European Journal of Clinical Pharmacology

, Volume 73, Issue 12, pp 1523–1537 | Cite as

Drug-induced oral lichenoid reactions: a real clinical entity? A systematic review

Review
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Abstract

Purpose

Drug-induced oral lichenoid reactions (DIOLRs) have been extensively reported in the literature, but the validity of the causality relationship between any drug and the oral lichenoid lesions (OLLs) still remains questionable. We sought to determine whether this causality relationship really exists, whether a resolution of the oral lesions upon withdrawal occurs, and what the most common alleged offending medications are.

Methods

Nine electronic databases from January 1966 to December 2016 were systematically searched to identify all relevant studies selected with specific inclusion criteria (a clinical and histopathological diagnosis of DIOLRs, and clearly statement on the systemic offending medication). Searched terms included but not limited to oral lichen planus/oral lichenoid lesions/oral lichenoid reactions, the adverse effects of medication, and drug-induced. Statistical analyses conducted.

Results

The search retrieved a total of 817 articles, of which only 46 were included into a qualitative synthesis: 40 case reports/series and 6 studies. The causality assessment was done only in 14.8% of cases with the C-D-R protocol. The Naranjo algorithm was not reported in the majority of cases (98.2%). Culprit medication was withdrawn in 68.5% of the cases, obtaining a partial or complete resolution without treatment in 16.7% of cases and with treatment in 27.7% of cases. The median number of culprit medication(s) described was 1 with the most frequent ones being Methyldopa (20.37%), Interferon (IFN)-alpha (11.11%), and Imatinib and Infliximab (9.26%).

Conclusion

This systematic review demonstrated that there is no strong scientific evidence to support the causal relationship between any drug and oral lichenoid lesions; therefore, in all reviewed cases, we must question whether the DIOLRs represent a real and separate clinical entity. Further and more thorough investigations using one of the available algorithms for adverse drug reaction are warranted.

Keywords

Oral lichen planus Oral lichenoid lesions Oral licheniod reactions Diagnosis Management Medication Drug 

Notes

Acknowledgements

We would like to thank Ms. Thelisia Davis, Department of Libraries, Louisiana State University Health Sciences Center, for her help in editing the manuscript.

Funding information

No funding source has been provided for this work.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Supplementary material

228_2017_2325_MOESM1_ESM.docx (18 kb)
ESM 1 (DOCX 17 kb)

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Copyright information

© Springer-Verlag GmbH Germany 2017

Authors and Affiliations

  1. 1.Department of Diagnostic Science, New Orleans School of DentistryLouisiana State University Health Sciences CenterNew OrleansUSA
  2. 2.D.eb.RA. Mexico FoundationMonterreyMexico
  3. 3.Federico Navarro Institute – School of Orgonomy “Piero Borrelli”NaplesItaly
  4. 4.Department of Economics and StatisticsFederico II University of NaplesNaplesItaly
  5. 5.Department of Libraries, New Orleans School of DentistryLouisiana State University Health Sciences CenterNew OrleansUSA

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