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ObjectivesTo explore the demographic and clinical profile of erosive lichen planus (ELP) across multiple ethnicities within a single cohort, deepening our understanding of disease severity, progression and outcomes.MethodsA longitudinal retrospective cohort study of ELP patients in the ethnically diverse population of East London was carried out, profiling ELP (n = 57) against the milder reticular lichen planus (RLP) (n = 35).ResultsA higher prevalence of ELP was observed in white populations compared to other ethnicities. Affected females were no more likely than males to develop ELP. There was an increased time to diagnosis for ELP patients (median ELP: 452 days, RLP: 312 days), spending longer in primary care before onward referral, in particular when referred by their general medical practitioner (GP) (median dentist 313 days, GP: 606 days). Depression was more likely to occur alongside ELP. Being an ex-smoker is a risk factor for ELP while being a current smoker is associated with RLP. A higher proportion of patients with ELP were missing teeth and had periodontal disease. Multisite involvement was more common in ELP, (ELP: 68% RLP: 11.43%). 55% of ELP cases developed scarring and were less likely to respond to first line medications, requiring systemic immunosuppression. The duration of follow up was increased in the ELP who were reviewed for almost twice as long as RLP patients (ELP 71 months, RLP 35 months).ConclusionELP takes longer to diagnose, requires prolonged tertiary care and is more resistant to treatment, when compared across multiple ethnicities. These patients have increased medical and oral health needs and are at greater risk of scarring than the reticular form. A greater education amongst primary carers on its presentation, as well as a greater understanding of the cellular and molecular mechanisms driving ELP are required to improve diagnostics and identify novel therapeutic approaches.

Aim: This comparative study evaluated the effectiveness and safety profile of topical amlexanox and triamcinolone for the management of erosive oral lichen planus (EOLP). Materials and Methods: This prospective, observational study included 21 patients diagnosed clinically and histopathologically with EOLP and categorized into two groups. Subjects in the two groups were prescribed topical amlexanox and triamcinolone, respectively, for 4 weeks. The area of the erosive lesion and burning sensation was measured at baseline, at the end of the first, 2second, and fourth week. These outcome measures were documented and statistically analyzed. The statistical analyses were performed using the IBM SPSS Statistics version 22. Analysis for age distribution was done by independent sample t test. Analysis of sex distribution was done by chi-square test. Variations within a single group for both the outcome parameters were calculated by Wilcoxon signed rank test. (P < 0.05 statistically significant). Results: A total of 30 erosive sites were evaluated in 21 patients over a 4-week duration. The most common site was the buccal mucosa in both groups (23 of 30; 76.67% of total lesions assessed), followed by the tongue (5 of 30; 16.67% of total lesions assessed), the palate (1 of 30; 3.33% of total sites assessed), and the maxillary attached gingiva (1 of 30; 3.33% of total sites assessed). Group 1 (amlexanox) was comprised of 11 subjects, whereas Group 2 (triamcinolone) was comprised of 10 subjects. Pre and posttreatment comparison revealed no statistically significant difference (P = 0.756; 0.512, respectively), for the area of the erosion and burning sensation. Intragroup analysis showed that in Groups 1 and 2, there was a statistically significant reduction in the measures posttreatment (P < 0.05). Conclusions: Amlexanox provides an earlier onset of pain relief in the treatment of EOLP, whereas providing a comparable reduction in the erosive area compared with triamcinolone. Topical amlexanox appears to be as effective as triamcinolone and is a promising alternative in the management of the erosive lichen planus with minimal adverse effects. [ABSTRACT FROM AUTHOR]

Objective: This research assessed the efficiencies of aloe vera, 0.1% triamcinolone acetonide, and 5% amlexanox in the management of OLP. Materials and Methods: A total of 120 participants diagnosed with oral lichen planus (OLP) were equally divided into three groups and treated with: aloe vera, (Group A), 0.1% triamcinolone acetonide (Group B), and 5% amlexanox (Group C) topical medicaments. The patients were evaluated for pain, using the visual analogue scale (VAS). They were also evaluated for ulcerative lesion type and erosive area on days 1, 7, and 15 of the study. Results: There was a statistically considerable decrease in the VAS pain scale score, reduction in the erosive area on buccal mucosa, and healing of ulcer from day 1st to 15th day with all three tested drugs. Conclusion: All drugs used in this study; aloe vera, triamcinolone acetonide, and amlexanox were effective in treating OLP patients.

Key Clinical Message: Ulcerative lichen planus, a challenging variant of lichen planus, has limited response to traditional treatments. Tofacitinib, a JAK–STAT pathway inhibitor, shows promise in effectively treating these lesions. Lichen planus is a mucocutaneous disease that can cause various manifestations, such as itchy erythematous papules, cicatricial alopecia, erosion, and mucocutaneous ulcers. One uncommon manifestation of this disease is the occurrence of erosion and skin ulcers in the soles of the feet, which can cause many problems for patients. Tofacitinib, a Janus Kinase (JAK) inhibitor drug, has found a special place in the field of inflammatory diseases, especially inflammatory skin diseases. In this regard, studies on the effective role of this drug in the treatment of certain forms of lichen planus, including lichen planopilaris, and erosive lichen planus have been performed. In upcoming study, we introduce a 52‐year‐old woman with lichen planus who complained of ulcerative lesions on the sole of her foot, for whom a diagnosis of plantar ulcerative lichen planus was proposed. After the patient did not respond therapeutically to intralesional triamcinolone acetonide injection, as well as methotrexate and cyclosporine tablets, significant improvement was finally achieved with a 5 mg twice daily dose of tofacitinib. In the following, we will comprehensively review previous articles on the role of tofacitinib in the treatment of lichen planus lesions, as well as the proposed treatment options for erosive and ulcerative lichen planus lesions specifically located on the sole of the foot. Despite limited reports of the successful treatment of mucosal erosive lesions in the oral, esophageal, genital, and ocular mucosa areas with tofacitinib, no previous study has reported the successful treatment of ulcerative lichen planus lesions of the plantar area with tofacitinib. While reporting this case, we recommend considering tofacitinib as a treatment option for plantar ulcerative lichen planus. To confirm its effectiveness, it is necessary to conduct more extensive studies with a larger sample size. [ABSTRACT FROM AUTHOR]

