DOI: http://dx.doi.org/10.17305/bjbms.2018.3133 | Full Text: [PDF]

Clinical features and management of oral lichen planus (OLP) with emphasis on the management of hepatitis C virus (HCV)-related OLP

Alexandru Mester, Ondine Lucaciu, Lidia Ciobanu, Dragos Apostu, Aranka Ilea, Radu Septimiu Campian

Abstract


Oral lichen planus (OLP) is a chronic inflammatory disease characterized by the occurrence of multiple, symmetrical lesions in the oral cavity. Hepatitis C virus (HCV) infection has been suggested as an etiological factor in OLP. The purpose of this review was to summarize the current literature regarding the treatment of OLP in patients with HCV infection. An electronic search of the PubMed database was conducted until January 2018, using the following keywords: OLP, HCV, corticosteroids, retinoids, immunomodulatory agents, surgical interventions, photochemotherapy, laser therapy, interferon, ribavirin, and direct-acting antivirals. We selected the articles focusing on the clinical features and treatment management of OLP in patients with/without HCV infection. Topical corticosteroids are considered the first-line treatment in OLP. Calcineurin inhibitors or retinoids can be beneficial for recalcitrant OLP lesions. Systemic therapy should be used in the case of extensive and refractory lesions that involve extraoral sites. Surgical intervention is recommended for isolated lesions. In patients with HCV, monotherapy with interferon (IFN)-α may either improve, aggravate or trigger OLP lesions, while combined IFN-α and ribavirin therapy does not significantly influence the progression of lesions. Direct-acting antiviral (DAA) therapy appears to be a promising approach in patients with HCV-related OLP, as it can improve symptoms of both liver disease and OLP, with fewer side effects. Nevertheless, for clinical utility of DAAs in OLP patients, further studies with larger sample sizes, adequate treatment duration, and long term follow-up are required.


Keywords


Oral lichen planus; OLP; hepatitis C virus infection; HCV; management of oral pathology; direct acting antivirals; DAA

Full Text:

[PDF]

References


De Rossi SS, Ciarrocca K. Oral lichen planus and lichenoid mucositis. Dent Clin North Am 2014;58(2):299-313. https://doi.org/10.1016/j.cden.2014.01.001.

Lucchese A, Dolci A, Minervini G, Salerno C, DI Stasio D, Minervini G, et al. Vulvovaginal gingival lichen planus: Report of two cases and review of literature. Oral Implantol (Rome) 2016;9(2):54-60. https://doi.org/10.11138/orl/2016.9.2.054.

Scully C, Carozzo M. Oral mucosa disease: Lichen planus. Br J Oral Maxilofac Surg 2008;46(1):15-21. https://doi.org/10.1016/j.bjoms.2007.07.199.

Garcovich S, Garcovich M, Capizzi R, Gasbarrini A, Zocco MA. Cutaneous manifestations of hepatitis C in the era of new antiviral agents. World J Hepatol 2015; 7(27):2740-8. https://doi.org/10.4254/wjh.v7.i27.2740.

Salgado DS, Jeremiah F, Cappella MV, Onofre MA, Massucato EMS, Orrico SRP. Plaque control improves the painful symptoms of oral lichen planus gingival lesions. A short-term study. J Oral Pathol Med 2013;42(10):728-32. https://doi.org/10.1111/jop.12093.

Gheorghe C, Mihai L, Parlatescu I, Tovaru S. Association of oral lichen planus with chronic C hepatitis. Review of the data in literature. Maedica (Buchar) 2014;9(1):98-103.

Leao JC, Ingafou M, Khan A, Scully C, Porter S. Desquamative gingivitis: Retrospective analysis of disease associations of a large cohort. Oral Diseases 2008;14(6):556-60. https://doi.org/10.1111/j.1601-0825.2007.01420.x.

Lo Russo L, Guiglia R, Pizzo G, Fierro G, Ciavarella D, Lo Muzio L, et al. Effect of desquamative gingivitis on periodontal status: A pilot study. Oral Dis 2010;16(1):102-7. https://doi.org/10.1111/j.1601-0825.2009.01617.x.

