Rotim Zeljko, Bolanca Zeljana, Rogulj Ana Andabak, Andabak Matej, Boras Vanja Vucićević, Vrdoljak Danko Velimir
Acta Clin Croat. 2015 Dec;54(4):516-20.
Oral lichen planus (OLP) and oral lichenoid reaction (OLR) are clinically and histopathologically similar diseases. Whereas OLP is a consequence of T cell mediated autoinflammatory process to a still unknown antigen, OLR might be caused by drugs, dental restorative materials and dental plaque. Pubmed was searched and 24 publications published over the last three years regarding etiology, diagnosis and malignant alteration were included in this study. Patients with OLR who have amalgam fillings near lesions should have them replaced, i.e. when possible they should be referred to patch test, as well as when drug-induced OLR are suspected. OLR lesions induced by drugs should disappear when the offending drug has been discontinued. Histology finding in OLR consists of more eosinophils, plasma cells and granulocytes in comparison to OLP lesions. Furthermore, OLP lesions showed more p53, bcl-2 and COX-2 positivity when compared to OLR. OLP is characterized by infiltration, atrophic epithelium, rete pegs and Max Joseph spaces, while deep infiltration into connective tissue and hyperkeratosis were the criteria for making the diagnosis of OLR. The number of degranulated mastocytes in the reticular layer, as well as the number of capillaries was higher in OLR in comparison to OLP. It seems that OLR are more prone to malignant alteration in comparison to OLP.
口腔扁平苔藓（OLP）和口腔苔藓样反应（OLR）在临床和组织病理学上是相似的疾病。OLP是T细胞介导的针对一种仍未知抗原的自身炎症过程的结果，而OLR可能由药物、牙科修复材料和牙菌斑引起。检索了PubMed，并纳入了过去三年发表的24篇关于病因、诊断和恶性改变的出版物。患有OLR且病变附近有汞合金填充物的患者应更换填充物，即尽可能将他们转诊进行斑贴试验，以及在怀疑药物性OLR时。药物引起的OLR病变在停用致病药物后应消失。与OLP病变相比，OLR的组织学表现为嗜酸性粒细胞、浆细胞和粒细胞更多。此外，与OLR相比，OLP病变显示更多的p53、bcl-2和COX-2阳性。OLP的特征是浸润、萎缩性上皮、 rete钉突和Max Joseph间隙，而深层浸润到结缔组织和角化过度是诊断OLR的标准。与OLP相比，OLR网状层中脱颗粒肥大细胞的数量以及毛细血管的数量更高。与OLP相比，OLR似乎更容易发生恶性改变。
