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口腔扁平苔藓(OLP):临床与辅助诊断

Oral lichen planus (OLP): clinical and complementary diagnosis.

作者信息

Canto Alan Motta do, Müller Helena, Freitas Ronaldo Rodrigues de, Santos Paulo Sérgio da Silva

机构信息

Oral and Maxillofacial Surgery Service, Santa Casa de Sao Paulo, Brazil.

出版信息

An Bras Dermatol. 2010 Sep-Oct;85(5):669-75. doi: 10.1590/s0365-05962010000500010.

Abstract

Lichen planus is a common disorder of the stratified squamous epithelium that affects oral and genital mucous membranes, skin, nails, and scalp. Oral Lichen Planus (OLP) affects middle-aged women and shows distribution patterns and characteristics such as white striations, white plaques or papules, erythema, blisters and erosions, and may be associated with medication and/or dental materials used by the patient. The clinical diagnosis can only be made if the disease presents classical patterns such as concomitant lesions in the oral mucosa and skin. The laboratory diagnosis is histopathologically characterized by the presence of projections of the epithelium in the form of sawtooth and Civatte bodies and allows the exclusion of dysplasia and malignancy. Direct immunofluorescence is used when there is suspicion of other diseases, such as pemphigus and pemphigoid. OLP is treated with anti-inflammatory agents, particularly topical corticosteroids; new agents and techniques have proved effective. The malignant transformation of OLP and its exact incidence remain controversial. This work aims at presenting, through literature review, the etiopathogenesis, clinical diagnosis, laboratory tests, and complications of OLP.

摘要

扁平苔藓是一种常见的复层鳞状上皮疾病,可累及口腔和生殖器黏膜、皮肤、指甲及头皮。口腔扁平苔藓(OLP)好发于中年女性,具有白色条纹、白色斑块或丘疹、红斑、水疱及糜烂等分布模式和特征,可能与患者使用的药物和/或牙科材料有关。只有当疾病呈现出如口腔黏膜和皮肤同时出现病变等典型模式时,才能做出临床诊断。实验室诊断的组织病理学特征为上皮呈锯齿状突起及出现基底层液化变性小体,并可排除发育异常和恶性肿瘤。当怀疑有其他疾病,如天疱疮和类天疱疮时,需进行直接免疫荧光检查。OLP采用抗炎药物治疗,尤其是局部用皮质类固醇;新的药物和技术已被证明有效。OLP的恶变及其确切发生率仍存在争议。本文旨在通过文献综述介绍OLP的病因发病机制、临床诊断、实验室检查及并发症。

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