Sufiawati Irna, Megawati Ani, Al Farisyi Muhammad, Putra I Nyoman Gede Juwita
Department of Oral Medicine, Faculty of Dentistry, Padjajaran University, Indonesia.
Oral Medicine Residency Program, Faculty of Dentistry, Padjadjaran University, Indonesia.
Case Rep Dent. 2022 Oct 6;2022:1915122. doi: 10.1155/2022/1915122. eCollection 2022.
Oral lichen planus (OLP) is a chronic inflammatory disease of the oral mucosa with unknown etiology. Suggested predisposing factors for the development of OLP include genetic factors, viral infections, psychological stress, trauma, drug intake, and some systemic diseases. This serial case aimed to evaluate the psychological stress in triggering various types of OLP and its management. . Six patients, four females and two males with an age range from 23 to 57 years, came to an oral medicine clinic with chief complaints of chronic pain and burning sensations in the oral cavity. All cases showed typical clinical features of OLP on the oral mucosa, including reticular, plaque-like, erosive, and ulcerative lesions. An incisional biopsy was performed in some cases and the histopathology features confirmed the diagnosis of OLP with no signs of dysplasia/malignancy. According to the Depression, Anxiety, Stress Scale (DASS)-21, the patients had different levels of depression ranging from mild to severe; 3 patients were considered to have moderate anxiety and others had severe anxiety; and 5 patients experienced mild stress and 1 patient had moderate stress. The patients were given corticosteroids, supportive therapy, and psychological counseling. All patients experienced significant improvement of the lesions after treatment.
Psychological stressors play an essential role as a risk factor in the development of OLP. Therefore, management of OLP encompasses not only an appropriate treatment of the lesions but also psychological intervention.
口腔扁平苔藓（OLP）是一种病因不明的口腔黏膜慢性炎症性疾病。OLP发生的潜在诱发因素包括遗传因素、病毒感染、心理压力、创伤、药物摄入以及一些全身性疾病。本系列病例旨在评估心理压力在引发各类OLP中的作用及其管理。6名患者，4名女性和2名男性，年龄在23至57岁之间，因口腔慢性疼痛和烧灼感前来口腔内科就诊。所有病例在口腔黏膜上均表现出OLP的典型临床特征，包括网状、斑块状、糜烂性和溃疡性病变。部分病例进行了切取活检，组织病理学特征证实为OLP诊断，无发育异常/恶性迹象。根据抑郁、焦虑、压力量表（DASS）-21，患者有不同程度的抑郁，从轻度到重度；3名患者被认为有中度焦虑，其他患者有重度焦虑；5名患者经历轻度压力，1名患者有中度压力。给予患者皮质类固醇、支持性治疗和心理咨询。所有患者治疗后病变均有显著改善。
心理压力作为OLP发生的危险因素起着至关重要的作用。因此，OLP的管理不仅包括对病变的适当治疗，还包括心理干预。
