Thesis--University of Helsinki, 1989. / At head of title: Department of Oral Surgery, Institute of Electron Microscopy, University of Helsinki, and Fourth Department of Medicine, Helsinki University Central Hospital, Helsinki, Finland. Includes bibliographical references (p. 58-71).

OBJECTIVE: Lichen planus is a disease that can affect both skin and mucosa, in some cases both at the same time. Among patients with lichen planus, the oral version of lichen planus (OLP) can be observed in 50 – 70 %. OLP is the most common chronic inflammatory disease of oral mucosa. Today it is known that OLP is an inflammatory condition but it is not known exactly what substances are prominent and active during this specific inflammatory process. The aim of this study was to examine inflammatory factors involved in OLP. METHODS: A total of 24 individuals were included in this prospective study. 15 of these were patients diagnosed with mucosal LP, whereas the other nine were healthy controls. Blood samples were taken from all participants and sent to Life Science Lab in Uppsala where they used Olinks inflammation panel to analyse inflammatory markers in the blood samples. RESULTS: There were differences in inflammatory factors in blood between the controls and patients with mucosal lichen planus. The inflammatory factors that contributed the most to this difference were IL-5, SCF, FGF-19 and FGF-21. CONCLUSIONS: Due to the differences between LP-patients and controls we can conclude that there are tendencies to an inflammatory process going on systemically involving different levels of mainly IL-5, SCF, FGF-19 and FGF-21. The inflammatory factors that contributed the most to the differences between the two groups are not the typical ones that have been the resulting elevated inflammatory factors in other previous studies.

Magister Chirurgiae Dentium (MChD) / Oral lichen planus (OLP) is a T-cell mediated chronic inflammatory disease with different clinical types that remains inscrutable in respect of its pathogenetic mechanisms and effective therapy. Increased apoptosis may influence the histopathological criteria of oral lichen planus (decrease in thickness of the epithelium and band of inflammatory infiltrate). Null hypothesis: The apoptotic rate does not correlate with a decrease in the epithelial thickness as well as the thickness of the band of inflammatory infiltrate in OLP. Aim: The present study aims to quantify apoptotic activity and to correlate the apoptotic rate with epithelial thickness as well as thickness of the inflammatory infiltrate of OLP cases diagnosed at Tygerberg Hospital from 2006 – 2015. Further, the epithelial thickness and thickness of the inflammatory infiltrate were also assessed for their association, if any. Materials and Methods: The study sample comprised 17 diagnostically verified cases of OLP. Sections stained with Haematoxylin and Eosin (H&E) were used to identify and count the number of apoptotic cells as well as measure the thickness of epithelium and the thickness of the lymphocytic inflammatory infiltrate by using software morphometric analysis (Zen Blue lite 2012). Statistical analysis was applied to analyse the correlation between apoptotic cells and histopathological features of OLP. Results: The present study's results showed no statistically significant association between the apoptotic rate, the epithelial thickness and the thickness of the lymphocytic inflammatory infiltrate.

ABSTRACT   The aim of this study is to chart a cohort of patients in the county of Västerbotten in Sweden who have been diagnosed with lichen planus. In addition to charting, the cohort has also been compared to similar previously studied groups.   The studied group consist of patients who have been referred to the Department of Medical Biosciences and Pathology between years 2009-2015 with suspicious diagnosis of LP.   After exclusion, 214 patients remained of which 130 were diagnosed with Oral LP and 84 with Genital LP. Different data such as age, medications and diseases was extracted from the dental journals.   In this cohort women were more likely to be affected by LP. The mean age for females was 63 years and 53 years for men. In the studied group 17 % were being treated for hypertension, 14 % were treated with 5 or more different medications. Tobacco use was found in 17 % and 12 % were diagnosed with an autoimmune disease.   The results from the studied cohort were in accordance with similar populations in previous studies. There is an undergoing discussion whether OLP and LP are the same disease that affects different sites.

No description available.

