| 1. |
- Dafar, Amal, et al.
(författare)
-
Factors associated with geographic tongue and fissured tongue
- 2016
-
Ingår i: Acta Odontologica Scandinavica. - : Informa UK Limited. - 0001-6357 .- 1502-3850. ; 74:3, s. 210-216
-
Tidskriftsartikel (refereegranskat)abstract
- Objectives: The primary objective of this study was to investigate the association of systemic diseases, use of medications, allergies and tobacco habits with geographic tongue (GT) and fissured tongue (FT) lesions. The secondary objectives were to evaluate the clinical characteristics of tongue lesions and to compare the overall results for referred and non-referred patients. Methodology: Non-referred patients with GT (GTgp; n=130) and FT (FTgp; n=62) were examined by general practitioners (gp) and compared to a control group without oral mucosal lesions (C; n=1029). Referred patients with GT (GTs; n=166) and FT (FTs; n=15) were examined by oral medicine specialists (s) and compared to GTgp and FTgp. Statistical analyses were performed using unpaired t-test or Fisher's exact test. A multiple logistic regression model was developed to control for age and gender as confounders. Results: Compared to the C group, GTgp patients used more anti-hypertensive medications and Swedish snus (p<0.01). The GTgp group consisted of older males (p<0.001) compared to C. Compared to the GTgp group, the GTs group was younger, more likely to have symptomatic lesions (p<0.0001) and comprised of more females. Among the groups examined, FT patients had the highest mean age. Conclusion: This study identified an association between GT and anti-hypertensive medications, as well as the use of Swedish snus. It also found differences in the activities and symptoms of the lesions between referred patients and their counterparts who were seen in general dental practice; these parameters influenced the results when these conditions were taken into account.
|
|
| 2. |
- Dafar, Amal, et al.
(författare)
-
Langerhans Cells, T Cells, and B Cells in Oral Lichen Planus and Oral Leukoplakia
- 2022
-
Ingår i: International Journal of Dentistry. - : Hindawi Limited. - 1687-8728 .- 1687-8736. ; 2022
-
Tidskriftsartikel (refereegranskat)abstract
- Although oral lichen planus (OLP) and oral leukoplakia (LPL) have different pathogenetic profiles, both may involve chronic inflammation. The aim of this observational study was to evaluate the inflammatory cell profiles of OLP and LPL. The inflammatory cell infiltrates in patients with OLP and LPL were analyzed for the presence of Langerhans cells (LCs; CD1a), T cells (CD3), and B cells (CD20), as well as for the proliferation marker Ki-67. Biopsied specimens from patients with OLP (N = 14) and LPL without dysplasia (N = 13) were immunohistochemically stained with antibodies directed against CD1a, CD3, CD20, and Ki-67, followed by quantitative analyses. A significant increase in the number of CD3+ cells and CD20+ cells was found in the submucosa of OLP, as compared to LPL (p<0.01). Likewise, the number of CD3+ cells was significantly higher in the epithelium of OLP than of LPL (p<0.05). No differences were found in the expression of Ki-67 and the number of CD1a+ cells between the two groups. Although an immune response is elicited in both conditions, there are differences at the cellular level between OLP and LPL. A more robust immune activation involving T cells and B cells is seen in OLP. The role of B cells in OLP needs to be further elucidated. Although the number of B cells in LPL is low, their role in the inflammatory response cannot be ruled out.
|
|
| 3. |
- Einarsdottir, Margret, et al.
(författare)
-
Topical clobetasol treatment for oral lichen planus can cause adrenal insufficiency.
- 2024
-
Ingår i: Oral diseases. - 1601-0825. ; 30:3, s. 1304-1312
-
Tidskriftsartikel (refereegranskat)abstract
- Glucocorticoids suppress the hypothalamic-pituitary-adrenal axis, which may lead to glucocorticoid-induced adrenal insufficiency. The study aimed to investigate the prevalence of this state in patients with oral lichen planus treated with topical clobetasol propionate.In this cross-sectional study, 30 patients with oral lichen planus receiving long-term (>6weeks) clobetasol propionate gel 0.025% were invited to participate. Adrenal function was assessed by measuring morning plasma cortisol after a 48-h withdrawal of clobetasol treatment. In patients with plasma cortisol <280nmol/L, a cosyntropin stimulation test was performed.Twenty-seven patients were included. Twenty-one (78%) patients presented with plasma cortisol ≥280nmol/L (range 280-570nmol/L), and six (22%) <280nmol/L (range 13-260nmol/L). Five of these six patients underwent cosyntropin stimulation that revealed severe adrenal insufficiency in two patients (cortisol peak 150nmol/L and 210nmol/L) and mild adrenal insufficiency in three patients (cortisol peak 350-388nmol/L).In this study, approximately 20% of patients receiving intermittent topical glucocorticoid treatment for oral lichen planus had glucocorticoid-induced adrenal insufficiency. It is essential for clinicians to be aware of this risk and to inform patients about the potential need for glucocorticoid stress doses during intercurrent illness.