Diffuse dermal angiomatosis (DDA) is a cutaneous reactive angiomatosis. Typically presenting as ulcerated, erythematous, violaceous, or purpuric plaques on the breast or lower extremities, DDA is believed to be a reaction to tissue ischemia. Granuloma inframammary adultorum (GIA) is a type of irritant dermatitis of multifactorial etiology, clinically presenting as papules and nodules. Herein, we report an interesting rash presenting as fungiform papulonodules overlying a large violaceous plaque on the left breast. Biopsy revealed an exuberant epidermal proliferation and a diffuse and deep dermal proliferation, consisting of small slit-like blood vessels in between collagen bundles. In light of these clinical and histopathologic findings in the setting of an indurated plaque on a pendulous breast of a woman with multiple risk factors for local tissue ischemia, a diagnosis of concurrent diffuse angiomatosis of the breast (DDAB) and GIA was rendered. This case highlights the critical importance of clinicopathologic correlation in the diagnosis of multiple diagnostic entities.

Objectives: This study aimed to compare the efficiencies of 0.05% clobetasol propionate, 0.1% triamcinolone acetonide, and 5% amlexanox in the management of oral lichen planus (OLP). Material and Method: A total of 120 patients diagnosed with oral lichen planus were equally divided into three groups and treated with 0.05% clobetasol propionate (group A), 0.1% triamcinolone acetonide (group B), and 5% amlexanox (group C) topical medicaments. The patients were evaluated for pain using the visual analog scale (VAS) and erosive lesion. Results: There was a statistically significant decrease in the VAS pain scale score from day 1 to day 15 in all of the tested groups. There was also a reduction in the erosive area on the right and left buccal mucosa on the 15th day with all three tested drugs. Triamcinolone acetonide (0.1%) was effective in reducing the erosive lesions on buccal mucosa when compared with 0.05% clobetasol propionate and 5% amlexanox. Conclusion: Clobetasol propionate, triamcinolone acetonide, and amlexanox were effective in treating OLP patients.

Objective: This research assessed the efficiencies of aloe vera, 0.1% triamcinolone acetonide, and 5% amlexanox in the management of OLP. Materials and Methods: A total of 120 participants diagnosed with oral lichen planus (OLP) were equally divided into three groups and treated with: aloe vera, (Group A), 0.1% triamcinolone acetonide (Group B), and 5% amlexanox (Group C) topical medicaments. The patients were evaluated for pain, using the visual analogue scale (VAS). They were also evaluated for ulcerative lesion type and erosive area on days 1, 7, and 15 of the study. Results: There was a statistically considerable decrease in the VAS pain scale score, reduction in the erosive area on buccal mucosa, and healing of ulcer from day 1st to 15th day with all three tested drugs. Conclusion: All drugs used in this study; aloe vera, triamcinolone acetonide, and amlexanox were effective in treating OLP patients. [ABSTRACT FROM AUTHOR]

Key Clinical Message Ulcerative lichen planus, a challenging variant of lichen planus, has limited response to traditional treatments. Tofacitinib, a JAK–STAT pathway inhibitor, shows promise in effectively treating these lesions. Abstract Lichen planus is a mucocutaneous disease that can cause various manifestations, such as itchy erythematous papules, cicatricial alopecia, erosion, and mucocutaneous ulcers. One uncommon manifestation of this disease is the occurrence of erosion and skin ulcers in the soles of the feet, which can cause many problems for patients. Tofacitinib, a Janus Kinase (JAK) inhibitor drug, has found a special place in the field of inflammatory diseases, especially inflammatory skin diseases. In this regard, studies on the effective role of this drug in the treatment of certain forms of lichen planus, including lichen planopilaris, and erosive lichen planus have been performed. In upcoming study, we introduce a 52‐year‐old woman with lichen planus who complained of ulcerative lesions on the sole of her foot, for whom a diagnosis of plantar ulcerative lichen planus was proposed. After the patient did not respond therapeutically to intralesional triamcinolone acetonide injection, as well as methotrexate and cyclosporine tablets, significant improvement was finally achieved with a 5 mg twice daily dose of tofacitinib. In the following, we will comprehensively review previous articles on the role of tofacitinib in the treatment of lichen planus lesions, as well as the proposed treatment options for erosive and ulcerative lichen planus lesions specifically located on the sole of the foot. Despite limited reports of the successful treatment of mucosal erosive lesions in the oral, esophageal, genital, and ocular mucosa areas with tofacitinib, no previous study has reported the successful treatment of ulcerative lichen planus lesions of the plantar area with tofacitinib. While reporting this case, we recommend considering tofacitinib as a treatment option for plantar ulcerative lichen planus. To confirm its effectiveness, it is necessary to conduct more extensive studies with a larger sample size.

