口腔扁平苔藓癌变的临床分析

作者对经临床和组织学确诊的６３３例口腔扁平苔藓患者进行１～１７年随访，有８例扁平苔藓癌变，癌变率为１．３％。其中男性３例，占男性扁平苔藓数的１．６％；女性５例，占女性扁平苔藓数的１．１％。癌变组平均年龄为５０．９岁，病史平均为１０．９年；癌变损害部位分别为颊部、下唇和舌腹缘；损害类型均为糜烂型，１例伴斑块增殖。癌变组术后随访到７例，平均随访３．６年，有２例癌肿复发。     

口腔扁平苔藓416例治疗分析

口腔扁平苔藓(OLP)是口腔粘膜病中最普遍的常见病,它可能产生恶变,而治疗尚有困难。我们于1978年起先后采用中医药及西药单一或联合治疗OLP16例取得一定疗效,现报告如下。 临床资料 一、性别与年龄:本组416例中男197例(47.4％),     

102例口腔扁平苔藓临床治疗回顾性分析

目的探讨口腔扁平苔藓的临床特点和治疗方法。方法回顾性分析102例口腔扁平苔藓患者的临床特点、治疗方法及疗效。结果本研究中患者以女性多见,占55.0%;病损部位以颊黏膜多见,占82.4%;多部位病损患者占73.5%。采用局部和全身联合用药方式,充血糜烂型和溃疡型患者口服硫酸羟氯喹片、白芍总苷胶囊,病损区域基底部行醋酸曲安奈德注射液封闭治疗。反复出现糜烂或溃疡且曲安奈德局部封闭无效者给予他克莫司软膏病损处外用。单纯网纹型患者口服白芍总苷胶囊,局部外用维甲酸软膏。所有患者均给予碳酸氢钠溶液含漱和西吡氯铵含片含服。3个月总有效率为79.4%,6个月为86.3%,1年为88.2%。结论根据口腔扁平苔藓的临床特点采用局部和全身联合用药疗法效果较理想。     

口腔扁平苔藓癌变临床病理分析

口腔扁平苔藓 (ＯｒａｌＬｉｃｈｅｎＰｌａｎｕｓ ;ＯＬＰ)是最常见的口腔粘膜病之一 ,ＯＬＰ是否癌变直接关系到临床治疗方法和患者的预后。自 190 5年Ｂｅｔｔｍａｎ首次报道ＯＬＰ癌变以来 ,国内外学者对之进行了广泛的调查与研究。现将我们 1977～ 1998年间收治的 4例ＯＬＰ发生恶变的病例报告如下。一、材料和方法4例患者均为ＯＬＰ病例 ,2例发展为不典型增生 ,2例恶变为鳞癌 ,癌前后均经病理学证实。 4例患者中男性 1例 ,女性 3例 ,年龄 33岁～ 5 6岁 ,平均 46 .0岁。典型病例 :女 ,33岁。右颊部、右下唇糜烂 8年。 1977年 3月就诊 ,…     

口腔扁平苔藓724例的回顾性分析

目的对口腔扁平苔藓（oral lichen planus，OLP）的临床及病理学特点进行大样本量的研究。方法对上海交通大学医学院附属第九人民医院·口腔医学院口腔黏膜科1978年1月至2006年10月的存档病例进行筛选，选出临床及病理诊断为OLP且半年内至少复诊1次的病例共724例，记录病例的性别、年龄、部位、类型、家族史、病理活检、随访时间、是否癌变及系统性疾病史，并对病例资料进行统计学分析。结果本组OLP病例的随访时间从1个月到259个月（平均随访时间为21个月）。在724例患者中，68．23％是女性，31．77％是男性。OLP的累及部位依次为颊部、舌背、舌腹、唇部、牙龈、腭部、口底。在原发的病损类型中，大部分为斑纹型，占总数的53．82％。病损发生在两个部位以上的OLP患者占总数的48．76％。15例发生了癌变，癌变率为2．07％。结论OLP具有癌变潜能，长时间及规律的随访对于监控OLP的恶性转变过程至关重要。     

