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Objectives: Oral lichen planus with exclusive keratotic reticular, papular, and/or plaque-like lesions (K-OLP) is a clinical pattern of OLP that may be associated with a complex symptomatology and psychological alteration. The aim of the study was to evaluate the prevalence of anxiety (A) and depression (D) in patients with K-OLP, analyzing the potential predictors which can affect mental health status. Methods: Three hundred K-OLP patients versus 300 healthy controls (HC) were recruited in 15 Italian universities. The Numeric Rating Scale (NRS), Total Pain Rating Index (T-PRI), and Hamilton Rating Scales for Depression and for Anxiety (HAM-D and HAM-A) were administered. Results: The K-OLP patients showed statistically higher scores in the NRS, T-PRI, HAM-D, and HAM-A compared with the HC (p-value < 0.001**). A and D were found in 158 (52.7%) and 148 (49.3%) K-OLP patients. Strong linear correlations were identified between HAM-A, HAM-D, NRS, T-PRI, and employment status and between HAM-D, HAM-A, NRS, T-PRI, employment status, and female gender. Multivariate logistic regression revealed that HAM-D and HAM-A showed the greatest increase in the R2 value for A and D in the K-OLP patients, respectively (DR2 = 55.5% p-value < 0.001**; DR2 = 56.5% p-value < 0.001**). Conclusions: The prevalence of A and D is higher in the K-OLP patients compared with the HC, also found in K-OLP subjects without pain, suggesting that the processing of pain may be in a certain way independent of the processing of mood. Clinical relevance: Mood disorders and pain assessment should be carefully performed in relation to K-OLP to obtain a complete analysis of the patients. [ABSTRACT FROM AUTHOR]

Objectives: To analyze psychological profiles, pain, and oral symptoms in patients with oral lichen planus (OLP). Materials and methods: 300 patients with keratotic OLP (K‐OLP; reticular, papular, plaque‐like subtypes), 300 patients with predominant non‐keratotic OLP (nK‐OLP; erythematosus atrophic, erosive, ulcerative, bullous subtypes), and 300 controls were recruited in 15 universities. The number of oral sites involved and oral symptoms were recorded. The Numeric Rating Scale (NRS), Total Pain Rating Index (T‐PRI), Hamilton Rating Scales for Depression and for Anxiety (HAM‐D and HAM‐A), Pittsburgh Sleep Quality Index (PSQI), and Epworth Sleepiness Scale (ESS) were administered. Results: The OLP patients, especially the nK‐OLP, showed higher scores in the NRS, T‐PRI, HAM‐D, HAM‐A and PSQI compared with the controls (p‐value <.001**). A positive correlation between the NRS, T‐PRI, HAM‐A, HAM‐D, and PSQI was found with the number of oral symptoms and number of oral sites involved. Pain was reported in 67.3% of nK‐OLP and 49.7% of K‐OLP cases with poor correspondence between the site of lesions and the site of the symptoms. Conclusions: Mood disorders are frequently associated with OLP with an unexpected symptomatology correlated with the number of oral symptoms and with the extension of disease suggesting a peripheral neuropathy. [ABSTRACT FROM AUTHOR]

Objectives: To analyze psychological profiles, pain, and oral symptoms in patients with oral lichen planus (OLP). Materials and methods: 300 patients with keratotic OLP (K‐OLP; reticular, papular, plaque‐like subtypes), 300 patients with predominant non‐keratotic OLP (nK‐OLP; erythematosus atrophic, erosive, ulcerative, bullous subtypes), and 300 controls were recruited in 15 universities. The number of oral sites involved and oral symptoms were recorded. The Numeric Rating Scale (NRS), Total Pain Rating Index (T‐PRI), Hamilton Rating Scales for Depression and for Anxiety (HAM‐D and HAM‐A), Pittsburgh Sleep Quality Index (PSQI), and Epworth Sleepiness Scale (ESS) were administered. Results: The OLP patients, especially the nK‐OLP, showed higher scores in the NRS, T‐PRI, HAM‐D, HAM‐A and PSQI compared with the controls (p‐value <.001**). A positive correlation between the NRS, T‐PRI, HAM‐A, HAM‐D, and PSQI was found with the number of oral symptoms and number of oral sites involved. Pain was reported in 67.3% of nK‐OLP and 49.7% of K‐OLP cases with poor correspondence between the site of lesions and the site of the symptoms. Conclusions: Mood disorders are frequently associated with OLP with an unexpected symptomatology correlated with the number of oral symptoms and with the extension of disease suggesting a peripheral neuropathy. [ABSTRACT FROM AUTHOR]

