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Submucosal Fibrotic Bands in Oral Lichen Planus: A Clinico-Pathological Investigation of a Newly Described Phenomenon

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Abstract

Fibrosis is a recognized complication of chronic inflammatory conditions, which has not yet been described in oral lichen planus. To describe characteristics of submucosal fibrotic bands in oral lichen planus. Prospective study. Patients with biopsy confirmed lichen planus were included. Clinical examination recorded fibrotic bands, mouth opening, vestibular depth loss, gingival recessions adjacent to band, lichen subtypes, areas of affected mucosa, extra-oral manifestations. Patients completed the Chronic Oral Mucosal Disease Questionnaire, with additional questions regarding stiffness, restricted opening, symptom frequency, time from diagnosis of lichen, co-existing medical conditions. 73 patients were included, 14 M, 59 F, age 28–84 (mean 61) years. Buccal fibrous bands were palpated in 22 (30.1%), 13 (59%) were bilateral. Self-reported restricted opening/stiffness were significantly associated with fibrous bands (36% Vs. 11% in controls, p = 0.02). Mouth opening less than 40 mm was recorded in only 2 (9%) with bands, none in controls. Reduced vestibular depth was significantly associated with bands (11 (50%) Vs 3 (6%) in controls, p = 0.0001).Gingival recessions adjacent to bands were recorded in 3 (13.6%). No association was demonstrated between fibrous bands and erosive lesions, extra oral involvement, smoking, age, visual analogue scale, quality of life questionaire and disease duration. Histological evaluation of one case each with and without band and control showed increased mean width of connective tissue. Submucous fibrous band is first described in the present study. It is common in oral lichen planus, may lead to feeling restricted mouth opening, stiffness, loss of vestibular depth and adjacent gingival recession.

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References

  1. Roopashree MR, Gondhalekar RV, Shashikanth MC, George J, Thippeswamy SH, Shukla A. Pathogenesis of oral lichen planus-a review. J Oral Pathol Med. 2010;39:729–34.

    Article  CAS  Google Scholar 

  2. McCartan BE, Healy CM. The reported prevalence of oral lichen planus: a review and critique. J Oral Pathol Med. 2008;37:447–53.

    Article  CAS  Google Scholar 

  3. Carbone M, Arduino PG, Carrozzo M, Gandolfo S, Argiolas MR, Bertolusso G, et al. Course of oral lichen planus: a retrospective study of 808 northern Italian patients. Oral Dis. 2009;15:235–43.

    Article  CAS  Google Scholar 

  4. Van Der Meij EH, Van Der Waal I. Lack of clinicopathologic correlation in the diagnosis of oral lichen planus based on the presently available diagnostic criteria and suggestions for modifications. J. Oral Pathol. Med. 2003;32:507–12.

    Article  Google Scholar 

  5. Bradding P, Pejker G. The controversial role of mast cells in fibrosis. Immunol Rev. 2018;282(1):198–231.

    Article  CAS  Google Scholar 

  6. Sharma Sircar K, Singh S, Rastogi V. Role of mast cells in pathogenesis of oral lichen. J Oral Maxillofac Pathol. 2011;15(3):267–71.

    Article  Google Scholar 

  7. Neill SM, Lewis FM. Vulvovaginal lichen planus: a disease in need of a unified approach. Arch Dermatol. 2008;144:1502–3.

    Article  Google Scholar 

  8. Eisen D. The evaluation of cutaneous, genital, scalp, nail, esophageal, and ocular involvement in patients with oral lichen planus. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 1999;88:431–6.

    Article  CAS  Google Scholar 

  9. Assouly P, Reygagne P. Lichen planopilaris: update on diagnosis and treatment. Semin Cutan Med Surg. 2009;28:3–10.

    Article  CAS  Google Scholar 

  10. Cram DL, Muller SA. Unusual variations of lichen planus. Mayo Clin Proc. 1966;41:677–88.

    CAS  PubMed  Google Scholar 

  11. Quispel R, van Boxel OS, Schipper ME, Sigurdsson V, Canninga-van Dijk MR, Kerckhoffs A, et al. High prevalence of esophageal involvement in lichen planus: a study using magnification chromoendoscopy. Endoscopy. 2009;41:187–93.

    Article  CAS  Google Scholar 

  12. Brewer JD, Ekdawi NS, Torgerson RR, et al. Lichen planus and cicatricial conjunctivitis: disease course and response to therapy of 11 patients. J Eur Acad Dermatol Venereol. 2011;25:100–4.

    Article  CAS  Google Scholar 

  13. Kaplan I, Ventura-Sharabi Y, Gal G, Calderon S, Anavi Y. The dynamics of oral lichen planus: a retrospective clinicopathological study. Head Neck Pathol. 2012;6:178–83.

    Article  Google Scholar 

  14. Kalluri R, Neilson EG. Epithelial-mesenchymal transition and its implications for fibrosis. J Clin Investig. 2003;112:1776–84.

    Article  CAS  Google Scholar 

  15. Cattell MA, Anderson JC, Hasleton PS. Age-related changes in amounts and concentrations of collagen and elastin in normotensive human thoracic aorta. Clin Chim Acta. 1996;245:73–84.

    Article  CAS  Google Scholar 

  16. Liu Y. Renal fibrosis: new insights into the pathogenesis and therapeutics. Kidney Int. 2006;69:213–7.

    Article  CAS  Google Scholar 

  17. Vongwiwatana A, Tasanarong A, Rayner DC, Melk A, Halloran PF. Epithelial to mesenchymal transition during late deterioration of human kidney transplants: the role of tubular cells in fibrogenesis. Am J Transpl. 2005;5:1367–74.

    Article  CAS  Google Scholar 

  18. Pindborg JJ, Sirsat SM. Oral submucous fibrosis. Oral Surg Oral Med Oral Pathol. 1966;22:764–79.

    Article  CAS  Google Scholar 

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Shteiner, M., Kleinman, S., Shuster, A. et al. Submucosal Fibrotic Bands in Oral Lichen Planus: A Clinico-Pathological Investigation of a Newly Described Phenomenon. Head and Neck Pathol 15, 395–401 (2021). https://doi.org/10.1007/s12105-020-01203-6

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  • DOI: https://doi.org/10.1007/s12105-020-01203-6

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