

Background: Inflammatory cytokines have long been considered closely related to the development of oral lichen planus (OLP), and we further explored the causal relationship between the two by Mendelian randomization (MR) method. Methods: We performed bidirectional MR analyses by large genome-wide association studies (GWAS). The data included a large-scale OLP dataset, as well as datasets of 41 inflammatory cytokines. All data were obtained from the University of Bristol database, which includes 41 inflammatory cytokines, and the GWAS Catalog database, which includes 91 inflammatory cytokines. OLP data were obtained from the Finngen database, which includes 6411 cases and 405770 healthy controls. We used the inverse variance weighted (IVW) method, MR-Egger method, weighted median method, simple mode method and weighted mode method to analyze the causal relationship between inflammatory cytokines and OLP, and we also combined with sensitivity analysis to further verify the robustness of the results. We performed a meta-analysis of positive or potentially positive results for the same genes to confirm the reliability of the final results. Results: We primarily used the IVW analysis method, corrected using the Benjamin Hochberg (BH) method. When p<0.00038 (0.05/132), the results are significantly causal; when 0.00038

[Detection of molecular affecting sensitivity to local glucocorticoid therapy in oral lichen planus through transcriptome sequencing].

OBJECTIVE: To detect key genes of local glucocorticoid therapy in oral lichen planus (OLP) through transcriptome sequencing. METHODS: The study prospectively enrolled 28 symptomatic patients who visitied Department of Oral Mucosa, Peking University Hospital of Stomatology from November 2019 to March 2023. Topical inunction of 0.1 g/L of dexamethasone was applied for 1 min, 3 times daily for 4 weeks. The patients' signs and pain symptoms were recorded and they were classified as effective group and ineffective group according to the treatment outcome. Their mucosa samples were collected before treatment. After isolating total RNA, transcriptome sequencing was performed. The gene expression data obtained by sequencing were analyzed differently using the DESeq2 package in R software, and the Kyoto encyclopedia of genes and genomes (KEGG) pathway enrichment analysis was performed on the basis of the hypergeometric distribution algorithm to describe the biological function of differentially expressed genes (DEGs), accordingly detecting sensitivity related molecular affecting therapeutic effect of dexamethasone. RESULTS: After 4 weeks treatment by topical dexamethasone, 13 cases of the 28 OLP patients responding well with the sign score reducing from 7.0 (4.5, 9.0) to 5.0 (3.0, 6.3), pain score decreasing from 5.0 (2.0, 5.5) to 2.0 (0.0, 3.5), oral health impact profile lessening from 5.0 (3.5, 9.0) to 1.0 (0.0, 5.0) significantly (P<0.01) were classified as effective group and 15 cases with poor response to the drug were sorted as ineffective group. There were no significant differences of demographic and baseline levels of clinical features, especially disease severity between these two groups. A total of 499 DEGs including 274 upregulated and 225 downregulated genes were identified between effective group and ineffective group. KEGG enrichment analysis showed that upregulated genes in effective group compared with ineffective group including CLDN8, CTNNA3, MYL2 and MYLPF were associated with leukocyte transendothelial migration, while downregulated genes were significantly enriched in tumor necrosis factor (TNF), interleukin-17 (IL-17), nuclear factor kappa B (NF-κB) signaling pathways, and cortisol synthesis and secretory. CONCLUSION: High expressions of CLDN8, CTNNA3, MYL2 and MYLPF genes in patients with oral lichen planus have a good clinical response to topical dexamethasone, while patients with high expression genes of inflammation pathway such as TNF, IL-17, NF-κB and cortisol synthesis and secretion received poor effect.

Evaluation of the association between TNF-α-1031 T/C polymorphism with oral lichen planus disease.