Salerno C, Di Stasio D, Petruzzi M, Lauritano D, Gentile E, Guida A, et al. An overview of burning mouth syndrome. Front Biosci (Elite Ed) 2016;8:213-8. https://doi.org/10.2741/e762.

Jungell P, Konttinen YT, Nortamo P, Malmström M. Immunoelectron microscopic study of distribution of T cell subsets in oral lichen planus. Scand J Dent Res 1989;97(4):361-7. https://doi.org/10.1111/j.1600-0722.1989.tb01624.x.

Sugerman PB, Satterwhite K, Bigby M. Autocytotoxic T-cell clones in lichen planus. Br J Dermatol 2000;142(3):449-56. https://doi.org/10.1046/j.1365-2133.2000.03355.x.

Lavanya N, Jayanthi P, Rao UK, Ranganathan K. Oral lichen planus: An update on pathogenesis and treatment. J Oral Maxillofac Pathol 2011;15(2):127-32. https://doi.org/10.4103/0973-029X.84474.

Zhao ZZ, Sugerman PB, Zhou XJ, Walsh LJ, Savage NW. Mast cell degranulation and the role of T cell RANTES in oral lichen planus. Oral Dis 2001;7(4):246-51. https://doi.org/10.1034/j.1601-0825.2001.70408.x.

Roopashree, MR, Gondhalekar RV, Shashikanth MC, George J, Thippeswamy SH, Shukla A. Pathogenesis of oral lichen planus - A review. J Oral Pathol Med 39(10):729-34. https://doi.org/10.1111/j.1600-0714.2010.00946.x.

WHO. Global hepatitis report. World Health Organization; 2017.

Di Bisceglie AM. Hepatitis C. Lancet 1998;351(9099):351-5. https://doi.org/10.1016/S0140-6736(97)07361-3.

Petti S, Rabiei M, De Luca M, Scully C. The magnitude of the association between hepatitis C virus infection and oral lichen planus: Meta-analysis and case control study. Odontology 2011;99(2):168-78. https://doi.org/10.1007/s10266-011-0008-3.

Mohd Hanafiah K, Groeger J, Flaxman AD, Wiersma ST. Global epidemiology of hepatitis C virus infection: New estimates of age-specific antibody to HCV seroprevalence. Hepatology 2013;57(4):1333-42. https://doi.org/10.1002/hep.26141.

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

Carrozzo M, Francia Di Celle P, Gandolfo S, Carbone M, Conrotto D, Fasano ME, et al. Increased frequency of HLA-DR6 allele in Italian patients with hepatitis C virus-associated oral lichen planus. Br J Dermatol 2001;144(4):803-8.

https://doi.org/10.1046/j.1365-2133.2001.04136.x.

El-Kabir M, Scully C, Porter S, Porter K, Macnamara E. Liver function in UK patients with oral lichen planus. Clin Exp Dermatol 1993;18(1):12-6.

https://doi.org/10.1111/j.1365-2230.1993.tb00957.x.

Tanei R, Watanabe K, Nishiyama S. Clinical and histopathologic analysis of the relationship between lichen planus and chronic hepatitis C. J Dermatol 1995; 22(5):316-23. https://doi.org/10.1111/j.1346-8138.1995.tb03395.x.

Carrozzo M, Gandolfo S. The management of oral lichen planus. Oral Dis 1999;5(3):196-205. https://doi.org/10.1111/j.1601-0825.1999.tb00301.x.

Vincent SD, Fotos PG, Baker KA, Williams TP. Oral lichen planus: The clinical, historical, and therapeutic features of 100 cases. Oral Surg Oral Med Oral Pathol 1990; 70(2):165-71. https://doi.org/10.1016/0030-4220(90)90112-6.

Gonzalez-Moles MA, Ruiz-Avila I, Rodriguez-Archilla A, Morales-Garcia P, Mesa-Aguado F, Bascones-Martinez A, et al. Treatment of severe erosive gingival lesions by topical application of clobetasol propionate in custom trays. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2003;95(6):688-92. https://doi.org/0.1067/moe.2003.139.