|
|
| 4. |
- Robledo-Sierra, Jairo, et al.
(författare)
-
Clinical characteristics of patients with concomitant oral lichen planus and thyroid disease.
- 2015
-
Ingår i: Oral surgery, oral medicine, oral pathology and oral radiology. - : Elsevier BV. - 2212-4411 .- 2212-4403. ; 120:5, s. 602-8
-
Tidskriftsartikel (refereegranskat)abstract
- To study the prevalence and profile of thyroid disease in a cohort of referred patients with oral lichen planus (OLP) in comparison with a random population sample and to examine the clinical characteristics of OLP patients with and without thyroid disease.
|
|
| 5. |
- Robledo-Sierra, Jairo, et al.
(författare)
-
How general dentists could manage a patient with oral lichen planus
- 2018
-
Ingår i: Medicina Oral Patologia Oral y Cirugia Bucal. - : Medicina Oral, S.L.. - 1698-4447 .- 1698-6946. ; 23:2
-
Tidskriftsartikel (refereegranskat)abstract
- Background: The literature hardly contains information on how patients suffering from oral lichen planus could be managed by dentists. Material and Methods: Based on the limited available literature and particularly on the long-term clinical and histopathological experience of one of the authors, suggestions on how dentists could manage patients with oral lichen planus have been put forward. Results: In most cases, the dentist should be able to establish a correct diagnosis. Occasionally, the dentist may call upon a specialist, usually an oral medicine specialist or an oral and maxillofacial surgeon for confirmation of the diagnosis, possibly a biopsy procedure, and management of the patient in case of severe symptoms. Proper patient information is of utmost importance in the management. Conclusions: General dentists can be expected to manage the majority of patients with oral lichen planus. Some patients may need to be referred for diagnostic purposes to a specialist; this is also the case for the rare patient with severe symptoms, possibly requiring systemic treatment. © Medicina Oral S. L. C.I.F.
|
|
| 6. |
- Robledo-Sierra, Jairo, et al.
(författare)
-
Oral lichen sclerosus: an overview and report of three cases
- 2018
-
Ingår i: International Journal of Oral and Maxillofacial Surgery. - : Elsevier BV. - 0901-5027. ; 47:12, s. 1550-1556
-
Tidskriftsartikel (refereegranskat)abstract
- Lichen sclerosus is an unusual, chronically relapsing mucocutaneous disease that usually afflicts the anogenital region. Oral lesions of lichen sclerosus are rare, with only 36 histologically verified cases reported to date. The classic histopathologic findings of oral lichen sclerosus include: an area of subepithelial hyalinization, loss of elastic fibres, and band-like mononuclear inflammatory infiltrate. Despite its rarity, oral lichen sclerosus should be included in the differential diagnosis of porcelain- or ivory-white macules. Here we present three new cases of oral lichen sclerosus. A review of these cases and the previously reported cases revealed that oral lichen sclerosus is slightly more common in women and can affect individuals of any age. Oral lesions of lichen sclerosus usually do not require treatment, except when there are significant symptoms or aesthetic complaint. Almost 50% of the patients with oral lichen sclerosus present with extraoral manifestations. Thus, referral to a dermatologist and a gynaecologist is advised. Although no cases of malignant transformation of oral lichen sclerosus have been reported, regular, long-term follow-up of patients with oral lichen sclerosus is indicated.
|
|
| 7. |
- Robledo-Sierra, Jairo, et al.
