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.

No description available.

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.

Made available in DSpace on 2014-06-11T19:33:24Z (GMT). No. of bitstreams: 0 Previous issue date: 2009-03-25Bitstream added on 2014-06-13T19:23:17Z : No. of bitstreams: 1 sousa_fscg_dr_sjc.pdf: 590497 bytes, checksum: 402da6099907d4db4a4b39c13731e3c6 (MD5) / Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES) / O objetivo deste trabalho foi analisar possíveis alterações dos mecanismos de proliferação celular e apoptose no líquen plano bucal, comparando-as com as observadas na displasia epitelial e no carcinoma epidermóide, visando avaliar o seu potencial de transformação maligna. Foram selecionados 24 casos de cada lesão e a partir deles, novos cortes histológicos foram obtidos, sendo parte submetidos à técnica de AgNOR e parte à técnica imunoistoquímica da estreptoavidina-biotina-peroxidase para análise da expressão das proteínas PCNA, p53, bax e bcl-2. A média de NORs/núcleo no líquen plano bucal, na displasia epitelial e no carcinoma epidermóide bucal foram, respectivamente, 1,74±0,32, 2,42±0,62 e 2,41±0,61. A análise de variância revelou haver diferença estatisticamente significante entre o líquen plano bucal e as demais lesões (p<0,05). Quanto à PCNA, p53, bax e bcl-2, o teste de qui-quadrado não revelou haver diferença significante entre a expressão da p53 e da bcl-2. Contudo, a expressão da PCNA foi significativamente menor no líquen plano bucal do que nas demais lesões. Não houve diferença estaticamente significante entre a expressão da PCNA e da bax na displasia epitelial e no carcinoma epidermóide bucal. Conclui-se que alterações na expressão destas proteínas podem ser observadas tanto no líquen plano bucal quanto na displasia epitelial e no carcinoma epidermóide bucal, sugerindo o potencial de transformação maligna desta lesão e enfatizando a importância do acompanhamento em longo prazo dos pacientes. Neste contexto, a análise das NORs se mostrou ferramenta útil em avaliar os casos de líquen plano bucal que apresentem maior risco de transformação maligna. / The purpose of this study was to analyze possible alterations in the mechanisms of cell proliferation and apoptosis in oral lichen planus, comparing them with those observed in epithelial dysplasia and squamous cell carcinoma, aiming to establish its malignant transformation potential. Twenty-four cases of each lesion were selected and new histological cuts were obtained, being part of the cuts submitted to the AgNOR and part to the immunohistochemical technique of streptoavidine-biotin technique for analysis of the expression of the PCNA, bax and bcl-2 proteins. The NORs/nucleous mean for oral lichen planus, epithelial dysplasia and squamous cell carcinoma was respectively 1.74±0.32, 2.42±0.62 and 2.41±0.61. Analysis of variance showed statistically significant difference between the oral lichen planus and the others lesions (p<0.05). Regarding PCNA, p53, bax and bcl-2, chi-squared test showed no significant differences between the expression of p53 and bcl-2. However, the expression of PCNA was significantly lower in oral lichen planus than in epithelial dysplasia and oral squamous cell carcinoma. No significant differences between the expression of PCNA and bax in epithelial dysplasia and oral squamous cell carcinoma were observed. It was concluded that alterations in the expression of these proteins can be observed in oral lichen planus, suggesting the potential of malignant transformation of this lesion and emphasizing the importance of follow-up of patients. Within this context, the NORs analysis is a useful tool to evaluate the oral lichen planus cases with high risk of malignant transformation.