Background: Lichen planus is a chronic inflammation of skin and mucosa with unknown cause. Oral Lichen Planus, OLP, affects around 2% of the population. Autoimmunity has been suggested as a possible cause as the disease has autoimmune features such as female predominance, cyclic nature and cytotoxic T-cell infiltrate. It has been suggested that the intense inflammatory response seen in OLP is caused by factors on the keratinocyte surface triggering the immune system. Chronic inflammation is one of the hallmarks of oral lichen planus and chronic inflammation is connected to increased risk of tumor development. WHO classifies OLP as a potentially malignant condition with increased risk of developing Squamous cell carcinoma of head and neck, SCCHN, but malignant transformation of OLP is a matter of controversy. The aim of these studies was to further elucidate the autoimmune and premalignant character of OLP. Factors involved in malignant transformation, autoimmunity and inflammation were analyzed in normal oral mucosa, OLP and SCCHN. Factors studied were the signal transducers of Transforming growth factor-β the Smad proteins, microRNAs, COX-2, the receptor CXCR-3 and its ligands CXCL-10 and -11 and ELF-3. Material and methods: In the study on Smad protein expression formalin fixed and paraffin embedded biopsies from normal oral mucosa, OLP and SCCHN was used. For the remaining studies fresh frozen biopsies from OLP and normal controls was used. All of the fresh frozen OLP samples and their controls were micro dissected to be able to analyze the epithelial part only as well as sections of the whole biopsy. Methods used are immunohistochemistry, qRT-PCR and Western blot. Results: Analyses of smad proteins expression showed a clear increase of smad3 and smad7 in OLP compared to normal oral mucosa. The expressions of smad proteins in the tumors were more heterogeneous. Some of the SCCHN samples showed a similar expression as OLP while others did not. Micro RNA analyzes showed that miR-21 and miR-203 was significantly increased in OLP epithelium compared to normal oral epithelium while the expression of miR-125b and their potential targets p53 and p63 was decreased in OLP. The presence of COX-2 was significantly higher in OLP than normal controls. At the same time the expression of miR-26b, a suggested repressor of COX-2 was decreased in OLP compared to normal mucosa. The receptor CXCR-3 and its ligands CXCL-10 and -11 were increased in OLP. Expressions of the differentiation involved factor ELF-3 mRNA as well as protein were decreased in OLP. Conclusion: The factors studied are involved in differentiation, malignant transformation and inflammation. Some of the results in these studies indicate a similar expression pattern for OLP and SCCHN. Several of the factors studied are involved in differentiation and their deregulation suggests a disturbed differentiation pattern and this could indicate a premalignant character of OLP but malignant transformation of OLP lesions are relative rare. A lot of these factors are also involved in inflammatory processes and connected to autoimmune diseases and their deregulation in OLP could also support an autoimmune cause of the disease. Based on our studies a suggestion is that the disturbed differentiation pattern triggers the intense immune response directed against the epithelial cells seen in OLP.

Thesis (doctoral)--Umeå University, Sweden, 1995. / Added t.p. with thesis statement inserted. Includes bibliographical references.

Thesis (doctoral)--Umeå University, Sweden, 1995. / Added t.p. with thesis statement inserted. Includes bibliographical references.

Magister Scientiae Dentium - MSc(Dent) / Lichen planus is a systemic disease that follows a chronic course. The exact aetiology remains unknown but an immune mediated pathogenesis has been implicated. Oral lichen planus is a common form of this disease and can occur in isolation or it may include the skin, genitalia and lesions involving the scalp and hair follicles. Epidemiological studies on oral lichen planus are few. Those that have been conducted have been in developed nations such as North America and Europe as well as Asia and the Middle East. Few African studies report on the demographics of the affected patients. Factors such as patient demographics and trends of diseases are essential to investigate. Findings of such studies may be useful in determining additional patient based criteria that can assist in obtaining a definitive diagnosis and subsequently aid in the management protocols of the specific disease in question. This process is as essential for oral lichen planus as for other diseases. Oral lichen planus can have clinical similarities with other diseases of the oral mucosa. Similarities can also be seen histologically that may further complicate the process of defining the diagnosis. Oral lichen planus may not be commonly associated with frank morbidity, but severe discomfort can be experienced in some clinical variants. This disease has been described as “difficult to manage” Camacho-Alonso et al, 2007). Furthermore, there is an ongoing debate about its malignant potential (Sugerman & Savage; 2002; Scully and Carrozzo; 2008). These factors support the relevance of further investigation of oral lichen planus. This study will report the demographics of patients who have been diagnosed with oral lichen planus in a subset of the South African population, within the Western Cape. The description of the ethnic groups in South Africa was as described by Statistics South Africa, namely; “African” was used to describe Black individuals, “Coloured” was used to describe individuals of mixed ethnic origin, “Indian” was used to describe patients whose ethnic origin was of the Indian/Asian continent, the latter however excluded persons of Chinese decent and “White” described those persons of European origin. The ethnic distribution reported from within the literature will report on the terminology used by the respective authors and hence not follow the guidelines outlined above.