Objectives: Compare 5% amlexanox, 0.1% triamcinolone acetonide, and 0.03% tacrolimus in the management of oral lichen planus (OLP). Materials and Methods: A received 0.03% tacrolimus, group B received 0.1% triamcinolone acetonide and group C received topical 5% amlexanox. All patients were evaluated for pain on visual analog scale (VAS) and erosive area on day 1, 7, and 15. Results: There was decrease in visual analogue score (VAS) for pain in all tested group after 15 days. There was significant decrease in erosive area in left and right buccal mucosa in all groups after 15 days for inter and intra group comparison. Conclusion: All the drugs used were effective in management of patients with OLP and thus it can be advised to consider these agents as alternatives.

Objective: We attempted to investigate the role of interleukin‐6 (IL‐6) family expression in local tissues as it relates to presentations and outcomes in oral lichen planus (OLP), which is a common chronic inflammatory oral disease. Materials and Methods: A clinical follow‐up cohort of OLP patients was established, and a biological sample library was constructed with categorization into erosive type (EOLP) and nonerosive type (NEOLP). Transcriptome sequencing of the lesions was then performed. A multiple regression model was used to explore the differences in IL‐6 family expression among patients with different clinical types and clinical outcomes. Results: OLP tissue transcriptome sequencing showed that IL‐6 family expression in EOLP increased significantly. It was also found that IL‐6 family factors in the OLP recurrent erosion group were significantly increased compared to the persistent nonerosion group. Based on the multiple regression analysis of the OLP clinical cohort, it was found that the increased expression of the IL‐6 family was closely related to the clinical types and clinical outcomes of OLP. Conclusion: The high expression of the IL‐6 family is closely related to the erosion of local mucosa and poor prognosis of OLP patients. IL‐6‐related factors may be used as therapeutic targets for OLP patients. [ABSTRACT FROM AUTHOR]

Background: One of the crucial factors in the pretreatment analysis of patients with oral squamous cell carcinoma (OSCC) is the detection of the presence of bony invasion. This will indicate aggressiveness, and its patterns may also express the conduct of the lesion. The extent of bony invasion by the tumor will alter the treatment planning and increases the morbidity rate and quality of life. Aim: To evaluate the mandibular invasion patterns in cone beam computed tomography (CBCT) of patients with OSCC. Methodology: A total of 31 CBCT images of OSCC involving the mandible with bony invasion were included and assessed for various invasion patterns. Bony invasion is classified into three patterns: erosive, infiltrative, and mixed. Results: Descriptive analysis was carried out to assess the frequency among various bony invasion patterns. Chi-square test was carried out to find significance between the inferior alveolar nerve canal (IANC) involvement among various patterns of OSCC, which found be to be highly significant. Conclusion: Erosive pattern is the common pattern observed and the mixed pattern was the most frequently associated pattern with the IANC involvement.

Objectives: Compare 5% amlexanox, 0.1% triamcinolone acetonide, and 0.03% tacrolimus in the management of oral lichen planus (OLP). Materials and Methods: A received 0.03% tacrolimus, group B received 0.1% triamcinolone acetonide and group C received topical 5% amlexanox. All patients were evaluated for pain on visual analog scale (VAS) and erosive area on day 1, 7, and 15. Results: There was decrease in visual analogue score (VAS) for pain in all tested group after 15 days. There was significant decrease in erosive area in left and right buccal mucosa in all groups after 15 days for inter and intra group comparison. Conclusion: All the drugs used were effective in management of patients with OLP and thus it can be advised to consider these agents as alternatives. [ABSTRACT FROM AUTHOR]

Background: Fixed drug eruption is a drug reaction characterized by the recurrent occurrence of erosive or ulcerative lesions in skin or mucosa surfaces upon the use of a specific drug. The occurrence of fixed drug eruption in oral mucosa is rare and ill documented. Case report: A 37‐year‐old woman who presented with recurrent erosive lesions in the palatal marginal gingiva of the upper first molars for 3 consecutive months. In anamnesis and follow‐up, the time association with the intake of piroxicam to treat menstrual pain led us to the diagnosis of fixed drug eruption. Conclusion: Piroxicam is a rare culprit drug to fixed drug eruption, especially in oral mucosa. [ABSTRACT FROM AUTHOR]

Objectives: To explore the demographic and clinical profile of erosive lichen planus (ELP) across multiple ethnicities within a single cohort, deepening our understanding of disease severity, progression and outcomes., Methods: A longitudinal retrospective cohort study of ELP patients in the ethnically diverse population of East London was carried out, profiling ELP ( n = 57) against the milder reticular lichen planus (RLP) ( n = 35)., Results: A higher prevalence of ELP was observed in white populations compared to other ethnicities. Affected females were no more likely than males to develop ELP. There was an increased time to diagnosis for ELP patients (median ELP: 452 days, RLP: 312 days), spending longer in primary care before onward referral, in particular when referred by their general medical practitioner (GP) (median dentist 313 days, GP: 606 days). Depression was more likely to occur alongside ELP. Being an ex-smoker is a risk factor for ELP while being a current smoker is associated with RLP. A higher proportion of patients with ELP were missing teeth and had periodontal disease. Multisite involvement was more common in ELP, (ELP: 68% RLP: 11.43%). 55% of ELP cases developed scarring and were less likely to respond to first line medications, requiring systemic immunosuppression. The duration of follow up was increased in the ELP who were reviewed for almost twice as long as RLP patients (ELP 71 months, RLP 35 months)., Conclusion: ELP takes longer to diagnose, requires prolonged tertiary care and is more resistant to treatment, when compared across multiple ethnicities. These patients have increased medical and oral health needs and are at greater risk of scarring than the reticular form. A greater education amongst primary carers on its presentation, as well as a greater understanding of the cellular and molecular mechanisms driving ELP are required to improve diagnostics and identify novel therapeutic approaches., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2024 Macken, Senusi, O’Toole, Caley, Rognoni and Fortune.)

