Department of Dentistry, Far Eastern Memorial Hospital, New Taipei City, Taiwan; Graduate Institute of Clinical Dentistry, School of Dentistry, National Taiwan University, Taipei, Taiwan; Department of Dentistry, National Taiwan University Hospital, College of Medicine, National Taiwan University, Taipei, Taiwan; Graduate Institute of Oral Biology, School of Dentistry, National Taiwan University, Taipei, Taiwan.
Graduate Institute of Clinical Dentistry, School of Dentistry, National Taiwan University, Taipei, Taiwan; Department of Dentistry, National Taiwan University Hospital, College of Medicine, National Taiwan University, Taipei, Taiwan; Graduate Institute of Oral Biology, School of Dentistry, National Taiwan University, Taipei, Taiwan.
J Formos Med Assoc. 2018 Sep;117(9):756-765. doi: 10.1016/j.jfma.2018.01.021. Epub 2018 Feb 19.
Oral lichen planus (OLP) is a chronic inflammatory oral mucosal disease that occurs more frequently in middle-aged and elderly female patients. Previous studies indicate that OLP is a T-cell dysfunction-induced localized autoimmune disease. Clinically, six types of OLP, namely reticular, papular, plaque-like, atrophic/erosive, ulcerative, and bullous types, can be identified. OLP more commonly affects buccal mucosa, tongue, and gingiva. It always has a bilateral and symmetric distribution of the oral lesions. Plaque-like and atrophic/erosive OLP may be misdiagnosed as oral leukoplakia and oral erythroleukoplakia, respectively. Our previous study found serum autoantibodies in 195 (60.9%) of the 320 OLP patients. Specific serum anti-nuclear, anti-smooth muscle, anti-mitochondrial, gastric parietal cell, thyroglobulin, and thyroid microsomal autoantibodies are present in 28.1%, 8.4%, 1.6%, 26.3%, 21.3%, and 24.4% of 320 OLP patients, respectively. Furthermore, we also discovered that 21.9%, 13.6%, 7.1%, 0.3%, and 14.8% of 352 OLP patients have hemoglobin, iron, vitamin B12, and folic acid deficiencies, and abnormally high serum homocysteine level, respectively. Therefore, it is very important to examine the serum autoantibody, hematinic and homocysteine levels in OLP patients before starting the treatments for OLP patients. Because OLP is an immunologically-mediated disease, corticosteroids are the drugs of choice for treatment of OLP.
口腔扁平苔藓（OLP）是一种常见于中年和老年女性患者的慢性炎症性口腔黏膜疾病。先前的研究表明，OLP 是一种 T 细胞功能障碍引起的局部自身免疫性疾病。临床上，OLP 可分为网状型、丘疹型、斑块状、萎缩/糜烂型、溃疡性和水疱型六种类型。OLP 更常影响颊黏膜、舌和牙龈。口腔病变通常呈双侧对称分布。斑块状和萎缩/糜烂型 OLP 可能分别误诊为口腔白斑病和口腔红斑病。我们之前的研究发现 320 例 OLP 患者中有 195 例（60.9%）存在血清自身抗体。在 320 例 OLP 患者中，分别有 28.1%、8.4%、1.6%、26.3%、21.3%和 24.4%存在特异性血清抗核、抗平滑肌、抗线粒体、胃壁细胞、甲状腺球蛋白和甲状腺微粒体自身抗体。此外，我们还发现 352 例 OLP 患者中有 21.9%、13.6%、7.1%、0.3%和 14.8%分别存在血红蛋白、铁、维生素 B12、叶酸缺乏和血清同型半胱氨酸水平升高。因此，在开始治疗 OLP 患者之前，检查 OLP 患者的血清自身抗体、血液学和同型半胱氨酸水平非常重要。因为 OLP 是一种免疫介导的疾病，皮质类固醇是治疗 OLP 的首选药物。