Resumo: O objetivo deste trabalho foi analisar possíveis alterações dos mecanismos de proliferação celular e apoptose no líquen plano bucal, comparando-as com as observadas na displasia epitelial e no carcinoma epidermóide, visando avaliar o seu potencial de transformação maligna. Foram selecionados 24 casos de cada lesão e a partir deles, novos cortes histológicos foram obtidos, sendo parte submetidos à técnica de AgNOR e parte à técnica imunoistoquímica da estreptoavidina-biotina-peroxidase para análise da expressão das proteínas PCNA, p53, bax e bcl-2. A média de NORs/núcleo no líquen plano bucal, na displasia epitelial e no carcinoma epidermóide bucal foram, respectivamente, 1,74±0,32, 2,42±0,62 e 2,41±0,61. A análise de variância revelou haver diferença estatisticamente significante entre o líquen plano bucal e as demais lesões (p<0,05). Quanto à PCNA, p53, bax e bcl-2, o teste de qui-quadrado não revelou haver diferença significante entre a expressão da p53 e da bcl-2. Contudo, a expressão da PCNA foi significativamente menor no líquen plano bucal do que nas demais lesões. Não houve diferença estaticamente significante entre a expressão da PCNA e da bax na displasia epitelial e no carcinoma epidermóide bucal. Conclui-se que alterações na expressão destas proteínas podem ser observadas tanto no líquen plano bucal quanto na displasia epitelial e no carcinoma epidermóide bucal, sugerindo o potencial de transformação maligna desta lesão e enfatizando a importância do acompanhamento em longo prazo dos pacientes. Neste contexto, a análise das NORs se mostrou ferramenta útil em avaliar os casos de líquen plano bucal que apresentem maior risco de transformação maligna. / Abstract: The purpose of this study was to analyze possible alterations in the mechanisms of cell proliferation and apoptosis in oral lichen planus, comparing them with those observed in epithelial dysplasia and squamous cell carcinoma, aiming to establish its malignant transformation potential. Twenty-four cases of each lesion were selected and new histological cuts were obtained, being part of the cuts submitted to the AgNOR and part to the immunohistochemical technique of streptoavidine-biotin technique for analysis of the expression of the PCNA, bax and bcl-2 proteins. The NORs/nucleous mean for oral lichen planus, epithelial dysplasia and squamous cell carcinoma was respectively 1.74±0.32, 2.42±0.62 and 2.41±0.61. Analysis of variance showed statistically significant difference between the oral lichen planus and the others lesions (p<0.05). Regarding PCNA, p53, bax and bcl-2, chi-squared test showed no significant differences between the expression of p53 and bcl-2. However, the expression of PCNA was significantly lower in oral lichen planus than in epithelial dysplasia and oral squamous cell carcinoma. No significant differences between the expression of PCNA and bax in epithelial dysplasia and oral squamous cell carcinoma were observed. It was concluded that alterations in the expression of these proteins can be observed in oral lichen planus, suggesting the potential of malignant transformation of this lesion and emphasizing the importance of follow-up of patients. Within this context, the NORs analysis is a useful tool to evaluate the oral lichen planus cases with high risk of malignant transformation. / Orientador: Luiz Eduardo Blumer Rosa / Coorientador: Yasmin Rodarte Carvalho / Banca: Adriana Aigotti Haberbeck Brandão / Banca: Fábio Daumas Nunes / Banca: Carlos Eduardo Dias Colombo / Banca: Horácio Faig Leite / Doutor

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.

Realizar estudo imuno-histoquímico com os marcadores p16 e Ki-67 nas lesões de líquen plano bucal em pacientes assintomáticos e sintomáticos, verificando a presença e modo de marcação, analisando se existe correlação entre os resultados que possa indicar os riscos de transformação maligna. MATERIAL E MÉTODOS: nove pacientes assintomáticos e 12 sintomáticos de líquen plano bucal. Cinco amostras de hiperplasia fibrosa inflamatória foram empregadas como grupo controle. Foram utilizados anticorpos p16 (pré-diluído – BioSB/EUA) e Ki-67 (clone MIB-1 – DAKO/EUA) pela técnica Envision Labelled (DAKO). Os resultados foram analisados de acordo com os parâmetros baseados no estudo de Klaes et al. (2001) avaliando a porcentagem de células marcadas, a distribuição pela camada epitelial e a intensidade da marcação. A análise estatística procedeu ao estudo do risco relativo entre