Background: The wellbeing of oral lichen planus patients (OLPs) may be strongly influenced by a poor quality of sleep (QoS) and psychological impairment. The aims were to analyze the prevalence of sleep disturbance, anxiety, and depression in OLPs and to validate the Pittsburgh Sleep Quality Index (PSQI) in OLPs. Methods: Three hundred keratotic OLPs (K‐OLPs), 300 with predominant non‐keratotic OLP (nK‐OLPs), and 300 controls were recruited in 15 Italian universities. The PSQI, Epworth Sleepiness Scale (ESS), Hamilton Rating Scales for Depression and Anxiety (HAM‐D and HAM‐A), Numeric Rating Scale (NRS), and Total Pain Rating Index (T‐PRI) were administered. Results: Oral lichen planus patients had statistically higher scores than the controls in the majority of the PSQI sub‐items (p‐values < 0.001**). Moreover, OLPs had higher scores in the HAM‐D, HAM‐A, NRS, and T‐PRI (p‐values < 0.001**). No differences in the PSQI sub‐items' scores were found between the K‐OLPs and nK‐OLPs, although nK‐OLPs suffered from higher levels of anxiety, depression, and pain (p‐values: HAM‐A, 0.007**, HAM‐D, 0.009**, NRS, <0.001**, T‐PRI, <0.001**). The female gender, anxiety, depression (p‐value: 0.007**, 0.001**, 0.020*) and the intensity of pain, anxiety, and depression (p‐value: 0.006**, <0.001**, 0.014*) were independent predictors of poor sleep (PSQI > 5) in K‐OLPs and nK‐OLPs, respectively. The PSQI's validation demonstrated good internal consistency and reliability of both the total and subscale of the PSQI. Conclusions: The OLPs reported an overall impaired QoS, which seemed to be an independent parameter according to the regression analysis. Hence, clinicians should assess QoS in OLPs and treat sleep disturbances in order to improve OLPs management. [ABSTRACT FROM AUTHOR]

Objectives: We sought to determine the efficacy of psychotropic drug in the management of BMS-like oral symptoms in patients with reticular oral lichen planus (R-OLP) refractory to conventional therapies, and its impact on anxious and depressive symptoms. Materials and methods: We enrolled 28 cases of symptomatic R-OLP. The Numeric Rating Scale (NRS), the Total Pain Rating Index (T-PRI), the Hamilton rating scales for Depression (HAM-D) and Anxiety (HAM-A) were performed at baseline (time 0), after 2 months of topical clonazepam (time 1) and after 6 months of benzodiazepine and antidepressant drugs (time 2). Results: R-OLP patients showed a statistically significant improvement in the NRS and T-PRI scores from time 0 [median: 9.0 (IQR: 7.2-10.0) and 10.5 (IQR: 7.0-13.0), respectively] to time 2 [(median: 2.0 (IQR: 2.0-3.0) (p < .001) and 3.0 (IQR: 2.0-4.7) (p < .001), respectively]. Similarly, the HAM-A and HAM-D scores showed an improvement from time 0 [(median: 15.0 (IQR: 10.2-17.8) and 13.0 (IQR: 12.0-15.0), respectively] to time 2 [median: 6.0 (IQR: 4.0-7.0) (p < .001) and 5.5 (IQR: 4.25-6.0) (p < .001), respectively]. Conclusions: Psychotropic drugs turned out to be effective in the management of BMS-like oral symptoms in R-OLP patients refractory to conventional immunosuppressive therapy, although in a long-term period. [ABSTRACT FROM AUTHOR]

Objectives: To analyze intra, extra-oral symptoms and psychological profiles in symptomatic patients with reticular (R) forms of oral lichen planus (OLP).Materials and Methods: Thirty symptomatic R-OLP (sR-OLP) patients were compared with an equal number of non-symptomatic R-OLP (nsR-OLP) patients, burning mouth syndrome (BMS) patients, and healthy subjects (HS). The Numeric Rating Scale (NRS), the Total Pain Rating Index (T-PRI), and the Hamilton Rating Scales for Depression (HAM-D) and Anxiety (HAM-A) were administered. Descriptive statistics, the non-parametric ANOVA procedure by Kruskal-Wallis, the exact Fisher test, and the multiple comparison test by the Mann-Whitney U test were performed.Results: The median and IQR of the HAM-D and HAM-A were 16.0 (11.7-24.0) and 17.5 (13.7-27.2) for the BMS, 13.5 (12.0-15.0) and 15.5 (10.7-18.0) for the sR-OLP patients, 2.0 (2.0-3.2) and 2.0 (2.0-4.0) for the nsR-OLP patients, and 3.0 (2.0-4.0) and 3.0 (2.0-4.0) for the HS, respectively. The median and IQR of the NRS and T-PRI were 9.0 (7.7-10.0) and 11.0 (9.0-12.2) for the BMS and 9.0 (7.7-10.0) and 11.5 (7.0-13.0) for the sR-OLP patients, respectively. Comparison analysis between the BMS and sR-OLP patients revealed a non-significant difference between the medians of the psychological profile and pain in the two groups (P-value>.05).Conclusions: The oral complaints are correlated with anxious and depressive symptoms in sR-OLP patients. Mood disorders could modulate the pain perception or that patients could develop two different associated oral diseases, OLP and BMS. [ABSTRACT FROM AUTHOR]

Background Although the exact incidence of pediatric oral lichen planus ( OLP) is unknown, the oral mucosa seems to be less commonly involved, and the clinical presentation is often atypical. The aim of the study is to present a case series of OLP in childhood. Methods From our database, we retrospectively selected and analyzed the clinical data of OLP patients under the age of 18 where the diagnosis had been confirmed by histopathological analysis. Results The case series from our database shows eight patients, four males and four females. The mean (± SD) age at the time of diagnosis of the disease was 13.5 (±2.73) years, ranging in age from 9 to 17. Clinically, a reticular pattern was present in six patients (75%), and the tongue was the most commonly involved oral site (six cases, 75%). We also report the first case of OLP in a 9-year-old girl affected by autoimmune polyendocrinopathy-candidiasis-ectodermal dystrophy. Conclusions We report the largest case series of pediatric OLP published in literature thus far. Differences in the disease between adults and pediatric patients have been detected, but further investigation and a larger case series are needed to establish any detailed differences in clinical outcomes. [ABSTRACT FROM AUTHOR]