Erosive beverages cause dissolution of natural teeth and intra-oral restorations, resulting in surface characteristic changes, particularly roughness and degradation. The purpose of this study was to evaluate the surface roughness and topography of a dental ceramic following immersion in locally available erosive solutions. A total of 160 disc specimens of a nano-fluorapatite type ceramic (12 mm diameter and 2 mm thickness) were fabricated and equally distributed into two groups (n = 80) and then evenly distributed among the following five testing groups (n = 16): lemon juice, citrate buffer solution, 4% acetic acid, soft cola drink, and distilled water which served as a control. The surface roughness (Ra) and topography were evaluated using a profilometer and scanning electron microscope at baseline, 24 h, 96 h, and 168 h respectively. Data were analyzed using ANOVA and Tukey's multiple comparisons (p ≤ 0.05). Surface changes were observed upon exposure to all acidic beverages except distilled water. Amongst all immersion media, 4% acetic acid produced the most severe surface roughness across all time periods (i.e., baseline, 24 h, 96 h, and 168 h). A statistically significant difference in the surface roughness values between all immersion media and across all four time intervals was observed. Erosive agents had a negative effect on the surface roughness and topography of the tested ceramic. The surface roughness increased with increased storage time intervals. [ABSTRACT FROM AUTHOR]

Abstract Background This study measured the magnitude and determinants of clinical and radiological progression in patients with hand osteoarthritis (HOA) over a 2-year prospective follow-up to gain a greater understanding of the disease time course. Methods Two hundred three consecutive outpatients diagnosed with HOA were followed for 2 years (183 women, median age 69 years). Pain and function were evaluated using the Australian/Canadian Osteoarthritis Hand Index (AUSCAN), and clinical examination recorded the number of painful/swollen joints and nodes. X-rays were scored using Kellgren-Lawrence (KL) and Verbruggen-Veys scales. Clinical progression was defined as deterioration in AUSCAN ≥ the minimal clinically important difference. Radiographic progression was defined as (a) one new erosive/remodeled joint, (b) progression of ≥ one anatomical stage in one joint, or (c) change in KL total score above the smallest detectable difference. Logistic regression was performed to determine whether patient characteristics influenced clinical and radiological progression. Results After 2 years, all radiographic scores deteriorated significantly in the study population (p

Background: Oral lichen planus (OLP) is a chronic inflammatory disorder of the oral mucosa. Currently there is no approved treatment for OLP. We report on the efficacy and safety of a novel mucoadhesive clobetasol patch (Rivelin®‐CLO) for the treatment of OLP. Methods: Patients with confirmed OLP and measurable symptomatic ulcer(s) participated in a randomized, double‐blind, placebo‐controlled, multicenter clinical trial testing a novel mucoadhesive clobetasol patch (Rivelin®‐CLO) in OLP across Europe, Canada, and the United States. Patients were randomized to placebo (nonmedicated), 1, 5, 20 µg Clobetasol/patch, twice daily, for 4 weeks. The primary endpoint was change in total ulcer area compared to baseline. Secondary endpoints included improvement from baseline in pain, disease activity, and quality of life. Results: Data were analyzed and expressed as mean [SD]. One hundred thirty‐eight patients were included in the study; 99 females and 39 males, mean age was 61.1 [11.6] years. Statistical analyses revealed that treatment with 20‐μg Rivelin®‐CLO patches demonstrated significant improvement with ulcer area (p = 0.047), symptom severity (p = 0.001), disease activity (p = 0.022), pain (p = 0.012), and quality of life (p = 0.003) as compared with placebo. Improvement in OLP symptoms from beginning to the end of the study was reported as very much better (best rating) in the 20‐µg group (25/32) patients compared to the placebo group (11/30), (p = 0.012). Adverse events were mild/moderate. Candidiasis incidence was low (2%). Conclusions: Rivelin®‐CLO patches were superior to placebo demonstrating statistically significant, clinically relevant efficacy in objective and subjective improvement and, with a favorable safety profile. [ABSTRACT FROM AUTHOR]

Objectives: This study aimed to compare the efficiencies of 0.05% clobetasol propionate, 0.1% triamcinolone acetonide, and 5% amlexanox in the management of oral lichen planus (OLP). Material and Method: A total of 120 patients diagnosed with oral lichen planus were equally divided into three groups and treated with 0.05% clobetasol propionate (group A), 0.1% triamcinolone acetonide (group B), and 5% amlexanox (group C) topical medicaments. The patients were evaluated for pain using the visual analog scale (VAS) and erosive lesion. Results: There was a statistically significant decrease in the VAS pain scale score from day 1 to day 15 in all of the tested groups. There was also a reduction in the erosive area on the right and left buccal mucosa on the 15th day with all three tested drugs. Triamcinolone acetonide (0.1%) was effective in reducing the erosive lesions on buccal mucosa when compared with 0.05% clobetasol propionate and 5% amlexanox. Conclusion: Clobetasol propionate, triamcinolone acetonide, and amlexanox were effective in treating OLP patients. [ABSTRACT FROM AUTHOR]