Lehner T, Lyne C. Adrenal function during topical oral corticosteroid treatment. Br Med J 1969;4(5676):138-41. https://doi.org/10.1136/bmj.4.5676.138.

Plemons JM, Rees TD, Zachariah NY. Absorption of a topical steroid and evaluation of adrenal suppression in patients with erosive lichen planus. Oral Surg Oral Med Oral Pathol 1990;69(6):688-93. https://doi.org/10.1016/0030-4220(90)90349-W.

Carbone M, Goss E, Carrozzo M, Castellano S, Conrotto D, Broccoletti R, et al. 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.

https://doi.org/10.1034/j.1600-0714.2003.00173.x.

Gonzalez-Moles MA, Scully C. Vesiculo-erosive oral mucosal disease. Management with topical corticosteroids: (2) Protocols, monitoring of effects and adverse reactions, and the future. J Dent Res 2005;84(4):302-8. https://doi.org/10.1177/154405910508400402.

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. https://doi.org/10.1111/j.1601-0825.2005.01142.x.

Lopez-Jornet P, Camacho-Alonso F, Salazar-Sanchez N. Topical tacrolimus and pimecrolimus in the treatment of oral lichen planus: An update. J Oral Pathol Med 2010; 39(3):201-5. https://doi.org/10.1111/j.1600-0714.2009.00830.x.

Lener EV, Brieva J, Schachter M, West LE, West DP, el-Azhary RA. Successful treatment of erosive lichen planus with topical tacrolimus. Arch Dermatol 2001;137(4):419-22.

Kaliakatsou F, Hodgson TA, Lewsey JD, Hegarty AM, Murphy AG, Porter SR. Management of recalcitrant ulcerativeoral lichen planus with topical tacrolimus. J Am Acad Dermatol 2002;46(1):35-41. https://doi.org/10.1067/mjd.2002.120535.

Morrison L, Kratochvil FJ III, Gorman A. An open trial of topical tacrolimus for erosive oral lichen planus. J Am Acad Dermatol 2002;47(4):617-20. https://doi.org/10.1067/mjd.2002.126275.

Rozycki TW, Rogers RS III, Pittelkow MR, McEvoy MT, el-Azhary RA, Bruce AJ, et al. Topical tacrolimus in the treatment of symptomatic oral lichen planus: A series of 13 patients. J Am Acad Dermatol 2002;46(1):27-34. https://doi.org/10.1067/mjd.2002.119648.

Olivier V, Lacour JP, Mousnier A, Garraffo R, Monteil RA, Ortonne JP. Treatment of chronic erosive oral lichen planus with low concentrations of topical tacrolimus: An open prospective study. Arch Dermatol 2002;138(10):1335-8. https://doi.org/10.1001/archderm.138.10.1335.

Hodgson TA, Sahni N, Kaliakatsou F, Buchanan JA, Porter SR. Long-term efficacy and safety of topical tacrolimus in the management of ulcerative/erosive oral lichen planus. Eur J Dermatol 2003;13(5):466-70.

Swift JC, Rees TD, Plemons JM, Hallmon WW, Wright JC. The effectiveness of 1% pimecrolimus cream in the treatment of oral erosive lichen planus. J Periodontol 2005; 76(4):627-35. https://doi.org/10.1902/jop.2005.76.4.627.

Gorouhi F, Solhpour A, Beitollahi JM, Afshar S, Davari P, Hashemi P, et al. Randomized trial of pimecrolimus cream versus triamcinolone acetonide paste in the treatment of oral lichen planus. J Am Acad Dermatol 2007;57(5):806-13. https://doi.org/10.1016/j.jaad.2007.06.022.

Lodi G, Scully C, Carrozzo M, Griffiths M, Sugerman PB, Thongprasom K. Current controversies in oral lichen planus: Report of an international consensus meeting. Part 1. Viral infections and etiopathogenesis. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2005;100(1):40-51. https://doi.org/10.1016/j.tripleo.2004.06.077.

Sciubba JJ. Oral mucosal diseases in the office setting - Part II: Oral lichen planus, pemphigus vulgaris, and mucosal pemphigoid. Gen Dent 2007;55(5):464-76; quiz 477-8, 488.