pacientes assintomáticos e sintomáticos com relação ao local da expressão celular (nuclear, citoplasmática ou ambas), com as localizações mais prevalentes da lesão (mucosa jugal e língua) e com os tipos clínicos mais comuns (reticular e atrófico). RESULTADOS: a correlação entre pacientes assintomáticos e sintomáticos foi estatisticamente significativa (p<0,05) quando avaliamos a distribuição da p16 pela camada epitelial com relação ao local da expressão celular e com a localização da lesão. Odds ratio da marcação nuclear foi de 4,091. A total (nuclear e citoplasmática) foi de 5,179. Já a marcação somente citoplasmática teve odds ratio de 8,461. A correlação com a localização resultou num odds ratio de 5,130 para a língua e 14,234 para a mucosa jugal. As outras categorias avaliadas, porcentagem e intensidade da p16, as características clínicas avaliadas e os resultados do Ki-67, não foram significativos em nenhum item avaliado. CONCLUSÕES: o risco relativo maior quando da marcação somente citoplasmática nos mostra que este é um importante sítio de expressão da p16, não devendo ser desprezado, como sugerido por alguns estudos. A localização apontada na literatura como de maior prevalência nos casos de transformação maligna é a língua, porém o risco relativo no nosso estudo foi maior na mucosa jugal. Como a distribuição foi o único item estatisticamente significativo, faz-se necessário estudo futuro para incluir ou excluir a presença do vírus do papiloma humano nas lesões de líquen plano bucal, visto que a proteína p16 vem sendo indicada para detectar anormalidades celulares nas amostras de cérvice uterina, sendo atribuída a sua superexpressão com a presença de HPV de alto riso, além de estudo da p16 nos casos de displasias liquenóides. / We realized immunohistochemical procedures with p16 and Ki-67 in lesions of oral lichen planus to verify the presence and kind of its immunoexpression amog the two groups of patients, asymptomatic and symptomatic, correlating the clinical and histopathological diagnosis with the immunohistochemical data in order to verify if oral lichen planus can be considered a lesion with risk of malignant transformation. MATERIAL AND METHOD: nine asymptomatic patients and 12 symptomatic of oral lichen planus. Five cases of inflammattory fibrous hyperplasia were included as control group. For immunohistochemical studies we used p16 (prediluted–BioSB/USA) and Ki-67 (clone MIB-1–DAKO/USA) by Envision Labelled techniques (DAKO). Results were annalyzed according to parameters based on Klaes et al. (2001) evaluating the immunomarked cell rates, the distribution through the epithelial layer and the immunoexpression intensity. The statistics analysis proceeded the study of relative risk between asymptomatic and symptomatic patients regarding to its cellular immunoexpression (nuclear, cytoplasmic or both), the more prevalent topography of the lesion (buccal mucosa and tongue) and clinical characteristics (atrophic and reticular types). RESULTS: the correlation between asymptomatic and symptomatic patients was statistically significant (p<0.05) when comparison was made of the distribution of p16 throug the epithelial layer by analysis its cellular imumunoexpression. The nuclear immunoexpression of p16 showed an odds ratio of 4.091. The nuclear and cytoplasmatic were 5.179. The odds ratio for cytoplasmatic expression was 8.461. The correlation between immunoexpression and topography resulted in an odds ratio of 5.130 for tongue and 14.234 for buccal mucosa. The other categories availed as percentage and intensity of the p16 immunoexpression, clinical characteristics, besides the Ki-67 results gave non significant results. CONCLUSIONS: The citoplasmatic expression results indicates that this immunoexpression must not be discarded, as suggested by some studies. The high relative risk saw in buccal mucosa rather than tongue was an unexpected result, because the localization pointed as with greater involvement in cases of malignat transformation is the tongue. The distribution was the only one that reached a statistically significant result, so further studies must be made in order to include or exclude the human papillomavirus presence in oral lichen planus lesions, since the p16 protein is currently nowadays used as an indicator of cellular abnormalities in cervical lesions, where its overexpression is related to the presence of high risk human papillomavirus, beyond study of p16 in the cases of liquenoid dysplasia.