Abstract Introduction The present study aimed (a) to evaluate the clinical and radiographic characteristics of hand erosive osteoarthritis (EOA) in a group of consecutive patients, (b) to correlate the severity of radiographic involvement with clinical and laboratory findings and (c) to associate the levels of pain and functional impairment with some radiographic findings. Methods Patients with EOA were consecutively enrolled. Inclusion criteria required the American College of Rheumatology (ACR) criteria for hand osteoarthritis and the presence of at least one joint in “E” or “R” phase according to Verbruggen–Veys. For each patient, demographic and clinical data were collected including evaluation of pain and function with the Australian Canadian Osteoarthritis Hand Index (AUSCAN) scale and Health Assessment Questionnaire (HAQ). Laboratory parameters and plain radiography of both hands were also collected. Each radiograph was evaluated in accordance with the Verbruggen–Veys classification and scored with the Kallman score. Results During the study period 60 patients (M/F 13:47) with EAO were enrolled. More severe radiographic disease (“E” or “R”) was often found at II and III distal interphalangeal (IP) joints. In addition, Kallman score, presence of osteophytes, erosions and joint space narrowing correlated significantly with duration of symptoms, AUSCAN, pain and active joints. More severe radiographic involvement was associated with AUSCAN and with the presence of ankylosis only at proximal IP joints. Conclusion The present study showed that EOA is characterised by a significant correlation between radiographic involvement and some clinical characteristics of the disease. However, an impairment of joint function was mainly associated to radiological proximal IP joint involvement, but not with other symptoms such as pain.

Objectives: The objectives of this study were to compare the serum cortisol level in oral lichen planus (OLP) patients with normal healthy individuals and to compare the serum cortisol level in patients with erosive and nonerosive forms of OLP. Materials and Methods: A case–control study involving 60 patients within the age group of 20–50 years was carried out. Group A included 15 subjects with nonerosive lichen planus, without skin involvement; Group B included 15 subjects with erosive lichen planus, without skin; and Group C included 30 subjects with no apparent lesions of the oral mucosa and the skin. From the cases and controls, 7mL venous blood was taken from median cubital vein two times (between 8 and 10 am, and 4 and 6 pm) by using a 10mL syringe from which 5mL was taken for estimation of serum cortisol. Results: The serum cortisol levels of the erosive OLP patients were significantly higher than those of nonerosive OLP patients and controls. There was no significant difference in the serum cortisol levels between nonerosive OLP in comparison with controls.

Erosive beverages cause dissolution of natural teeth and intra-oral restorations, resulting in surface characteristic changes, particularly roughness and degradation. The purpose of this study was to evaluate the surface roughness and topography of a dental ceramic following immersion in locally available erosive solutions. A total of 160 disc specimens of a nano-fluorapatite type ceramic (12 mm diameter and 2 mm thickness) were fabricated and equally distributed into two groups (n = 80) and then evenly distributed among the following five testing groups (n = 16): lemon juice, citrate buffer solution, 4% acetic acid, soft cola drink, and distilled water which served as a control. The surface roughness (Ra) and topography were evaluated using a profilometer and scanning electron microscope at baseline, 24 h, 96 h, and 168 h respectively. Data were analyzed using ANOVA and Tukey’s multiple comparisons (p ≤ 0.05). Surface changes were observed upon exposure to all acidic beverages except distilled water. Amongst all immersion media, 4% acetic acid produced the most severe surface roughness across all time periods (i.e., baseline, 24 h, 96 h, and 168 h). A statistically significant difference in the surface roughness values between all immersion media and across all four time intervals was observed. Erosive agents had a negative effect on the surface roughness and topography of the tested ceramic. The surface roughness increased with increased storage time intervals.

Introduction: Oxidative stress has been suggested as pathogenesis of oral lichen planus (OLP), implicating the vital role of antioxidants in its treatment. Curcumin, naturally found in turmeric has potent antioxidant and inflammatory properties and can be useful in reducing spread and subsiding burning and pain sensation in patients with OLP. The present study was done to evaluate the role of curcumin in the treatment of symptomatic OLP compared with the control group. Materials and Method: A total of 40 patients with symptomatic OLP were divided into 2 groups of 20 subjects each. Group A was treated with curcumin oral gel and a multivitamin capsule containing zinc, whereas Group B was given multivitamin containing zinc only. Patients were followed-up twice, that is, after 1 month and 3 months. A modified REU (reticulation/keratosis, erythema and ulceration) score for spread and Visual analogue scale for pain/burning sensation was used and the difference of score was calculated by t test. Results: During F1 period, 0.61 (Group A) and 0.19 (Group B) points improvement and in F2 period, the REU score further increased significantly to 1.36 (Group A) and 0.43 (Group B), respectively. The mean score reduction in Visual analogue scale during F1 period was 1.71 and 0.71, which further increased significantly to 2.88 and 1.24 during F2 period in Groups A and B, respectively. Conclusion: Curcumin, an active ingredient of turmeric is commercially available in gel form to treat different oral lesions and significantly effective in reducing spread and providing symptomatic relief in OLP without any adverse effects.