Liu V, Mackool BT. Mycophenolate in dermatology. J Dermatolog Treat 2003; 14(4):203-11. https://doi.org/10.1080/09546630310016826.

Hodak E, Yosipovitch G, David M, Ingber A, Chorev L, Lider O, et al. Low-dose low-molecular-weight heparin (enoxaparin) is beneficial in lichen planus: A preliminary report. J Am Acad Dermatol 1998;38(4):564-8. https://doi.org/10.1016/S0190-9622(98)70118-5.

Cheng A, Mann C. Oral erosive lichen planus treated with efalizumab. Arch Dermatol 2006;142(6):680-2. https://doi.org/10.1001/archderm.142.6.680.

Emslie ES, Hardman FG. The surgical treatment of oral lichen planus. Trans St Johns Hosp Dermatol Soc 1970;56(1):43-4.

Hovick CJ, Kalkwarf KL. Treatment of localized oral erosive lichen planus lesions with free soft tissue grafts. Periodontal Case Rep 1987;9(2):21-4.

Tamizi M, Moayedi M. Treatment of gingival lichen planus with a free gingival graft: A case report. Quintessence Int 1992;23(4):249-51.

Katz J, Goultschin J, Benoliel R, Rotstein I, Pisanty S. Lichen planus evoked by periodontal surgery. J Clin Periodontol 1988;15(4):263-5.

https://doi.org/10.1111/j.1600-051X.1988.tb01580.x.

Malmstrom M, Leikomaa H. Experiences with cryotherapy in the treatment of oral lesions. Proc Finn Dent Soc 1980;76(3):117-23.

Azizi A, Rezaee M. Comparison of periodontal status in gingival oral lichen planus patients and healthy subjects. Dermatol Res Pract 2012;2012:561232. https://doi.org/10.1155/2012/561232.

Guiglia R, Di Liberto C, Pizzo G, Picone L, Lo Muzio L, Gallo PD, et al. A combined treatment regiment for desquamative gingivitis in patients with oral lichen planus. J Oral Pathol Med 2007;36(2):110-6. https://doi.org/10.1111/j.1600-0714.2007.00478.x.

Lundquist G, Forsgren H, Gajecki M, Emtestam L. Photochemotherapy of oral lichen planus. A controlled study. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 1995; 79(5):554-8. https://doi.org/10.1016/S1079-2104(05)80094-0.

Al-Maweri SA, Ashraf S, Kalakonda B, Halboub E, Petro W, AlAizari NA. Efficacy of photodynamic therapy in the treatment of symptomatic oral lichen planus: A systematic review. J Oral Pathol Med 2018;47(4):326-32. https://doi.org/10.1111/jop.12684.

Bakhtiari S, Azari-Marhabi S, Mojahedi SM, Namdari M, Rankohi ZE, Jafari S. Comparing clinical effects of photodynamic therapy as a novel method with topical corticosteroid for treatment of oral lichen planus. Photodiagnosis Photodyn Ther 2017;20:159-64. https://doi.org/10.1016/j.pdpdt.2017.06.002.

Maloth KN, Velpula N, Kodangal S, Sangmesh M, Vellamchetla K, Ugrappa S, et al. Photodynamic therapy - A non-invasive treatment modality for precancerous lesions. J Lasers Med Sci 2016;7(1):30-6. https://doi.org/10.15171/jlms.2016.07.

Jajarm HH, Falaki F, Sanatkhani M, Ahmadzadeh M, Ahrari F, Shafaee H. A comparative study of toluidine blue-mediated photodynamic therapy versus topical corticosteroids in the treatment of erosive-atrophic oral lichen planus: A randomized clinical controlled trial. Lasers Med Sci 2015;30(5):1475-80.

https://doi.org/10.1007/s10103-014-1694-1.

Saleh WE, Khashaba O, El nagdy S, Moustafa MD. Photodynamic therapy of oral erosive lichen planus in diabetic and hypertensive patients. Mansoura Journal of Dentistry 2014;1(3):119-23.

