ASSESSMENT OF THE CORRELATION BETWEEN HISTOPATHOLOGICAL CHANGES AND CLINICAL SYMPTOMS IN PATIENTS WITH ORAL LICHEN PLANUS: A CROSS-SECTIONAL STUDY IN PAKISTANI DENTAL CLINICS
Main Article Content
Keywords
Oral lichen planus, histopathology, clinical symptoms, basal cell degeneration, lymphocytic infiltration, hyperkeratosis, Pakistani population.
Abstract
Background: A chronic inflammatory condition with varied clinical manifestations, oral lichen planus (OLP) is not clearly associated with histological alterations.
Objective: To assess the correlation between histopathological changes and clinical symptoms in patients with OLP attending Pakistani dental clinics.
Methodology: This cross-sectional study was conducted from January 2024 to June 2024. 186 clinically diagnosed OLP patients in all had thorough oral exams and histological analysis. Using a defined severity scale, clinical symptoms—burning sensation, discomfort, mucosal erythema, ulceration—were evaluated. Examined were histopathological characteristics including hyperkeratosis, lymphocytic invasion, and basal cell degeneration. SPSS version 25 was used for statistical analysis; chi-square test was used to find relationships with a significance level of p 0.05.
Results: Reticular OLP (45.70%) followed by erosive (33.33%) and atrophic (20.97%) was the most often occurring clinical subtype. The most often mentioned symptom (76.34%) was burning feeling; pain (52.15%) followed. Higher symptom severity was clearly correlated with severe basal cell degeneration and lymphocytic infiltration (p<0.001). Although hyperkeratosis was seen in 77.42% of patients, it did not reveal any appreciable relationship with symptom severity.
Conclusion: A significant correlation was found between histopathological changes and clinical symptoms in OLP, emphasizing the need for an integrated diagnostic and treatment approach.
References
2. Manchanda Y, Rathi SK, Joshi A, Das S. Oral lichen planus: An updated review of etiopathogenesis, clinical presentation, and management. Indian Dermatology Online Journal. 2024 Jan 1;15(1):8-23. DOI: 10.4103/idoj.idoj_652_22.
3. Deng X, Wang Y, Jiang L, Li J, Chen Q. Updates on immunological mechanistic insights and targeting of the oral lichen planus microenvironment. Frontiers in Immunology. 2023 Jan 9;13:1023213. https://doi.org/10.3389/fimmu.2022.1023213.
4. Elenbaas A, Enciso R, Al-Eryani K. Oral lichen planus: a review of clinical features, etiologies, and treatments. Dentistry Review. 2022 Mar 1;2(1):100007. https://doi.org/10.1016/j.dentre.2021.100007.
5. Gururaj N, Hasinidevi P, Janani V, Divynadaniel T. Diagnosis and management of oral lichen planus–Review. Journal of Oral and Maxillofacial Pathology. 2021 Sep 1;25(3):383-93. DOI: 10.4103/jomfp.jomfp_386_21.
6. Parlatescu, I., Tovaru, M., Nicolae, C.L. et al. Oral health–related quality of life in different clinical forms of oral lichen planus. Clin Oral Invest 24, 301–308 (2020). https://doi.org/10.1007/s00784-019-02951-8
7. McCullough MJ, Alrashdan MS, Cirillo N. Oral lichen planus. Contemporary Oral Medicine. Springer International Publishing AG. 2017:1-40. DOI 10.1007/978-3-319-28100-1_14-1.
8. Ismail SB, Kumar SK, Zain RB. Oral lichen planus and lichenoid reactions: etiopathogenesis, diagnosis, management and malignant transformation. Journal of oral science. 2007;49(2):89-106. https://doi.org/10.2334/josnusd.49.89.
9. Wang R, Zhang X, Wang S. Differential genotypes of TNF-α and IL-10 for immunological diagnosis in discoid lupus erythematosus and oral lichen planus: A narrative review. Frontiers in Immunology. 2022 Aug 5;13:967281. https://doi.org/10.3389/fimmu.2022.967281.
10. Hashemipour MA, Sheikhhoseini S, Afshari Z, Gandjalikhan Nassab AR. The relationship between clinical symptoms of oral lichen planus and quality of life related to oral health. BMC Oral Health. 2024 May 13;24(1):556. https://doi.org/10.1186/s12903-024-04326-2.
11. Nukaly HY, Halawani IR, Alghamdi SM, Alruwaili AG, Binhezaim A, Algahamdi RA, Alzahrani RA, Alharamlah FS, Aldumkh SH, Alasqah HM, Alamri A. Oral Lichen Planus: a narrative review navigating etiologies, clinical manifestations, Diagnostics, and therapeutic approaches. Journal of Clinical Medicine. 2024 Jan;13(17):5280. https://doi.org/10.3390/jcm13175280.
12. Chancellor MB. Rationale for the Use of Topical Calcineurin Inhibitors in the Management of Oral Lichen Planus and Mucosal Inflammatory Diseases. Cureus. 2024 Nov 27;16(11). DOI: 10.7759/cureus.74570.
13. Pires AL, Alves LD, da Silva AM, Arsati F, Lima‐Arsati YB, Dos Santos JN, Calumby RT, Freitas VS. Salivary biomarkers to evaluate psychological disorders in oral lichen planus: A systematic review with meta‐analysis. Oral Diseases. 2023 Oct;29(7):2734-46. https://doi.org/10.1111/odi.14385.
14. Shahid A. A Comparative Evaluation Of The Efficacy Between Topical Applications Of Propolis And Tacrolimus In The Management Of Symptomatic Oral Lichen Planus Patients (Doctoral dissertation, Bbdcods). http://103.85.141.226:8071/jspui/bitstream/123456789/819/1/Areeba%20dissertation%20submission2018-2021.pdf.
15. Carrozzo M, Porter S, Mercadante V, Fedele S. Oral lichen planus: A disease or a spectrum of tissue reactions? Types, causes, diagnostic algorhythms, prognosis, management strategies. Periodontology 2000. 2019 Jun;80(1):105-25. https://doi.org/10.1111/prd.12260.
16. Adamo D, Cascone M, Celentano A, Ruoppo E, Leuci S, Aria M, Mignogna MD. Psychological profiles in patients with symptomatic reticular forms of oral lichen planus: A prospective cohort study. Journal of Oral Pathology & Medicine. 2017 Oct;46(9):810-6. https://doi.org/10.1111/jop.12577.
17. Orliaguet M, Misery L. Neuropathic and psychogenic components of burning mouth syndrome: a systematic review. Biomolecules. 2021 Aug 18;11(8):1237. https://doi.org/10.3390/biom11081237.
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Sadia Aman
Assistant professor, Department of Anatomy, Rawalpindi Medical University, Rawalpindi
Bismah Ahmad
Assistant Professor, CMH Lahore Medical College and Institute of Dentistry, Lahore
Halima Sadia Qazi
Dental Section, Ayub Medical College, Abbottabad, KPK, Pakistan
Fiaz Ahmad
Associate Professor, Department of Pathology, College of Medicine and Dentistry at Hills, Abbotabad
Khaqan Azam
Assistant Professor Department of Oral Medicine Akhtar Saeed Medical and Dental college, Lahore
Rabia Anwar
Assistant Professor Department of Dentistry, Ayub Medical College, Abbotabad