Objectives/hypothesis: Our objective was to identify the accuracy, sensitivity, and specificity of pathological interpretation of mandibular invasion by oral cavity squamous cell carcinoma (SCC) and compare the sensitivity of detecting mandibular invasion in the erosive versus the infiltrative patterns of invasion. We also aimed to describe the significance of the terminology the carcinoma "abuts the mandible" in pathologic interpretation of mandibular invasion.Study Design: Retrospective case series.Methods: Mandibulectomy specimens from patients who underwent surgical treatment for oral cavity SCC between January 1, 2005 and December 31, 2015 were retrospectively reviewed by a board-certified anatomic pathologist. The accuracy of pathologic interpretation of mandibular invasion was calculated using the retrospective interpretation of bone invasion as the true interpretation, which was compared to the interpretation on the original pathology report. Incidence of encountering the terminology the carcinoma "abuts the mandible" in the pathology report was calculated.Results: A series of 108 consecutive mandibulectomy specimens were reviewed. Sixty-nine percent (74/108) of cases were interpreted as having mandibular invasion. The accuracy of interpreting mandibular invasion was 84%. The sensitivities for interpretation of mandibular invasion for the erosive and infiltrative patterns of invasion were 77% (30/39) and 91% (32/35), respectively (P = .08). Nine percent (10/108) of pathology reports utilized the terminology the carcinoma "abuts the mandible," and 80% (8/10) of these cases exhibited mandibular invasion.Conclusions: The accuracy of identifying mandibular invasion is 84%, indicating a certain degree of sampling error and variability in interpretation. A precise pathologic definition of mandibular invasion should be applied during the interpretation of these specimens to minimize variability.Level Of Evidence: 4 Laryngoscope, 130:1721-1724, 2020. [ABSTRACT FROM AUTHOR]

Lichen planus (LP) is a chronic autoimmune condition of uncertain etiopathogenesis and usually affects the skin, oro-genital mucosa, nail and scalp appendages. LP is primarily seen in middle-aged individuals, and oral lesions of LP in children are relatively uncommon. Herewith, we report a case of oral LP in an 8-year-old boy, which regressed well with the treatment modality. [ABSTRACT FROM AUTHOR]

Aim:To determine whether there is an immunogenic connection and antigen difference between the HLA antigens in the erosive (EOLP) and reticular (ROLP) oral lichen planus. Materials and Method: 73 patients with ROLP and EOLP have been tested. Typing of the HLA antigens has been made for locus A and B. The typing of the HLA was conducted with the use of microlymphocyto toxic test by Terasaki. The reading of the findings has been conducted with an inverse microscope. When a reaction has 4 points it is considered to be positive. Results: The most frequently typified antigens in ROLP from locus A are HLA А2 (57.57%) and А3 (33.33)%, and for locus B 21.21%. In EOLP it is А9 (8888%). In locus B a connection has been found with HLA B8 (77.77%). The statistical analysis with the ×2 test has shown that the carriers of HLA A9 display a relative risk (RR) of 3.65 and ×2=20.72. Consequently, there is high static importance for locus A p<0,001. For locus B, In EOLP for HLA B8, RR=6. 7 ×2=37.64 and p<0,001. ROLP has shown association with HLA A3, where RR=2. 31 and ×2 =9.14 and p<0.05. Conclusions: In ROLP A3 antigen and in EOLP A9 and A8 may be considered as carriers with proneness to OLP. [ABSTRACT FROM AUTHOR]

Lichen planus (LP), a chronic inflammatory autoimmune mucocutaneous disease, is affecting about 2% of the population. There are three basic forms of oral LP (OLP) which includes hypertrophic, erythematous, and bullous forms, the erosive form being the second most common form of OLP following the reticular type. This case report reviews the clinical approach to an erosive variant of OLP a case wherein the patient was educated, counselled about the chronicity of the condition and also about its high risk of malignant transformation; immediate biopsy being prompted; followed by the institution of appropriate, timely treatment. [ABSTRACT FROM AUTHOR]

Objectives: This study aimed to compare the efficiencies of 0.05% clobetasol propionate, 0.1% triamcinolone acetonide, and 5% amlexanox in the management of oral lichen planus (OLP)., Material and Method: A total of 120 patients diagnosed with oral lichen planus were equally divided into three groups and treated with 0.05% clobetasol propionate (group A), 0.1% triamcinolone acetonide (group B), and 5% amlexanox (group C) topical medicaments. The patients were evaluated for pain using the visual analog scale (VAS) and erosive lesion., Results: There was a statistically significant decrease in the VAS pain scale score from day 1 to day 15 in all of the tested groups. There was also a reduction in the erosive area on the right and left buccal mucosa on the 15 th day with all three tested drugs. Triamcinolone acetonide (0.1%) was effective in reducing the erosive lesions on buccal mucosa when compared with 0.05% clobetasol propionate and 5% amlexanox., Conclusion: Clobetasol propionate, triamcinolone acetonide, and amlexanox were effective in treating OLP patients., Competing Interests: There are no conflicts of interest., (Copyright: © 2023 Journal of Pharmacy and Bioallied Sciences.)

Erosive pustular dermatosis of the scalp has particular relevance in Australia, due to its association with actinic damage. Despite its rarity, the recalcitrant nature of erosive pustular dermatosis of the scalp dictates a protracted recovery fraught with relapse and recurrence, posing inherent challenges to successful treatment and complete recovery. In Australia, erosive pustular dermatosis of the scalp is prevalent in the elderly, who are negatively affected due to the condition. We propose a management outline to aid clinical practice, to improve the quality of life in the elderly, whilst providing insight into the current understanding and treatment of erosive pustular dermatosis of the scalp. [ABSTRACT FROM AUTHOR]

Objectives: The objectives of this study were to compare the serum cortisol level in oral lichen planus (OLP) patients with normal healthy individuals and to compare the serum cortisol level in patients with erosive and nonerosive forms of OLP. Materials and Methods: A case-control study involving 60 patients within the age group of 20-50 years was carried out. Group A included 15 subjects with nonerosive lichen planus, without skin involvement; Group B included 15 subjects with erosive lichen planus, without skin; and Group C included 30 subjects with no apparent lesions of the oral mucosa and the skin. From the cases and controls, 7mL venous blood was taken from median cubital vein two times (between 8 and 10 am, and 4 and 6 pm) by using a 10 mL syringe from which 5 mL was taken for estimation of serum cortisol. Results: The serum cortisol levels of the erosive OLP patients were significantly higher than those of nonerosive OLP patients and controls. There was no significant difference in the serum cortisol levels between nonerosive OLP in comparison with controls. [ABSTRACT FROM AUTHOR]