(författare)
-
The morbidity of oral mucosal lesions in an adult Swedish population
- 2013
-
Ingår i: Medicina Oral Patologia Oral Y Cirugia Bucal. - : Medicina Oral, S.L.. - 1698-6946. ; 18:5
-
Tidskriftsartikel (refereegranskat)abstract
- Objectives: To study the severity of symptoms and estimate the prevalence of oral mucosal lesions in a non-referral adult Swedish population, as registered by general dental practitioners. This study also aims to evaluate the possibility of dental practitioners collecting large quantities of reliable and accurate clinical data on oral mucosal lesions. Study Design: Data from 6,448 adult Swedish patients were collected by general dental practitioners using a standardized registration method. A correlation analysis between a group with oral mucosal lesions and a control group, with no oral mucosal lesions, was performed for various parameters such as symptoms from the oral mucosa, systemic diseases, medication, allergy history, tobacco habits and the patient's own assessment of their general health. In addition, clinical photos were taken of all oral mucosal lesions in order to determine the degree of agreement between the diagnoses made by general dental practitioners and those made by oral medicine specialists. Results: A total of 950 patients (14.7%) presented with some type of oral mucosal lesion and of these, 141 patients (14.8%) reported subjective symptoms. On a visual analogue scale, 43 patients (4.5%) scored their symptoms <30, 65 patients (6.8%) scored their symptoms >= 30, and 28 patients (2.6%) scored their symptoms >= 60. The most debilitating condition was aphthous stomatitis and the most common oral mucosal lesion was snuff dipper's lesion (4.8%), followed by lichenoid lesions (2.4%) and geographic tongue (2.2%). There was agreement between the oral medicine specialists and the general practitioners over the diagnosis of oral mucosal lesions on the basis of a clinical photograph in 85% of the cases (n=803). Conclusions: Nearly 15% of the patients with oral mucosal lesions reported symptoms. General practitioners could contribute significantly to the collection of large quantities of reliable and accurate clinical data, although there is a risk that the prevalence of oral mucosal lesions may be underestimated.
|
|
| 8. |
- Robledo-Sierra, Jairo, et al.
(författare)
-
Use of systemic medication in patients with oral lichen planus - a possible association with hypothyroidism
- 2013
-
Ingår i: Oral Diseases. - : Wiley. - 1354-523X. ; 19:3, s. 313-319
-
Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Several drugs have been regarded as a possible aetiological factor for oral lichen OBJECTIVE: To investigate the medication profile of patients with OLP and its possible association with METHODS: Data from 956 patients with OLP and 1029 controls were collected using a standardized RESULTS: Patients with OLP used thyroid preparations (P < 0.001) and non-steroidal anti-inflammatory CONCLUSION: In this study, the use of levothyroxine was associated with OLP, which in turn suggests a
|
|
| 9. |
- Westin, Maria, et al.
(författare)
-
Mutations in the genes for keratin-4 and keratin-13 in Swedish patients with white sponge nevus
- 2018
-
Ingår i: Journal of Oral Pathology & Medicine. - : Wiley. - 0904-2512 .- 1600-0714. ; 47:2, s. 152-157
-
Tidskriftsartikel (refereegranskat)abstract
- BackgroundWhite sponge nevus is a rare autosomal dominant disorder that affects the non-keratinised stratified squamous epithelium. Mutations in the genes that encode mucosa-specific keratin-4 and keratin-13 are strongly linked to the manifestation of white sponge nevus. This study involved mutational analysis of the genes encoding keratin-4 and keratin-13 in two Swedish families with white sponge nevus. MethodsThe diagnosis of white sponge nevus was based on disease history, clinical characteristics of the lesions and, in the majority of the cases, histopathological examination. Samples were collected from the affected buccal mucosa using buccal swabs. DNA was subsequently extracted and amplified using touchdown-PCR. The keratin-4 and keratin-13 genes were sequenced, and a genetic analysis was performed. ResultsA novel heterozygous missense mutation was identified in exon 1A of the keratin-4 gene in Family 2. In addition, previously reported heterozygous missense mutations were identified in the keratin-4 (E449K, A72V, Q156R, R208H) and keratin-13 (L115P) genes in both families. ConclusionWe describe a novel heterozygous missense mutation in the keratin-4 gene of a Swedish family with white sponge nevus. Our results support the notion that mutations in keratin-4 and keratin-13 are the underlying cause of white sponge nevus.
|
|