BACKGROUND: Oral lichen planus (OLP) is a T-cell-mediated autoimmune disease that affects the epithelial cells of the oral cavity. This study was performed to investigate any possible relationship between - 1031(T/C) polymorphism (rs1799964) of the tumor necrosis factor α (TNF-α) gene with the risk and severity of oral lichen planus (OLP) disease among an Iranian population. METHOD: Saliva samples were collected from 100 patients with OLP and a similar number of healthy controls (age and sex-matched). Then, DNA was extracted from the collected samples for genotyping TNF-α-1031 T/C polymorphism using the PCR-CTPP method. The results were assessed using SPSS software. RESULTS: The findings revealed a significantly higher prevalence of the C allele in OLP patients (53%) compared to healthy controls (36%), suggesting an association between TNF-alpha gene polymorphism and OLP. A multivariate logistic regression analysis supported this finding, as the presence of the C allele was significantly associated with an increased risk of OLP [χ2 = 4.17, p = 0.04, 95% CI = 1.01-2.65, OR = 1.64]. However, our data indicated no significant association between TNF-alpha-1031 T/C gene polymorphism and OLP severity. CONCLUSIONS: These findings provide the first evidence supporting a possible role of TNF-α-1031 T/C gene polymorphism in OLP susceptibility in the Iranian population. The findings of this study demonstrate a positive association between TNF-α-1031 C/T allele distribution and the risk of OLP disease in the Iranian population. Therefore, carrying the C allele may increase the susceptibility to OLP disease.

Oral lichen planus and lichenoid lesions - challenges and pitfalls for the general dental practitioner.

Lichen planus is a chronic, mucocutaneous inflammatory condition which, due to its prevalence, will be familiar to the dental profession. However, diverse forms of presentation, important differential diagnosis, potential malignant change and monitoring requirements often result in challenges for those in primary care. This paper looks to examine these challenges and provide information to support those who are involved in recognition and management of patients with lichen planus.

[Study of the kinetics of accumulation and distribution of the photosensitizer photoditazin in the oral mucosa in patients with lichen planus]. / Izuchenie kinetiki nakopleniya i raspredeleniya fotosensibilizatora fotoditazin v slizistoi obolochke rta u patsientov s krasnym ploskim lishaem.

THE AIM OF THE STUDY: Was to explore the accumulation and distribution of the photosensitizer Photoditazine in the oral mucosa when applied to pathological lesions in patients with severe forms of lichen planus. MATERIAL AND METHODS: A clinical and laboratory examination was carried out in 50 patients with severe forms of lichen planus (bullous and erosive-ulcerative) aged 18 to 70 years, including 6 men and 44 women. For autofluorescent imaging a LED device with a wavelength in the violet region of the spectrum (400±10 nm) was used. Quantitative registration of the kinetics of accumulation and distribution of the photosensitizer was carried out using the method of local fluorescence spectroscopy by measuring the fluorescence spectra. RESULTS: The measurements were made before applying the photosensitizer, 10, 20 and 30 minutes after application. The study showed that in most patients with erosive-ulcerative and bullous forms of lichen planus, the accumulation of the photosensitizer in the lesions on the oral mucosa increased as the exposure time increased from 20 to 30 minutes. The fastest accumulation of the photosensitizer occurred in the areas of mucosal lesions with the most pronounced vascularization, namely, in the area of the tongue and the bottom of the oral cavity. CONCLUSION: Using the method of local fluorescence spectroscopy, the kinetics of accumulation and destruction of photosensitizer in pathological areas of the oral mucosa was determined, and therefore the optimal time of laser exposure to the lesion was determined.

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).

Photodynamic therapy for refractory erosive oral lichen planus: a case series study.

Oral lichen planus is a chronic inflammatory disease that occurs on the oral mucosa and is an oral potentially malignant disease. Treatment of oral lichen planus aims to promote healing of the erosion, relieve pain, reduce recurrence of the erosion, and prevent canceration. Corticosteroids are the first line of treatment for oral lichen planus. Refractory oral lichen planus is a clinical classification of oral lichen planus that has not responded to corticosteroid treatment for more than 2 months. Topical 5-aminolevulinic acid-mediated photodynamic therapy is an innovative and effective treatment for potentially malignant oral diseases and has been reported as an alternative treatment to conventional therapies for oral lichen planus. On this basis, we report 3 cases of refractory erosive oral lichen planus in which persistent erosive lesions healed after topical application of 5-aminolevulinic acid-mediated photodynamic therapy without any adverse effects or any signs of recurrence. Topical 5-aminolevulinic acid-mediated photodynamic therapy will become an effective clinical treatment for refractory erosive oral lichen planus.

