Therapeutic alternative for oral lichen planus treatment in an unusual location: case report

Autores

  • Thaís Torres Barros Dutra Doutoranda, Departamento de Patologia Oral, Faculdade de Farmácia, Odontologia e Enfermagem (FFOE), Universidade Federal do Ceará (UFC), 60430-355 Fortaleza - CE, Brazil
  • Thâmara Manoela Marinho Bezerra Pós-Doutoranda, Departamento de Patologia Oral, Faculdade de Farmácia, Odontologia e Enfermagem (FFOE), Universidade Federal do Ceará (UFC), 60430-355 Fortaleza - CE, Brazil
  • Filipe Nobre Chaves Professor Adjunto, Mestrado em Ciências da Saúde, Curso de Odontologia, Universidade Federal do Ceará, Campus Sobral, 62010-820 Sobral - CE, Brazil
  • Sthefane Gomes Feitosa Doutoranda, Departamento de Patologia Oral, Faculdade de Farmácia, Odontologia e Enfermagem (FFOE), Universidade Federal do Ceará (UFC), 60430-355 Fortaleza - CE, Brazil
  • Fábio Wildson Gurgel Costa Professor Adjunto, Departamento de Radiologia Odontológica, Faculdade de Farmácia, Odontologia e Enfermagem (FFOE), Universidade Federal do Ceará (UFC), 60430-355 Fortaleza - CE, Brazil
  • Karuza Maria Alves Pereira Professora Associada, Departamento de Morfologia, Faculdade de Medicina (FAMED), Universidade Federal do Ceará (UFC), 60430-160 Fortaleza - CE, Brazil

DOI:

https://doi.org/10.21270/archi.v10i5.4970

Palavras-chave:

Lichen Planus, Lichen Planus, Oral, Lip, Pharmaceutical Preparations

Resumo

Oral Lichen Planus (OLP) is considered a potentially malignant lesion (PML), although its rate of transformation is controversial. New treatments have been introduced recently, for example calcipotriene (D3 vitamin analog). Its incremental action with glucocorticoids is observed and isolated lip lesions may respond positively to combined topical therapy. Thus, objective of this case report is to show a therapeutic alternative for isolated and persistent OLP lip lesions. An 18-year-old teenager was referred to evaluate an erythematous lower lip lesion with approximately 10 years of evolution. The inspection revealed multiple erythematous areas surrounded by thin whitish streaks located in the vermilion of the lower lip. No abnormalities in the skin, nails, scalp or other areas of oral mucosa were observed. The incisional biopsy was performed and the microscopic exam showed areas of basal layer degeneration with intense mononuclear inflammatory infiltrate banded and predominantly subepithelial. The therapeutic proposal was topical application of Daivobet®, a combination of topical corticosteroids and vitamin D derivative. The lesion had remission after the fifteen days, medication was suspended and indicated when there was a relapse. During follow-up, no recurrences or complications were observed. That combination therapy may be a new approach in treating OLP.

Downloads

Não há dados estatísticos.

Referências

Roopashree MR, Gondhalekar RV, Shashikanth MC, George J, Thippeswamy SH, Shukla A. Pathogenesis of oral lichen planus–a review. J Oral Pathol Med. 2010;39(10):729-34.

Moger G, Thippanna CK, Kenchappa M, Puttalingaiah VD. Erosive oral lichen planus with cutaneous involvement in a 7-year-old girl: A rare case report. J Indian Soc Pedod Prev Dent. 2013;31:197-200.

Aminzadeh A, Jahanshahi G, Ahmadi M.A retrospective comparative study on clinico-pathologic features of oral lichen planus and oral lichenoid lesions. Dent Res J. 2013;10(2):168-72.

Alrashdan MS, Cirillo N, McCullough M. Oral lichen planus: a literature review and update. Arch Dermatol Res. 2016;308(8):539-51.

Eisen D. The clinical manifestations and treatment of OLP. Dermatol Clin. 2003;21(1):79-89.

Boorghani M, Gholizadeh N, Zenouz AT, Vatankhah M, Mehdipour M. Oral lichen planus: clinical features, etiology, treatment and management: a review of literature. J Dent Res Dent Clin Dent Prospect. 2010;4(1):3-9.