O presente estudo teve como objetivo verificar a associação entre o líquen plano oral (LPO) e a infecção de hepatite C (HCV) crônica em duas populações distintas do município de São Paulo. Foram avaliados um total de 308 pacientes distribuídos em dois grupos de estudo: grupo HCV composto por 275 pacientes (132 homens e 143 mulheres; idade média = 49,8 anos) com infecção de HCV crônica; e o grupo LPO composto por 33 pacientes (10 homens e 23 mulheres; idade média = 52,9 anos) com LPO. No grupo HCV o diagnóstico da infecção crônica foi estabelecido através de sorologia para anti-HCV (MEIA, kit AxSYM® HCV version 3.0, Abbott Laboratories, North Chicago, Illinois) confirmado pela pesquisa de RNA-HCV através do teste PCR qualitativo (Cobas Amplicor HCV MonitorTM test, version 2.0, Roche Diagnostic Systems, NJ, USA). No grupo LPO o diagnóstico para lesões orais seguiu critérios estabelecidos pela World Health Organization (WHO) em 1978 e posteriormente modificados por van der Meij e van der Waal em 2003. Como critérios de exclusão para o grupo HCV pacientes que fizeram uso de interferon e/ou ribavirina por um período menor que 6 meses foram excluídos do estudo, assim como pacientes que encontravam-se em terapia antiviral para HCV. Neste grupo a presença de co-infecções - HIV, HBV, HTLV - também foi desconsiderada. No grupo LPO pacientes com diagnóstico clínico sugestivo de reação liquenóide por uso a drogas (RLD) e reação liquenóide por contato (RLC) foram excluídos da amostra, assim como pacientes tratados local ou sistemicamente para LPO por um período menor que 6 meses. Casos com achados histopatológicos de displasia liquenóide também foram desconsiderados. Para análise dos resultados duas comparações foram efetuadas: (1) no grupo HCV a prevalência de LPO foi determinada e comparada com a prevalência de LPO em nossa instituição (grupo controle); (2) no grupo LPO a prevalência da infecção de HCV foi determinada e comparada com a prevalência da infecção de HCV na população de São Paulo. A prevalência de LPO em pacientes com HCV crônica (grupo HCV) foi de 2,18% e de 1,54% no grupo controle (P = 0,39). A prevalência de HCV crônica em pacientes com diagnóstico de LPO (grupo LPO) foi de 3,03% e de 1,42% na população em geral (P = 0,39). Nenhuma diferença estatisticamente significante foi verificada quando os grupos foram comparados. Em nossa análise não foi verificada associação entre o LPO e a infecção de HCV crônica, nas duas populações avaliadas no município de São Paulo. / The objective of the present study was to verify the association between oral lichen planus (OLP) and chronic hepatitis C virus infection (HCV) in two distinct populations in the municipality of São Paulo. A total of 308 patients were evaluated distributed in two study groups: group HCV, comprising 275 patients (132 men and 143 women; average age = 49.8 years old) with chronic HCV infection; and group OLP, comprising 33 patients (10 men and 23 women; average age = 52.9 years old) with OLP. In group HCV, the diagnosis of chronic infection was established through serology for anti-HCV (MEIA, kit AxSYM® HCV version 3.0, Abbott Laboratories, North Chicago, Illinois) confirmed by RNA-HCV research through qualitative PCR testing (Cobas Amplicor HCV MonitorTM test, version 2.0, Roche Diagnostic Systems, NJ, USA). In group OLP, the diagnosis of oral lesions followed the criteria established by the World Health Organization (WHO) in 1978 and later modified by van der Meij and van der Waal in 2003. As exclusion criteria for group HCV, patients that made use of interferon and/or ribavirin for a period below 6 months were excluded from the study, as well patients that were under antiviral treatment for HCV. In this group the presence of co-infections - HIV, HBV, HTLV - was also discarded. In group OLP, patients with clinical diagnosis suggestive of drug-induced lichenoid reactions (DLR) and oral lichenoid lesions related to dental materials (LLDM) were excluded from the sample, as well as patients treated locally or systemically for OLP for a period below 6 months. Cases with histopathological findings of lichenoid dysplasia were also discarded. For result analysis, two comparisons were conducted: (1) in group HCV, OLP prevalence was determined and compared to OLP prevalence in our institution (control group); (2) in group OLP, the prevalence of HCV infection was determined and compared to the prevalence of HCV infection in the São Paulo population. OLP prevalence in patients with Chronic HCV (group HCV) was 2.18% and 1.54% in the control group (P = 0.39). Chronic HCV prevalence in patients with a diagnosis of OLP (group OLP) was 3.03% and 1.42% in the general population (P = 0.39). No statistically significant difference was verified when groups were compared. Our study did not verify an association between OLP and chronic HCV infection in the two populations assessed in the municipality of São Paulo.