Mostafa D, Moussa E, Alnouaem M. Evaluation of photodynamic therapy in treatment of oral erosive lichen planus in comparison with topically applied corticosteroids. Photodiagnosis Photodyn Ther 2017;19:56-66. https://doi.org/10.1016/j.pdpdt.2017.04.014.

Soliman M, Kharbotly AE, Saafan A. Management of oral lichen planus using diode laser (980nm). A clinical study. Egypt Dermatol Online J 2005;1(1):1-12.

Van der Hem PS, Egges M, van der Wal JE, Roodenburg JL. CO2 laser evaporation of oral lichen planus. Int J Oral Maxillofac Surg 2008;37(7):630-3. https://doi.org/10.1016/j.ijom.2008.04.011.

Cafaro A, Albanese G, Arduino PG, Mario C, Massolini G, Mozzati M, et al. Effect of low-level laser irradiation on unresponsive oral lichen planus: Early preliminary results in 13 patients. Photomed Laser Surg 2010; 28 Suppl 2:S99-103. https://doi.org/10.1089/pho.2009.2655.

Trehan M, Taylor CR. Low-dose excimer 308-nm laser for the treatment of oral lichen planus. Arch Dermatol 2004;140(4):415-20. https://doi.org/10.1001/archderm.140.4.415.

Doutre MS, Beylot C, Couzigou P, Long P, Royer P, Beylot J. Lichen planus and virus C hepatitis: Disappearance of the lichen under interferon alpha therapy. Dermatology 1992;184(3):229. https://doi.org/10.1159/000247552.

Doutre MS, Couzigou P, Beylot-Barry M, Beylot C, Quinton A. Lichen planus and hepatitis C: Heterogeneity in the course of 6 cases treated with interferon alpha. Gastroenterol Clin Biol 1996;20(8-9):709-10.

Protzer U, Ochsendorf FR, Leopolder-Ochsendorf A, Holtermuller KH. Exacerbation of lichen planus during interferon alpha-2a therapy for chronic active hepatitis C. Gastroenterology 1993;104(3):903-5. https://doi.org/10.1016/0016-5085(93)91029-H.

Areias J, Velho GC, Cerqueira R, Barbêdo C, Amaral B, Sanches M, et al. Lichen planus and chronic hepatitis C: Exacerbation of the lichen under interferon alpha-2a therapy. Eur J Gastroenterol Hepatol 1996;8(8):825-8.

Nunez M, Miralies ES, De las Heras ME, Ledo A. Appearance of oral erosive lichen planus during interferon alpha-2a therapy for chronic active hepatitis C. J Dermatol 1995;22(6):461-2. https://doi.org/10.1111/j.1346-8138.1995.tb03424.x.

Nagao Y, Sata M, Ide T, Suzuki H, Tanikawa K, Itoh K, et al. Development and exacerbation of oral lichen planus during and after interferon therapy for hepatitis C. Eur J Clin Invest 1996;26(12):1171-4. https://doi.org/10.1046/j.1365-2362.1996.610607.x.

Schlesinger TE, Camisa C, Gay JD, Bergfeld WF. Oral erosive lichen planus with epidermolytic hyperkeratosis during interferon alpha-2b therapy for chronic hepatitis C virus infection. J Am Acad Dermatol 1997;36(6 Pt 1):1023-5.

https://doi.org/10.1016/S0190-9622(97)80296-4.

Zuckerman E, Keren D, Slobodin G, Rosner I, Rozenbaum M, Toubi E, et al. Treatment of refractory, symptomatic, hepatitis C virus related mixed cryoglobulinemia with ribavirin and interferon-alpha. J Rheumatol 2000;27(9):2172-8.

Johnson RJ, Gretch DR, Couser WG, Alpers CE, Wilson J, Chung M, et al. Hepatitis C virus-associated glomerulonephritis: Effect of alpha-interferon therapy. Kidney Int 1994;46(6):1700-4. https://doi.org/10.1038/ki.1994.471.