Background/Objectives: Erosive oral lichen planus (LP) may be painful and debilitating. Symptomatic oral LP has been treated with a wide spectrum of topical and systemic therapies, but few have been evaluated in large series. Hydroxychloroquine is suggested to be effective in oral LP. Methods: Twenty‐one consecutive patients with erosive, biopsy‐confirmed oral LP were prescribed. hydroxychloroquine sulphate 400 mg/day. Symptomatic improvement was evaluated by means of a visual analogue scale into three groups: no change, moderate to marked improvement and complete remission. Results: Five (24%) patients obtained complete remission, 12 (57%) patients showed moderate to marked improvement, 3 (14%) patients did not improve at all and in one patient therapy was terminated after 1 month due to side effects. Response to therapy was observed after 2–4 months. Side effects which ultimately led to termination of therapy in three patients were elevated creatinine serum levels (after 1 month), visual field defects (after 8 months) and hyperpigmentation (after 24 months). Among six patients who responded to therapy, three flared on stopping. Conclusions: Hydroxychloroquine sulphate may be effective and relatively safe treatment for erosive oral LP. [ABSTRACT FROM AUTHOR]

Introduction: The present study aimed (a) to evaluate the clinical and radiographic characteristics of hand erosive osteoarthritis (EOA) in a group of consecutive patients, (b) to correlate the severity of radiographic involvement with clinical and laboratory findings and (c) to associate the levels of pain and functional impairment with some radiographic findings.Methods: Patients with EOA were consecutively enrolled. Inclusion criteria required the American College of Rheumatology (ACR) criteria for hand osteoarthritis and the presence of at least one joint in "E" or "R" phase according to Verbruggen-Veys. For each patient, demographic and clinical data were collected including evaluation of pain and function with the Australian Canadian Osteoarthritis Hand Index (AUSCAN) scale and Health Assessment Questionnaire (HAQ). Laboratory parameters and plain radiography of both hands were also collected. Each radiograph was evaluated in accordance with the Verbruggen-Veys classification and scored with the Kallman score.Results: During the study period 60 patients (M/F 13:47) with EAO were enrolled. More severe radiographic disease ("E" or "R") was often found at II and III distal interphalangeal (IP) joints. In addition, Kallman score, presence of osteophytes, erosions and joint space narrowing correlated significantly with duration of symptoms, AUSCAN, pain and active joints. More severe radiographic involvement was associated with AUSCAN and with the presence of ankylosis only at proximal IP joints.Conclusion: The present study showed that EOA is characterised by a significant correlation between radiographic involvement and some clinical characteristics of the disease. However, an impairment of joint function was mainly associated to radiological proximal IP joint involvement, but not with other symptoms such as pain. [ABSTRACT FROM AUTHOR]

Highlights • An unusual case of nasopharyngeal stenosis following severe erosive oral lichen planus is described. • Initial surgical management was complicated by recurrent nasopharyngeal stenosis due to the intense underlying inflammatory disease process. • 'Nasal flossing' is described as a novel technique that can be used as an adjunct to prevent recurrence of nasopharyngeal stenosis and has relevance to a broad range of oral and nose and throat physicians. Abstract Introduction We describe a case of severe erosive oral lichen planus that led to nasopharyngeal stenosis. This is a rare clinical presentation that was ultimately, successfully treated by surgery combined with post-operative 'nasal flossing': a novel therapeutic intervention. Presentation of case A 76-year-old male suffering from a rare case of severe oral lichen planus that was resistant to conservative measures is described. Initial surgery was complicated by recurrence of nasopharyngeal stenosis. Definitive surgery required revision of nasopharyngeal stenosis release combined with a course of post- operative 'nasal flossing'. The technique for 'nasal flossing' is described and demonstrated in photographs. The patient remained asymptomatic at 3 years using this combined approach, with restoration of olfaction, taste perception and voice quality, significantly enhancing quality of life. Discussion Erosive oral lichen planus is a rare but important presentation in oral medicine. We found 'nasal flossing' to be a successful treatment to maintain nasopharyngeal patency following surgical repair of this uncommon condition. We are not aware that this combined approach has previously been described in the published literature. Conclusions Severe erosive oral lichen planus can lead to nasopharyngeal stenosis. Nasopharyngeal stenosis in these patients may be refractive to conventional surgical approaches. 'Nasal flossing' is demonstrated to be both practical and acceptable as a surgical adjunct in these difficult to treat cases of recurrent nasopharyngeal stenosis. This report has relevance for all those practicing oral and maxillofacial surgery, ear nose and throat surgery and oral medicine. [ABSTRACT FROM AUTHOR]

Abstract: Oral lichen planus (OLP) is a stress induced inflammatory condition with malignant potency. The mdr1 (multidrug resistance) is a stress gene overexpressed in cancerous conditions and its translated form, the p-glycoprotein efflux transporter is usually overexpressed with chemotherapy, leading to chemoresistance. OLP, a lesion with carcinogenic potency, is broadly classified into the asymptomatic reticular form and the aggressive erosive form. The objective of the study was to verify the expression level of p-glycoprotein in antifungal-treated and untreated reticular OLP, in untreated erosive OLP and erosive OLP patients treated with corticosteroid. Semi-quantitative reverse transcriptase polymerase chain reaction (SQ-RTPCR) and ELISA were performed on biopsy tissue samples to evaluate the mdr1 mRNA and protein expression of p-glycoprotein, respectively. The present study shows for the first time that mdr1 mRNA as well as its translated form p-glycoprotein are overexpressed in OLP subjects compared to healthy individuals. This overexpression is significantly higher in erosive than in reticular OLP patients, further confirming that the erosive form has higher risk for multidrug resistance. A higher expression is also observed in corticosteroid-treated erosive cases than similar untreated ones. The gradation of expression is in conformity with severity of the disease.