O líquen plano oral (LPO) é uma doença inflamatória crônica de causa desconhecida, e seu potencial de malignização é um tema bastante controverso. Diversos estudos têm sugerido que pacientes portadores de líquen plano apresentam um maior risco de desenvolver câncer. Contudo, muitos autores acreditam que não haja dados suficientes que provem uma associação entre líquen plano e câncer. Para esses autores, a maioria dos casos que sofreram transformação maligna é decorrente de falhas no diagnóstico inicial da lesão. Portanto, objetivou-se avaliar a expressão imuno-histoquímica das proteínas relacionadas à apoptose e proliferação celular, respectivamente caspase-3 ativa, Bcl-2 e Ki-67 no LPO e em displasias epiteliais na tentativa de explicar a polêmica em relação ao potencial de transformação maligna do LPO e enfatizar a importância de um acompanhamento de longo prazo dos pacientes com esta doença. Com esse propósito, foram selecionadas 14 amostras de LPO, 14 amostras de leucoplasia com displasia epitelial, além de 09 amostras de mucosa bucal normal como controle. A avaliação da expressão de caspase-3 ativa, Bcl-2 e Ki-67 foi conduzida de acordo com a técnica da imunoperoxidase. A contagem das células imunomarcadas nas amostras de LPO, de leucoplasia com displasia epitelial e de mucosa bucal normal resultou em número destas células por mm2 nas diferentes regiões (camada basal, camada suprabasal e infiltrado inflamatório) para cada imunomarcador. A expressão de Bcl-2 em células epiteliais, da camada basal, ocorreu mais frequentemente no grupo da leucoplasia com displasia epitelial, com diferença estatística entre o grupo do LPO e o grupo controle. Verificou-se também, uma alta expressão da proteína Bcl-2 em células inflamatórias de lesões de LPO e de leucoplasia com displasia epitelial. A expressão do marcador Ki-67 foi superior em todos os níveis teciduais analisados nas lesões de LPO e de leucoplasia com displasia epitelial quando comparados com o grupo controle. Concluiu-se que a expressão mais elevada das proteínas Bcl-2 e Ki-67 nos casos de LPO e de leucoplasia com displasia epitelial, podem revelar a possibilidade da presença de alterações moleculares morfologicamente imperceptíveis. / The oral lichen planus (OLP) is a chronic inflammatory disease of unknown cause, and its malignant potential is a very controversial issue. Several studies have suggested that patients with lichen planus have a higher risk of developing cancer. However, many authors believe that there is insufficient evidence to prove an association between lichen planus and cancer. For these authors, most of the cases that had undergone malignant transformation is due to flaws in the lesion initial diagnosis. Therefore, the aim was to evaluate the immunohistochemical expression of proteins related to apoptosis and cell proliferation, respectively active caspase-3, Bcl-2 and Ki-67 in epithelial dysplasia and LPO in an attempt to explain the controversy regarding the potential malignant transformation of OLP and emphasize the importance of a long-term monitoring of patients with this disease. For this purpose, we selected 14 samples of OLP, 14 samples of leukoplakia with epithelial dysplasia, and 09 samples of normal oral mucosa as controls. The evaluation of the expression of active caspase-3, Bcl-2 and Ki-67 was conducted in accordance with the immunoperoxidase technique. The immunostained cells counting in samples of OLP, epithelial dysplasia in leukoplakia and normal oral mucosa resulted in a number of these cells per mm2 in the different regions (basal layer, suprabasal layer and inflammatory infiltrate) for each immunostained. The expression of Bcl-2 in epithelial cells, the basal layer, occurred more frequently in the group of leukoplakia with epithelial dysplasia, with statistical difference between the group of OLP and the control group. There was a high expression of Bcl-2 protein in inflammatory cells in OLP lesions and leukoplakia with epithelial dysplasia. The expression of the marker Ki-67 was superior in all analyzed tissue levels in OLP lesions and leukoplakia with epithelial dysplasia when compared to the control group. It was concluded that the highest expression of Bcl-2 protein and Ki-67 in cases of OLP and leukoplakia with epithelial dysplasia, can reveal the possible presence of molecular changes morphologically imperceptible.