口腔扁平苔藓癌变

病例报告例1 喻某某,女,39岁,门诊号24295,住院号18912,因左舌缘溃疡伴白色损害于1979年来我院粘膜病专科门诊就诊。在就诊前2月参加普查时发现舌左缘中份有一小“溃疡”,疼痛明显,进食刺激性食物时疼痛加剧,周围有白色损害。患者认为“溃疡”与月经周期有关。尤其在行经前半月溃疡扩大,疼痛加重。就诊时查:舌左舌缘后份有—1×2cm大小的白色损害区,呈条纹状,粗糙,粘膜充血明显,局部糜烂,压痛,但质软,无硬结,舌质红、舌苔白,脉弦细数。临床诊断:口腔     

口腔扁平苔藓的临床治疗

口腔扁平苔藓(oral lichen planus,OLP)是一种常见的口腔黏膜的慢性炎性疾病,是细胞介导的免疫反应,发病率为0．1％～4％,癌变率为0．4％～3．3％。^[1],在临床上可分为网纹型、丘疹型、斑块型、水疱型、萎缩型和糜烂型6种^[2]。OLP的病因至今尚不十分清楚,其病程慢性迁延,治疗已成为临床上一个相当棘手的问题,目前还没有治愈OLP的方法。本文综述了国外OLP的治疗方法及治疗方案。     

口腔扁平苔藓中药治疗的临床观察

把６２例口腔扁平苔藓患者随机分为二组，一组服用自制的中药，另一组服用磷酸氯喹，用药２－３月后观察临床疗效，结果发现中药组的治疗效果优于磷酸氯喹组，该中药是一种更为有效地治疗口腔扁平苔藓的方法。     

中药治疗口腔扁平苔藓的临床观察

在中医辨证施治原则指导下,应用中药对治疗口腔扁平苔藓患者进行探索,在２３例患者中,痊愈４例,显效５例,好转１１例,明显高于服用磷酸氯喹的对照组。提示中药治疗口腔扁平苔藓作用是肯定的。     

儿童口腔黏膜扁平苔藓临床分析(附6例报告)

口腔扁平苔藓 (OLP)是一种常见口腔黏膜病 ,好发于中年人 ,儿童发病少见。我科收治 6例儿童患者 ,平均年龄 9.8岁 ,男 4例 ,女 2例 ,发病部位在下唇、颊部和舌腹 ,2例为非糜烂型 ,4例为糜烂型 ,采用宁康口内胶 (NT)和 /或康宁克通 -A(KT)局部治疗 ,1例痊愈 ,3例显效 ,2例有效 ,结果表明 ,皮质激素局部治疗对儿童OLP具有肯定的疗效。     

Candida in patients with oral lichen planus

The presence of yeasts in oral lichen planus (OLP) lesions was studied in cultivations from 41 OLP patients and by histological examination in 39 of these cases. The histological features of OLP were also recorded. The cultivation results were compared with those of a randomly selected, age- and sex-matched control group without mucosal changes. The extent of growth was recorded as "sparse" (1-10 colonies), "model-rate" (11-40 colonies), or "heavy" (greater than 40 colonies). Yeasts were found to be present on cultures or histologic sections from a total of 19 OLP patients (46%). "Moderate-heavy" growth was obtained in 29% of the OLP cases but in only 7% of the control group. Candida albicans accounted for over 80% of the yeasts. The histological examination revealed only 3 cases of invasive fungal growth. Regarding the criteria of OLP, hyperortho- or hyperparakeratosis and a band-shaped subepithelial infiltration of lymphocytes were present in all specimens, basilar liquefaction degeneration in 87% and an eosinophilic zone in 77%. Local treatment with amphotericin B (Fungizone) in 18 OLP patients with positive findings resulted in subjective relief of symptoms in 89% of the patients. Clinical improvement was seen in 94%. The presence of Candida was significantly correlated to low secretion rate in unstimulated saliva.     

A clinical study of 205 patients with oral lichen planus.

Two hundred and five patients with oral lichen planus were divided into two groups: those with only reticular lesions (group 1) and those with atrophic-erosive lesions with or without concomitant reticular lesions (group 2). A comparative study of the two groups showed that the most commonly affected oral location in both was the buccal mucosa. Lesions of the tongue, gingiva, lip, and palate predominated in group 2. Likewise, chronic liver disease and diabetes were more common in the second group, as was extension of the oral lesions (P less than .001).     