Aim: Oral lichen planus (OLP) is a chronic mucocutaneous disease with an immunological etiology. This study was conducted to evaluate the effect of selenium combined with Vitamins A, C & E (Selenium-ACE) in the treatment of erosive-ulcerative OLP as an adjunctive to topical corticosteroids plus antifungal agent. Subjects and Methods: Thirty patients with a confirmed clinical and histopathologic diagnosis of OLP participated in this clinical trial. Patients were randomly allocated into one of three groups and treated as follows: (I) Topical corticosteroids, (II) topical corticosteroids plus antifungal, and (III) SE-ACE combined with topical corticosteroids plus antifungal. The patients were followed for 6 weeks. The pain and severity of the lesions were recorded at the initial and follow-up visits. All recorded data were analyzed using paired t-test and ANOVA test. A P ≤ 0.05 was considered significant. Results: The experimental groups showed a marked reduction in pain sensation and size of lesions, particularly in the final follow-up period, but there was no significant difference between the first two Groups I and II. However, healing of lesions and improvement of pain sensation was effective in Group III since a significant difference was found favoring Group III over both Groups I and II. Conclusion: No significant difference was found in treating erosive-ulcerative lesions of OLP by topical corticosteroids alone or combined with antifungal. However, when using SE-ACE in combination with topical corticosteroids plus antifungal, this approach may be effective in managing ulcerative lesions of OLP; but more research with a larger sample size and a longer evaluation period may be recommended.

Introduction:Oral Lichen Planus(OLP)is a chronic mucocutaneus disease with an immunological etiology. This study was conducted to evaluate the effect of Cedar honey in treatment of erosive- atrophic OLP.Materials and Methods: Thirty patients with confirmed clinical and histopathologic of OLP participated in a randomized clinical trial in Mashhad Dental School.Patients were randomly allocated in two groups. Both groups received the standard treatment of OLP (dexamethasone mouthwash 0.5mg 3 times daily and fluconazole capsule 100 mg daily).Intervention group received Cedar honey (20 ml 3 times daily , swish and swallow technique)in addition to standard treatment. The patients were followed for 4 weeks.The pain and severity of the lesions were recorded at the initial visit and follow ups. All recorded data were analyzed with chi- square, T test, ANOVA using SPSS version 11.5and p-value less than 0.05 was considered significant.Results: Thirty patients were included in the study. Both groups had markedly reduction in pain, size of erosive area and atrophic lesions specially in first follow up but there was not a significant different between two groups (p>0.05). Honey was effective in healing of ulcerative lesions.(The average recovery in experimental group was 69% while the average relief of ulcerative lesion in control group was 50%).but this difference was not significant(p=0.896)Conclusion :No significant difference was found in the treatment of atrophic and erosive lesions of OLP by using honey as an alternative treatment, but it may be effective in ulcerative lesions of OLP , although more research with larger sample size is necessary.

Lichen planus is a chronic autoimmune, mucocutaneous disease, which can affect the oral mucosa, skin, genital mucosa, scalp and nails, and commonly seen in adults. Childhood lichen planus is a rare entity, which is characterized by skin lesions with the oral involvement being extremely uncommon. There are only a few reports on this subject in the literature. Early and correct diagnosis with adequate management is very important to avoid further complications as it is a pre-malignant condition. Herewith, we report a seven-year-old girl having erosive oral lichen planus with cutaneous involvement, which responded well to the treatment. This is to add another case of lichen planus in a child and to emphasize its consideration in the differential diagnosis of oral mucosal red and white lesions in children.

Introduction: Oral Lichen Planus (OLP) is a chronic immunological, mucocutaneous disease with a wide range of clinical appearances. The treatment of oral lichen planus is often difficult and disappointing. Aim: We have studied the efficacy of curcumin, a low molecular weight flavonoid with anti-inflammatory and anti-oxidant activities, in the treatment of OLP. Materials and Methods: In this study, a randomized, doubleblind, placebo-controlled trial was conducted with a total of 20 OLP patients. The patients were randomly divided into two groups, each treated with curcumin tablets at a dose of 2000 mg/day or placebo for a period of four weeks. Furthermore, the patients of both groups received routine treatment for OLP (i.e. Mouthwash Dexamethasone 0.5 mg and suspension Nystatin 100,000 Units). The baseline data were recorded for each patient. Patients were evaluated on day 14 and after completing the course of treatment. Pain and burning sensation were measured based on the Visual Analogue Scale, and the Thongprasom Index was used for clinical improvement and healing. Mann-Whitney and independent t-test were used to compare the responses between the two groups, p-value < 0.05 was considered statistically significant. Results: Our analyses demonstrated no significant difference between the curcumin and placebo treated groups. Conclusion: In conclusion, curcumin had no detectable effect in the treatment of OLP. However, a higher dose of curcumin administration and other forms of curcumin with improved bioavailability may be considered in future studies.