Sheikh MY, Wright RA, Burruss JB. Dramatic resolution of skin lesions associated with porphyria cutanea tarda after interferon-alpha therapy in a case of chronic hepatitis C. Dig Dis Sci 1998;43(3):529-33. https://doi.org/10.1023/A:1018854906444.

Lu SY, Lin LH, Lu SN, Wang JH, Hung CH. Increased oral lichen planus in a chronic hepatitis patient associated with elevated transaminase levels before and after interferon/ribavirin therapy. J Dent Sci 2009;4(4):191-7.

https://doi.org/10.1016/S1991-7902(09)60026-X.

Nagao Y, Sata M. Dental problems delaying the initiation of interferon therapy for HCV-infected patients. Virol J 2010;7:192. https://doi.org/10.1186/1743-422X-7-192.

Pawlotsky JM, Yahia MB, Andre C, Voisin MC, Intrator L, Roudot-Thoraval F, et al. Immunological disorders in C virus chronic active hepatitis: A prospective case-control study. Hepatology 1994;19(4):841-8. https://doi.org/10.1002/hep.1840190407.

Nagao Y, Kawaguchi T, Ide T, Kumashiro R, Sata M. Exacerbation of oral erosive lichen planus by combination of interferon and ribavirin therapy for chronic hepatitis C. Int J Mol Med 2005;15(2):237-41. https://doi.org/10.3892/ijmm.15.2.237.

EASL Recommendations on Treatment of Hepatitis C 2015. J Hepatol 2015;63(1):199-236. https://doi.org/10.1016/j.jhep.2015.03.025.

Wiznia LE, Laird ME, Franks AG Jr. Hepatitis C virus and its cutaneous manifestations: Treatment in the direct-acting antiviral era. J Eur Acad Dermatol Venererol 2017;31(8):1260-70. https://doi.org/10.1111/jdv.14186.

Soriano V, Labarga P, Fernandez-Montero JV, Benito JM, Poveda E, Rallon N, et al. The changing face of hepatitis C in the new era of direct-acting antivirals. Antiviral Res 2013;97(1):36-40. https://doi.org/10.1016/j.antiviral.2012.10.011.

Vespasiani-Gentilucci U, Galati G, Gallo P, De Vincentis A, Riva E, Picardi A. Hepatitis C treatment in the elderly: New possibilities and controversies towards interferon-free regimens. World J Gastroenterol 2015;21(24):7412-26. https://doi.org/10.3748/wjg.v21.i24.7412.

Nagao Y, Kimura K, Kawahigashi Y, Sata M. Successful treatment of hepatitis C virus-associated oral lichen planus by interferon-free therapy with direct-acting antivirals. Clin Transl Gastroenterol 2016;7(7):e179. https://doi.org/10.1038/ctg.2016.37.

Scott GD, Rieger KE. New-onset cutaneous lichen planus following therapy for hepatitis C with ledipasvir-sofosbuvir. J Cutan Pathol 2016;43(4):408-9. https://doi.org/10.1111/cup.12656.

Nagao Y, Tsuji M. The discovery through dentistry of potentially HCV-infected Japanese patients and intervention with treatment. Adv Res Gastroentero Hepatol 2017; 7(3):555711. https://doi.org/10.19080/ARGH.2017.07.555711.

Misaka K, Kishimoto T, Kawahigashi Y, Sata M, Nagao Y. Use of direct-acting antivirals for the treatment of hepatitis C virus-associated oral lichen planus: A case report. Case Rep Gastroenterol 2016;10(3):617-22. https://doi.org/10.1159/000450679.

Yoshikawa A, Terashita K, Morikawa K, Matsuda S, Yamamura T, Sarashina K, et al. Interferon-free therapy with sofosbuvir plus ribavirin for successful treatment of genotype 2 hepatitis C virus with lichen planus: A case report. Clin J Gastroenterol 2017;10(3):270-3. https://doi.org/10.1007/s12328-017-0742-3.


Refbacks






Quick links for Authors:Quick links for Peer Reviewers:
  

Advanced online | Current Issue | Archives | Submit a manuscript | About the Journal

© Association of Basic Medical Sciences of FBIH, 1998-2018. Credits to Public Knowledge Project