Submitted by Ricardo Cedraz Duque Moliterno (ricardo.moliterno@uefs.br) on 2015-07-23T00:43:35Z No. of bitstreams: 1 Disserta??o - Joana Dourado.pdf: 821764 bytes, checksum: bfa07d40df951323f82f2e6813b82f22 (MD5) / Made available in DSpace on 2015-07-23T00:43:35Z (GMT). No. of bitstreams: 1 Disserta??o - Joana Dourado.pdf: 821764 bytes, checksum: bfa07d40df951323f82f2e6813b82f22 (MD5) Previous issue date: 2014-03-14 / Coordena??o de Aperfei?oamento de Pessoal de N?vel Superior - CAPES / Introduction: Oral lichen planus is a chronic inflammatory disease, potentially malignant. Objective: To evaluate the association between psychological states (anxiety and depression) and oral lichen planus. Methods: In a first study, a systematic review by consulting the electronic databases was performed (PubMed, Science Direct and LILACS) in the period between October 2013 and January 2014, using a predefined protocol. A critical evaluation of the literature was conducted in three stages by two reviewers independently, strictly observing the established inclusion and exclusion criteria. The quality of the articles was assessed based on the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE). For the second study, in a case-control model were established two groups, the cases group composed of individuals with a clinical diagnosis / histopathological of LPB and the control group, made up of individuals obtained the same reference population of cases, no history oral lichen planus, admitted at random and matched by sex and age in those cases. Both groups were subjected to thorough clinical examination of the oral cavity, interview and psychometric tests (Anxiety Inventory and Beck Depression). Data were statistically analyzed using the Data Analysis and Statiscal Software (StataSE- StataCorp LP) version 10. Results: For the systematic review, seven articles were selected at the end of the analysis and in four of them were observed a significant association between psychological changes and the development of oral lichen planus. The analysis of the quality of the articles through the STROBE showed an average of 11.3 items included, with a standard deviation of 2.2. For the case-control, there was an association between psychological disorders and OLP (p <0.001), and the crude OR of the principal association 5.06 (95% CI: [2.02 to 12.08]), while in subgroup analysis, the multivariate model adjusted for occupation and indicated an adjusted OR of 3.67 (95% CI: [1.05 to 3.46]), also statistically significant. Conclusion: Based on the results obtained in the studies, safeguarding the necessary limitations of the proposed models, there was an association between OLP and the presence of anxiety and depression. / Introdu??o: O l?quen plano bucal ? uma doen?a inflamat?ria cr?nica, potencialmente maligna. Objetivo: Avaliar a associa??o entre os estados psicol?gicos (ansiedade e depress?o) e o l?quen plano bucal. M?todos: Em um primeiro estudo, foi realizada uma revis?o sistem?tica consultando as bases de dados eletr?nicas (PubMed, Science Direct e LILACS) entre o per?odo de outubro de 2013 a janeiro de 2014, utilizando um protocolo previamente definido. A avalia??o cr?tica dos artigos foi realizada em tr?s est?gios por dois revisores, de forma independente, obedecendo rigorosamente aos crit?rios de inclus?o e exclus?o estabelecidos. A qualidade dos artigos foi avaliada com base no Strengthening the Reporting of Observational Studies in Epidemiology (STROBE). Para o segundo estudo, em um modelo de caso-controle foram estabelecidos dois grupos, o grupo casos, composto de indiv?duos com diagn?stico cl?nico/histopatol?gico de LPB e o grupo controle, formado por indiv?duos obtidos da mesma popula??o de refer?ncia dos casos, sem hist?ria de l?quen plano bucal, admitidos de forma aleat?ria e pareados por sexo e idade em rela??o aos casos. Os dois grupos foram submetidos a exame cl?nico minucioso da cavidade bucal, entrevista e testes psicom?tricos (Invent?rios de Ansiedade e Depress?o de Beck). Os dados obtidos foram analisados estatisticamente utilizando o Data Analysis and Statiscal Software (StataSE- StataCorp LP) vers?o 10. Resultados: Para a revis?o sistem?tica, sete artigos foram selecionados ao final da an?lise e em quatro deles foram observadas uma associa??o significativa entre as altera??es psicol?gicas e o desenvolvimento do l?quen plano bucal. A an?lise da qualidade dos artigos atrav?s do STROBE mostrou uma m?dia de 11,3 itens inclu?dos, com desvio-padr?o de 2,2. Para o estudo de caso-controle, houve associa??o entre os dist?rbios psicol?gicos e o LPB (p<0,001), sendo a OR bruta da associa??o principal 5,06 (IC95%: [2,02-12,08]), enquanto na an?lise de subgrupos, o modelo multivariado e ajustado para ocupa??o indicou uma OR ajustada de 3,67 (IC95%: [1,05-3,46]), tamb?m estatisticamente significante. Conclus?o: Com base nos resultados obtidos nos estudos, resguardando as devidas limita??es dos modelos propostos, houve uma associa??o entre o LPB e a presen?a da ansiedade e depress?o.