Fraga, HF, Cerqueira NS, Ribeiro LSF, Souza SE, Paraguassú GM, Pinto FilhoJM, et al. The importance of diagnostic of oral lichen planus. J. Health Sci Inst. 2011;29(1):27-30.

Parashar P. Oral lichen planus. Otolaryngol Clin North Am. 2011;44(1):89-107.

Gonzalez-Moles MA, Scully C, Gil-Montoya JA. Oral lichen planus: controversies surrounding malignant transformation. Oral Dis. 2008;14:229-43.

González-Moles MÁ, Ruiz-Ávila I, González-Ruiz L, Ayén Á, Gil-Montoya JA, Ramos-García P. Malignant transformation risk of oral lichen planus: A systematic review and comprehensive meta-analysis. Oral Oncol. 2019;96:121-30.

Hasan, S. Lichen planus of lip – Report of a rare case with review of literature. J Family Med Prim Care. 2019;8(3):1269-75.

Thongprasom K, Luengvisut P, Wongwatanakij A, Boonjatturus C. Clinical evaluation in treatment of oral lichen planus with topical fluocinolone acetonide: a 2-year follow-up. J Oral Pathol Med. 2003;32(6):315-22.

Carbone M, Conrotto D, Carrozzo M, Broccoletti R, Gandolfo S, Scully C. Topical corticosteroids in association with miconazole and chlorhexidine in the long-term management of atrophic-erosive oral lichen planus: a placebo-controlled and comparative study between clobetasol and fluocinonide. Oral Dis. 1999;5(1):44-9.

Al-Hashimi I, Schifter M, Lockhart PB, Wray D, Brennan M, Migliorati CA, et al. Oral lichen planus and oral lichenoid lesions: diagnostic and therapeutic considerations. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2007;103 Suppl:S25.e1-12.

O’Neill ID, Scully C. Biologics in oral medicine: ulcerative disorders. Oral Dis. 2013;19:37–45.

Thongprasom K, Prapinjumrune C, Carrozzo M. Novel therapies for oral lichen planus. J Oral Pathol Med. 2013;42:721-27.

Papp KA, Guenther L, Boyden B, Larsen FG, Harvima RJ, Guilhou JJ et al. Early onset of action and efficacy of a combination of calcipotriene and betamethasone dipropionate in the treatment of psoriasis. J Am Acad Dermatol. 2003;48(1):48-54.

van der Velden HM, Pasch MC, van Erp PE, van Lingen RG, Otero ME, de Boer-van Huizen RT, et al. Treatment of plaque psoriasis with the two-compound product calcipotriol/betamethasone dipropionate versus both monotherapies: an immunohistochemical study. J Dermatolog Treat. 2010;21:13–22.

Singapore Lichen Planus Study Group. A randomized controlled trial to compare calcipotriol with betamethasone valerate for the treatment of cutaneous lichen planus. J Dermatolog Treat. 2004;15(3):141-45.

Eisen D, Carrozzo M, Bagan Sebastian JV, Thongprasom K. Number V oral lichen planus: clinical features and management. Oral Dis. 2005;11(6):338-49.

Farhi D, Dupin N. Pathophysiology, etiologic factors, and clinical management of oral lichen planus, part I: facts and controversies. Clin Dermatol. 2010;28(1):100-8.

Wagner G, Rose C, Sachse MM. Clinical variants of lichen planus. J Dtsch Dermatol Ges. 2013;11(4):309-19.

Nuzzolo P, Celentano A, Bucci P, Adamo D, Ruoppo E, Leuci S, et al. Lichen planus of the lips: An intermediate disease between the skin and mucosa? Retrospective clinical study and review of the literature. Int J Dermatol. 2016;55:473-81.

Xue JL, Fan MW, Wang SZ, Chen XM, Li Y, Wang L. A clinical study of 674 patients with oral lichen planus in China. J Oral Pathol Med. 2005;34(8):467-72.

Carrozzo M, Thorpe R. Oral lichen planus: a review. Minerva Stomatol. 2009;58(10):519-37.

Nico MM, Fernandes JD, Lourenço SV. Lichen Planus Affecting the Lips. J Clin Exp Dermatol Res. 2015;6:306.

Sugerman PB, Savage NW, Walsh LJ, Zhao ZZ, Zhou XJ, Khan A. The pathogenesis of oral lichen planus. Crit Rev Oral Biol Med. 2002;13:350-365.