Hydroxychloroquine for the management of recalcitrant oral lichen planus.

OBJECTIVE: The objective of this study is to describe the efficacy of hydroxychloroquine (HCQ) in patients with oral lichen planus (OLP) refractory to conventional therapy. STUDY DESIGN: In this single-center retrospective study, patients were prescribed HCQ 200 mg twice daily. Pain, reticulation, erythema, and ulceration scores were recorded. Two-sample and paired t tests were used to evaluate mean and paired pain scores and paired t test to determine substantial differences in paired REU scores, at HCQ initiation visit and final follow-up at 12 to 24 months. RESULTS: Thirty-six patients (69.4% female) with a median age of 70 ± 12.0 (range 48-99) were initiated on HCQ. Only 30 patients were evaluable because pruritus developed in 5 patients (13.9%) and gastrointestinal symptoms in 1 (2.8%). The mean follow-up was 23.2 months (range 1-74). In 19 patients, there was a significant decline in the worst pain score from a mean of 3.9 (SD± 2.8, n = 19) to 1.9 (SD ± 2.4, n = 19) (t = 2.837, P < .006). Paired reticulation, erythema, and ulceration (REU scores) decreased from a weighted mean score of 16.0 (SD ± 8.0, n = 12) to 12.0 (SD ± 6.3, n = 12) (t = 2.07, P < .032). CONCLUSION: Hydroxychloroquine was a suitable option and effective in reducing symptoms and disease severity in patients with recalcitrant OLP who do not adequately respond to standard therapy.

Oral lichen planus in children: A systematic review.

BACKGROUND:  Oral Lichen Planus is a common chronic inflammatory disease of the oral mucosa. The prevalence in adults ranges between 0.5% and 2%, while in children is reported to be about 0,03%. Clinical features of Oral Lichen Planus could be variable in both adults and children, ranging from painless white hyperkeratotic lesions to painful erythematous atrophic ones. Actually, there are no systematic reviews in the literature on OLP in children, whereby this paper aims to summarize all the pathophysiological aspects and identify all cases described in the literature of Oral Lichen Planus in children, reporting their clinical characteristics. MATERIAL AND METHODS:  A systematic review of the literature was performed in online databases including PubMed, Scopus, Web of Science, Science Direct, EMBASE. In addition, in order to identify reports not otherwise identifiable, an analysis of the gray literature was performed on google scholar and in Open Gray. RESULTS:  By literature analysis, it emerged that most cases were reported from India. The mean age at time of diagnosis of the disease was 11 years, ranging from 3 to 17 years. The most frequent pattern was the reticular pattern followed by plaque-like, erosive, atrophic, sclerosus, and bullous. The buccal mucosa was the most involved oral site, followed by the tongue, lips and gingiva. CONCLUSIONS: Although Oral Lichen Planus in children is rare, it may cause oral discomfort and need to be differentiated from other oral white lesions and/or chronic ulcers.

Oral bacteriome and oral potentially malignant disorders: A systematic review of the associations.

INTRODUCTION: Periodontal bacteria can infiltrate the epithelium, activate signaling pathways, induce inflammation, and block natural killer and cytotoxic cells, all of which contribute to the vicious circle of carcinogenesis. It is unknown whether oral dysbiosis has an impact on the etiology or prognosis of OPMD. AIMS: Within this paradigm, this work systemically investigated and reported on the composition of oral microbiota in patients with oral potentially malignant disorders (OPMD) versus healthy controls. METHODS: Observational studies that reported next generation sequencing analysis of oral tissue or salivary samples and found at least three bacterial species were included. Identification, screening, citation analysis, and graphical synthesis were carried out. RESULTS: For oral lichen planus (OLP), the bacteria with the highest abundance were Fusobacterium, Capnocytophaga, Gemella, Granulicatella, Porphyromonas, and Rothia; for oral leukoplakia (OLK), Prevotella. Streptococci levels in OLK and OLP were lower. The usage of alcohol or smoke had no effect on the outcomes. CONCLUSIONS: An increase in periodontal pathogenic bacteria could promote the development and exacerbation of lichen. Effective bacteriome-based biomarkers are worthy of further investigation and application, as are bacteriome-based treatments.