A clinical study of 674 patients with oral lichen planus in China

BACKGROUND: Oral lichen planus (OLP) is a chronic inflammatory disease with different clinical presentations that can be classified as reticular, atrophic or erosive. Although OLP is a relatively common disorder, the reports comprising large numbers of OLP patients with specific character are lacking in the literature. The purpose of this paper was to describe the clinical characteristics of OLP in 674 Chinese patients. METHODS: A total of 674 charts of patients with histologically confirmed OLP were collected from Stomatological Hospital of Wuhan University between 1963 and 2003. RESULTS: Of the 674 patients, 65.9% were women and 34.1% were men. The most common clinical presentation was the reticular type (51.3%), and symptomatic OLP was noted in 67.5% of the patients, mainly in those with the erosive form. The erosive presentations showed significantly longer duration, more sites affected and a much greater old patients predominance than reticular or atrophic ones. About 90.9% of the patients had multiple oral sites of involvement and isolated lower lip lichen planus were observed in 60 cases (8.9%) and isolated gingiva lichen in only one case (0.2%). Skin involvement of lichen planus was found in 11.4% of patients. No statistically significant differences could be identified between OLP and diabetes, cardiovascular disease, smoking or alcohol use. Precipitating factors that resulted in an exacerbation of the disease were frequently noted and included foods, stress, dental cusp and poor oral hygiene. The transformation of OLP into malignancy was observed in four patients at sites previously diagnosed by clinical examination as erosive or atrophic lichen planus. CONCLUSIONS: Patients with OLP in China usually present with distinctive clinical morphology and characteristic distribution and few may display lesions with a confusing array of forms mimicking other diseases. A long time follow up is of utmost importance to detect its malignant transformation.     

The characteristics of oral lichen planus

Lichen is a chronic, mucocutan disease with unknown origin. Oral lesions are usually bilateral, the most frequent location of the reticular form is the posterior part of the buccal mucosa. It undergo only rarely spontaneous remission, and it has a potential to turn into malignant tumor. It is hypothesized that due to an antigen-specific mechanism, auto-cytotoxic T-cells infiltrates the affected region. T-lymphocytes induces apoptosis in the keratinocytes of the basal epithelium. Since etiology is unknown, there is no cure for lichen. The symptomatic treatment has been focused on reducing the subjective discomfort and to maintain or improve the quality of life. The main course of therapy are topical retinoids, locally given steroids, but immunosuppressive therapies have been also tried. Data about exact etiology, diagnostical criteria and effective treatment are still limited. Therefore, besides the early detection of the disease, symptomatic treatment, and the close observation of dysplastic lesions is recommended.     

The management of oral lichen planus

OBJECTIVE: To review the current literature regarding the medical treatment of oral lichen planus (OLP).DATA SOURCES: PubMed on-line Medline data searches were carried out for the years 1966-1998 to identify reports on therapy of OLP.METHODS OF STUDY SELECTION: Single case reports or open trials were included if they covered new therapeutic approaches or suggested significant modifications of known treatment modalities. Review papers were limited to those dealing with the topic.DATA EXTRACTION AND SYNTHESIS: Every paper was critically examined. Because of the great heterogeneity of the response criteria, many data could not be directly compared. Stronger weight was given to therapies that have proven to be effective under placebo-controlled research protocols. Attention was also drawn to potential and effective adverse effects of every drug used.CONCLUSIONS: Among the various medications advocated for the treatment of OLP, several lack conclusive findings from adequately controlled trials. Mainly high-potency topical corticosteroids in an adhesive medium appear at present the safest and most efficacious. Adjuvant agents as antimycotics may be useful in topical steroid treatment. Systemic corticosteroids may be occasionally indicated for severe recalcitrant erosive OLP or for diffuse mucocutaneous involvement. Topical cyclosporine should be considered in steroid-unresponsive cases considering that its efficacy in OLP could be related to a systemic effect and its high cost. Classical PUVA therapy seems to have too many side effects; topical application of psoralen is promising but still experimental. Topically and systemically delivered retinoids combined with topical corticosteroids could improve the efficacy of these agents whereas complete remission is difficult to achieve with retinoids alone and they frequently cause adverse effects. Finally, there are only few data concerning the long-term effect of the medical treatments upon the course of OLP and we do not know if therapy influences the malignant evolution of OLP.