Carbone M, Conrotto D, Carrozzo M, Broccoletti R, Gandolfo S, Scully C. Topical corticosteroids in association with miconazole and chlorhexidine in the long-term management of atrophic-erosive oral lichen planus: a placebo-controlled and comparative study between clobetasol and fluocinonide. Oral Dis. 1999;5:44-9.

Thongprasom K, Luengvisut P, Wongwatanakij A, Boonjatturus C. Clinical evaluation in treatment of oral lichen planus with topical fluocinolone acetonide: a 2-year follow-up. J Oral Pathol Med. 2003;32:315-22.

Savage NW, McCullough MJ. Topical corticosteroids in dental practice. Aust Dent J. 2005;50:S40-S44.

Thongprasom K, Dhanuthai K. Steriods in the treatment of lichen planus: a review. J Oral Sci. 2008; 50:377-85.

Larcen CG, Kristensen M, Paludan K et al. 1,25(OH)2- D3 is a potent regulator of interleukin-1-induced inter- leukin-8 expression and production. Biochem Biophys Res Commun. 1991;176:1020-26.

Douglas WS, Poulin Y, Decroix J, Ortonne JP, Mrowietz U, Gulliver W et al. A new calcipotriol/betamethasone formulation with rapid onset of action was superior to monotherapy with betamethasone dipropionate or calcipotriol in psoriasis vulgaris. Acta Derm Venereol. 2002;82:131-35.

Kaufmann R, Bibby AJ, Bissonnette R, Cambazard F, Chu AC, Decroix J et al. A new calcipotriol/betamethasone dipropionate formulation (DaivobetTM) is an effective once-daily treatment for psoriasis vulgaris. Dermatology. 2002;205:389-93.

Cunliffe WJ, Berth-Jones J, Claudy A, Fairiss G, Goldin D, Gratton D et al. Comparative study of calcipotriol (MC 903) ointment and betamethasone 17-valerate ointment in patients with psoriasis vulgaris. J Am Acad Dermatol. J Am Acad Dermatol. 1992;26(5 Pt 1):736-43.

Ramsay CA, Berth-Jones J, Brundin G, Cunliffe WJ, Dubertret L, van de Kerkhof PC et al. Long-term treatment of chronic plaque psoriasis with calcipotriol. Dermatology. 1994;189(3):260-264.

Chuang TY, Samson CR. Clinical efficacy and safety of aug- mented betamethasone dipropionate ointment and diflo- rasone diacetate ointment for psoriasis—a multicentre, ran- domised, double-blind study. J Dermatol Treat. 1991;2:63-66.

Fredriksson T, Pettersson U. Severe psoriasis: oral therapy with a new retinoid. Dermatologica. 1978;157:238-44.

Siponen M, Huuskonen L, Laara E, Salo T. Association of oral lichen planus with thyroid disease in a Finnish popula- tion: a retrospective case-control study. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2010;110:319-24

Petersen PE. Oral cancer prevention and control–The approach of the World Health Organization. Oral Oncol. 2009;45(4-5):454-60.

van der Waal I. Potentially malignant disorders of the oral and oropharyngeal mucosa; present concepts of management. Oral Oncol. 2010;46(6):423-25.

Aghbari SMH, Abushouk AI, Attia A, Elmaraezy A, Menshawy A, Ahmed MS, et al. Malignant transformation of oral lichen planus and oral lichenoid lesions: A meta-analysis of 20095 patient data. Oral Oncol. 2017;68:92-102.

van der Meij EH, Mast H, van der Waal I. The possible premalignant character of oral lichen planus and oral lichenoid lesions: a prospective five-year follow- up study of 192 patients. Oral Oncol. 2007;43(8):742-48.

Publicado

2021-05-17

Como Citar

Dutra, T. T. B., Bezerra, T. M. M., Chaves, F. N., Feitosa, S. G., Costa, F. W. G., & Pereira, K. M. A. (2021). Therapeutic alternative for oral lichen planus treatment in an unusual location: case report. ARCHIVES OF HEALTH INVESTIGATION, 10(5), 734–739. https://doi.org/10.21270/archi.v10i5.4970

Edição

Seção

Original Articles