O presente estudo teve como objetivo verificar a associação entre o líquen plano oral (LPO) e a infecção de hepatite C (HCV) crônica em duas populações distintas do município de São Paulo. Foram avaliados um total de 308 pacientes distribuídos em dois grupos de estudo: grupo HCV composto por 275 pacientes (132 homens e 143 mulheres; idade média = 49,8 anos) com infecção de HCV crônica; e o grupo LPO composto por 33 pacientes (10 homens e 23 mulheres; idade média = 52,9 anos) com LPO. No grupo HCV o diagnóstico da infecção crônica foi estabelecido através de sorologia para anti-HCV (MEIA, kit AxSYM® HCV version 3.0, Abbott Laboratories, North Chicago, Illinois) confirmado pela pesquisa de RNA-HCV através do teste PCR qualitativo (Cobas Amplicor HCV MonitorTM test, version 2.0, Roche Diagnostic Systems, NJ, USA). No grupo LPO o diagnóstico para lesões orais seguiu critérios estabelecidos pela World Health Organization (WHO) em 1978 e posteriormente modificados por van der Meij e van der Waal em 2003. Como critérios de exclusão para o grupo HCV pacientes que fizeram uso de interferon e/ou ribavirina por um período menor que 6 meses foram excluídos do estudo, assim como pacientes que encontravam-se em terapia antiviral para HCV. Neste grupo a presença de co-infecções - HIV, HBV, HTLV - também foi desconsiderada. No grupo LPO pacientes com diagnóstico clínico sugestivo de reação liquenóide por uso a drogas (RLD) e reação liquenóide por contato (RLC) foram excluídos da amostra, assim como pacientes tratados local ou sistemicamente para LPO por um período menor que 6 meses. Casos com achados histopatológicos de displasia liquenóide também foram desconsiderados. Para análise dos resultados duas comparações foram efetuadas: (1) no grupo HCV a prevalência de LPO foi determinada e comparada com a prevalência de LPO em nossa instituição (grupo controle); (2) no grupo LPO a prevalência da infecção de HCV foi determinada e comparada com a prevalência da infecção de HCV na população de São Paulo. A prevalência de LPO em pacientes com HCV crônica (grupo HCV) foi de 2,18% e de 1,54% no grupo controle (P = 0,39). A prevalência de HCV crônica em pacientes com diagnóstico de LPO (grupo LPO) foi de 3,03% e de 1,42% na população em geral (P = 0,39). Nenhuma diferença estatisticamente significante foi verificada quando os grupos foram comparados. Em nossa análise não foi verificada associação entre o LPO e a infecção de HCV crônica, nas duas populações avaliadas no município de São Paulo. / The objective of the present study was to verify the association between oral lichen planus (OLP) and chronic hepatitis C virus infection (HCV) in two distinct populations in the municipality of São Paulo. A total of 308 patients were evaluated distributed in two study groups: group HCV, comprising 275 patients (132 men and 143 women; average age = 49.8 years old) with chronic HCV infection; and group OLP, comprising 33 patients (10 men and 23 women; average age = 52.9 years old) with OLP. In group HCV, the diagnosis of chronic infection was established through serology for anti-HCV (MEIA, kit AxSYM® HCV version 3.0, Abbott Laboratories, North Chicago, Illinois) confirmed by RNA-HCV research through qualitative PCR testing (Cobas Amplicor HCV MonitorTM test, version 2.0, Roche Diagnostic Systems, NJ, USA). In group OLP, the diagnosis of oral lesions followed the criteria established by the World Health Organization (WHO) in 1978 and later modified by van der Meij and van der Waal in 2003. As exclusion criteria for group HCV, patients that made use of interferon and/or ribavirin for a period below 6 months were excluded from the study, as well patients that were under antiviral treatment for HCV. In this group the presence of co-infections - HIV, HBV, HTLV - was also discarded. In group OLP, patients with clinical diagnosis suggestive of drug-induced lichenoid reactions (DLR) and oral lichenoid lesions related to dental materials (LLDM) were excluded from the sample, as well as patients treated locally or systemically for OLP for a period below 6 months. Cases with histopathological findings of lichenoid dysplasia were also discarded. For result analysis, two comparisons were conducted: (1) in group HCV, OLP prevalence was determined and compared to OLP prevalence in our institution (control group); (2) in group OLP, the prevalence of HCV infection was determined and compared to the prevalence of HCV infection in the São Paulo population. OLP prevalence in patients with Chronic HCV (group HCV) was 2.18% and 1.54% in the control group (P = 0.39). Chronic HCV prevalence in patients with a diagnosis of OLP (group OLP) was 3.03% and 1.42% in the general population (P = 0.39). No statistically significant difference was verified when groups were compared. Our study did not verify an association between OLP and chronic HCV infection in the two populations assessed in the municipality of São Paulo.