Oral lichen planus versus oral lichenoid reaction: Difficulties in the diagnosis

Lichen planus (LP) is a mucocutaneous disease with well-established clinical and microscopic features. The oral mucosa and skin may present clinical and microscopic alterations similar to those observed in LP, called lichenoid reactions (LRs), which are triggered by systemic or topical etiological a...

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Detalles Bibliográficos
Autores: Prado, Renata Falchete do, Marocchio, Luciana Sassa, Felipini, Renata Callestini [UNESP]
Tipo de recurso: artículo
Estado:Versión publicada
Fecha de publicación:2009
País:Brasil
Institución:Universidade Estadual Paulista (UNESP)
Repositorio:Repositório Institucional da UNESP
Idioma:inglés
OAI Identifier:oai:repositorio.unesp.br:11449/71073
Acceso en línea:http://dx.doi.org/10.4103/0970-9290.57375
http://hdl.handle.net/11449/71073
Access Level:acceso abierto
Palabra clave:Diagnosis
Lichen planus
Lichenoid reactions
Literature review
Therapy
autoimmune disease
contact dermatitis
differential diagnosis
human
lichen planus
lichenoid eruption
mouth disease
pathology
review
Autoimmune Diseases
Dermatitis, Contact
Diagnosis, Differential
Humans
Lichen Planus, Oral
Lichenoid Eruptions
Mouth Diseases
Descripción
Sumario:Lichen planus (LP) is a mucocutaneous disease with well-established clinical and microscopic features. The oral mucosa and skin may present clinical and microscopic alterations similar to those observed in LP, called lichenoid reactions (LRs), which are triggered by systemic or topical etiological agents. The difficulties faced to establish the differential diagnosis between the two pathologies were investigated in the literature. It was observed that the etiology of LP is still under discussion, with a tendency to self-immunity, while the etiology of LRs is related to the contact with specific agents, such as metallic restorative materials, resins, and drugs, allowing the establishment of a cause-effect relationship. In this case, the disease is caused by the antigen fixation in the epithelial cells, which are destructed by the immune system. Based on these data, protocols are suggested for this differentiation. The important role played by the integration between the clinician and the oral pathologist in the diagnostic process is highlighted. The treatment of LP comprises mainly the utilization of corticosteroids and the LR is treated by removal of the causal factor. Differentiation between the two diseases allows an effective and correct therapeutic approach.