Publication: Evolución clínica y seguimiento del liquen plano oral
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2016-04-18
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Universidad Complutense de Madrid
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Abstract
El liquen plano oral (LPO) es una enfermedad inflamatoria crónica de afectación mucocutánea. La prevalencia del LPO es de 1,2% en la población general, con una predilección por el sexo femenino, relación mujer/ hombre de 2:1, y en un rango de edad de inicio de las lesiones de entre los 30 y 60 años, siendo la media de edad en el comienzo entorno a los 50 años. Se considera una patología de base autoinmune y de etiología incierta, existe un mecanismo inmunológico mediado por células que origina la destrucción de la capa basal del epitelio, acompañado de un infiltrado intenso de linfocitos T a nivel subepitelial. Existen varios factores que favorecen la aparición de los brotes en LPO, y algunos de ellos se intentan relacionar con su etiología. Las manifestaciones orales únicas tienen una prevalencia del 25% mientras que el porcentaje mayoritario de los pacientes presentan lesiones cutáneas de liquen con lesiones asociadas en cavidad oral (40%). Las formas clínicas en boca pueden ser reticulares, en placa o atrófico-erosivas, siendo las más comunes la reticular y la atrófico-erosiva. La localización principal de las lesiones suele ser en mucosa yugal bilateral posterior, y la sintomatología se origina preferentemente en pacientes con formas atrófico-erosivas. Para el diagnóstico del LPO, se deben tener en cuenta criterios clínicos e histológicos que deben cumplirse de forma simultánea, ya que si no se denominará como lesión liquenoide oral (LLO), que tienen aspectos clínicos indistinguibles a los del LPO, afectan a la mucosa oral y no cumplen simultáneamente o no cumplen alguno de los criterios clinicopatológicos establecidos para el LPO. Se deben hacer diagnósticos diferenciales con patologías como leucoplasias, eritroplasia pénfigo o penfigoide entre otros...
Oral lichen planus (OLP) is a chronic inflammatory disease of mucocutaneous involvement. OLP prevalence is 1.2% in the general population, with a predilection for the female, female / male ratio of 2: 1, and in a range of age of onset of lesions of between 30 and 60 years, with an average age at onset of around 50 years. It is considered an autoimmune disease of unknown etiology base and there is a cell-mediated immunological mechanism which causes the destruction of the basal layer of the epithelium, accompanied by an intense infiltration of T lymphocytes to subepithelial level. Several factors affect the incidence of outbreaks in OLP, and some of them try to relate to its etiology. Exclusive oral manifestations have a prevalence of 25%, while the majority percentage of patients have skin lesions associated with lichen in oral cavity (40%) lesions. The clinical forms may be reticulated mouth, plaque or atrophic-erosive, the most common being the reticular and atrophic-erosive. The main location of the lesions is usually in bilateral posterior buccal mucosa, and preferably causes symptoms in patients with atrophic-erosive. For the diagnosis of OLP, should take into account clinical and histological criteria to be met simultaneously, since otherwise be referred to as oral lichenoid lesions (OLL), which are indistinguishable to the OLP clinical, affecting the mucosa oral and not simultaneously meet or do not meet any of the clinicopathological criteria for the LPO. Differential diagnosis should be made with conditions such as leukoplakia, pemphigus or pemphigoid erythroplakia among others...
Oral lichen planus (OLP) is a chronic inflammatory disease of mucocutaneous involvement. OLP prevalence is 1.2% in the general population, with a predilection for the female, female / male ratio of 2: 1, and in a range of age of onset of lesions of between 30 and 60 years, with an average age at onset of around 50 years. It is considered an autoimmune disease of unknown etiology base and there is a cell-mediated immunological mechanism which causes the destruction of the basal layer of the epithelium, accompanied by an intense infiltration of T lymphocytes to subepithelial level. Several factors affect the incidence of outbreaks in OLP, and some of them try to relate to its etiology. Exclusive oral manifestations have a prevalence of 25%, while the majority percentage of patients have skin lesions associated with lichen in oral cavity (40%) lesions. The clinical forms may be reticulated mouth, plaque or atrophic-erosive, the most common being the reticular and atrophic-erosive. The main location of the lesions is usually in bilateral posterior buccal mucosa, and preferably causes symptoms in patients with atrophic-erosive. For the diagnosis of OLP, should take into account clinical and histological criteria to be met simultaneously, since otherwise be referred to as oral lichenoid lesions (OLL), which are indistinguishable to the OLP clinical, affecting the mucosa oral and not simultaneously meet or do not meet any of the clinicopathological criteria for the LPO. Differential diagnosis should be made with conditions such as leukoplakia, pemphigus or pemphigoid erythroplakia among others...
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Tesis inédita de la Universidad Complutense de Madrid de la Facultad de Odontología del Departamento de Estomatología IV, leída el 17-12-2015