ORAL LİKEN PLANUS: DİRENÇLİ BİR OLGUNUN TEDAVİSİ

Year 2014, Volume: 48 Issue: 1, 57 - 64, 08.04.2014

Özge Özdal Ceren Özbek Kıvanç Bektaş-kayhan Nesimi Büyükbabani Meral Ünür

Abstract

Oral liken planus (OLP), oldukça yaygın görülen genellikle oral mukozanın çok katlı yassı epitel tabakasını etkileyen kronik inflamatuvar bir hastalıktır. Ortalama olarak popülasyonun %1-2'sini etkilemekle birlikte sıklıkla 3-6 dekat aralığında ve kadınlarda, erkeklere oranla 2 katı daha fazla görülmektedir. OLP'nin patogenezi tam olarak bilinmemekle birlikte, etyolojisinde immün sistemin rol oynadığı düşünülmektedir. 25 yaşındaki erkek hasta alt dudağındaki beyaz lezyonlar nedeniyle kliniğimize başvurdu. Yapılan klinik muayene sonucu dil sırtında, retromolar bölgede, dişetinde ve oral mukozanın bazı bölgelerinde de benzer lezyonlar saptandı. Direkt immunofloresan (DIF) ve histopatolojik incelemeler için biyopsi örnekleri alındı. Biyopsi sonuçlarına göre OLP teşhisi konuldu. Bu yazıdaki amacımız, hastamıza uyguladığımız tedaviyi ve tedavide gözlenen klinik değişiklikleri sunmaktır.

Keywords

Oral liken planus, steroid, lezyon içi enjeksiyon

Oral Lichen Planus: Treatment of a Refractory Case

Abstract

Oral lichen planus (OLP) is a relatively common, chronic inflammatory disease that often affects the stratified squamous epithelia of oral mucosa. The disease is affecting approximately 1-2% of the population. It is seen mostly in the third to sixth decades of life, and is twice as common in women than men. OLP’s pathogenesis of immune system is thought to have played a role in the etiology is not known. A 25-year-old male patient was referred our clinic due to white lesions on his lower lip. Similar lesions were detected on his tongue, retromolar region, gingiva as well as various parts of oral mucosa result of clinical examiation. Biopsies were taken for direct immunofluorescense (DIF) and histopathological examinations. As a result of bipsies OLP were diagnosed. In this paper the treatment of our patient and the clinical changes of patient with the treatment will be presented.

Keywords

Oral lichen planus, steroid, intralesional injection

References

• Sadaksharam J, Nayaki KP, Selvam NP. Treatment of oral lichen planus with methylene blue mediated photodynamic therapy--a clinical study. Photodermatol Photoimmunol Photomed 2012;28(2):97Roopashree 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. Unur M, Doğan Onur O. Ağız hastalıklarının teşhis ve tedavisi. 2. bs., İstanbul: Quintessence Yayıncılık, 2003, s.78-80. Sivolella S, Berengo M, Cernuschi S, Valente M. Diode laser treatment is effective for plaque-like lichen planus of the tongue: a case report. Lasers Med Sci 2012;27(2):521-4. de Magalhaes-Junior EB, Aciole GT, Santos NR, dos Santos JN, Pinheiro AL. Removal of oral lichen planus by CO2 laser. Braz Dent J 2011;22(6):522-6. Mignogna MD, Lo Muzio L, Lo Russo
• L, Fedele S, Ruoppo E, Bucci E. Clinical guidelines in early detection of oral squamous cell carcinoma arising in oral lichen planus: a 5-year experience. Oral Oncol 2001;37(3):262-7. Sobaniec S, Bernaczyk P, Pietruski J, Cholewa M, Skurska A, Dolinska E, Duraj E, Tokajuk G, Paniczko A, Olszewska
• E, Pietruska M. Clinical assessment of the efficacy of photodynamic therapy in the treatment of oral lichen planus. Lasers Med Sci 2013;28(1):311-6. Neville JA, Hancox JG, Williford PM, Yosipovitch G. Treatment of severe cutaneous ulcerative lichen planus with low molecular weight heparin in a patient with hepatitis
• C. Cutis 2007;79(1): 37-40. Lavanya N, Jayanthi P, Rao UK, Ranqanathan K. Oral lichen planus: An update on pathogenesis and treatment. J Oral Maxillofac Pathol 2011;15(2):127-32. Bombeccari GP, Guzzi G, Tettamanti
• M, Giannì AB, Baj A, Pallotti F, Spadari F. Oral lichen planus and malignant transformation: a longitudinal cohort study. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2011;112(3):328-34. Patel S, Yeoman CM, Murphy R. Oral lichen planus in childhood: a report of three cases. Int J Paediatr Dent 2005;15(2):118-22. Alam F, Hamburger J. Oral mucosal lichen planus in children. Int J Paediatr Dent 2001;11(3):209-14. Carbone M, Goss E, Carrozzo M, Castellano S, Conrotto D, Broccoletti R, Gandolfo S. Systemic and topical corticosteroid treatment of oral lichen planus: a comparative study with long-term follow-up. J Oral Pathol Med 2003;32(6):323-9.
• Conrotto D, Carbone M, Carrozzo M, Arduino P, Broccoletti R, Pentenero M, Gandolfo S. Ciclosporin vs. clobetasol in the topical management of atrophic and erosive oral lichen planus: a double-blind, randomized controlled trial. Br J Dermatol 2006;154(1):139-45.
• Thongprasom K, Chaimusig M, Korkij W, Sererat T, Luangjarmekorn L, Rojwattanasirivej S. A randomized-controlled trial to compare topical cyclosporin with triamcinolone acetonide for the treatment of oral lichen planus. J Oral Pathol Med 2007;36(3):142-6.
• Lozada-Nur F, Miranda C. Oral lichen planus: topical and systemic therapy. Semin Cutan Med Surg 1997;16(4):295-300.
• Xia J, Li C, Hong Y, Yang L, Huang Y, Cheng B. Short-term clinical evaluation of intralesional triamcinolone acetonide injection for ulcerative oral lichen planus. J Oral Pathol Med 2006;35(6):327-31.
• Xiong C, Li Q, Lin M, Li X, Meng W, Wu Y, Zeng X, Zhou H, Zhou G. The efficacy of topical intralesional BCG-PSN injection in the treatment of erosive oral lichen planus: a randomized controlled trial. J Oral Pathol Med 2009;38(7):551-5. Yazışma Adresi: Kıvanç BEKTAŞ-KAYHAN
• Istanbul Üniversitesi Diş Hekimliği Fakültesi Ağız, Diş ve Çene Cerrahisi A.D. 34093, Çapa-Fatih/İstanbul Tel: [phone] / 30322 e-posta: [e-mail]