ΑΝΕΠΑΡΚΕΙΑ (7)
oral Lichen planus (7)
1. 2014
evaluated the serum zinc level in 22 patients with erosive lichen planus and 22 patients with non erosive lichen planus and 44 healthy individuals and concluded that serum zinc levels were reduced in patients with lichen planus (and the lower, the worse the disease severity).
22 patients with erosive oral lichen planus, 22 patients with non erosive OLP and 44 healthy individuals as the control group.
Results: The mean serum zinc levels in the erosive and non erosive lichen planus groups and control groups were 8.3 (1.15), 11.15 (0.92) and 15.74 (1.75) μg/dl respectively. The difference was statistically significant (p< 0.05).
Conclusion: The serum zinc levels were decreased in patients with erosive oral lichen planus. This finding may probably indicate the promising role of zinc in development of oral lichen planus.
Gholizadeh N, Mehdipour M, Najafi Sh, Bahramian A, Garjani Sh, Khoeini Poorfar H. Evaluation of the serum zinc level in erosive and non-erosive oral lichen planus. J Dent (Shiraz). 2014 Jun;15(2):52-6. PMID: 24883340; PMCID: PMC4033083.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4033083/
2.-3.-4. 2016
- 52 patients with OLP(36 women and 16 men) were enrolled and 48 self-admitted healthy people.
Results: The mean±SD of serum zinc in case group was6.4±1.02 and in control group was 12.1±1.5 µg/dl, respectively. There were significant difference between two groups.P<0.01
Conclusion: Results of this study showed that plasma levels of zinc in OLP patients were lower than those in healthy subjects.
Azizi A, Alaee A. Comparison of serum zinc in lichen planus patients and healthy subjects. J Res Dent Sci 2016; 12 (4) :182-185 URL: http://jrds.ir/article-1-733-en.html
https://jrds.ir/browse.php?a_id=733&sid=1&slc_lang=en
- 14.0% (8/57) of patients with OLP were zinc deficient
Serum zinc levels in 368 patients with oral mucosal diseases: A preliminary study
https://pubmed.ncbi.nlm.nih.gov/27031065/
- With increasing severity of the clinical course is observed a significant decrease in the level of zinc.
The Role of Mineral Elements in The Pathogenesis of Lichen Planus of The Oral Mucosa. Sergey Vasilevich Chuykin*, Gyuzel Maratovna Akmalova, Oleg Sergeyevich Chuykin, Natalia Vyacheslavovna Makusheva, and Galina Grigoryevna Akatyeva
https://www.rjpbcs.com/pdf/2016_7(6)/[89].pdf
5. 2018
40 patients with OLP and 40 healthy control subjects.
Mean Zn concentration was lower in patients with erosive lichen planus compared to the non-erosive group and the healthy controls. However, only the difference between erosive lichen planus patients and healthy participants was significant.
Plasma level of trace elements in patients with oral lichen planus, Fahimeh Rezazadeh, MD 1 Mahshid Sokhakian
http://www.iranjd.ir/article_98352_aa5abe7c46e2e467df0cf3b69745d4a5.pdf
6. 2019
In this study serum Cu and Zn levels can be used as early diagnostic markers for the malignant transformation of OPMDs such as lichen planus.
Garg R, Gupta VV, Dicksit DD. Analysis of serum zinc and copper levels in patients with oral potentially malignant disorders: A cross-sectional study. J Int Oral Health 2019;11:208-12
https://www.jioh.org/article.asp?issn=0976-7428;year=2019;volume=11;issue=4;spage=208;epage=212;aulast=Garg
7. 2020
reduced levels of zinc have been reported in OLP patients
Gholizadeh N, Sheykhbahaei N. Micronutrients Profile in Oral Lichen Planus: a Review Literature. Biol Trace Elem Res. 2021 Mar;199(3):912-924. doi: 10.1007/s12011-020-02221-9. Epub 2020 Jun 12. PMID: 32533293.
https://pubmed.ncbi.nlm.nih.gov/32533293/
ΑΝΤΙΜΕΤΩΠΙΣΗ : 2 κλινικές δοκιμές (100 ασθενείς) + 3 case reports
oral Lichen planus
1. 2018
The present study aims at evaluation of serum Zn level in study case and controls.
30 patients with erosive oral lichen planus, non erosive lichen planus and 30 healthy individuals as the control group.
In a patient with clinically and histopathologically confirmed case of oral lichen planus 20mg Zinc is given once a daily from baseline, 15 days, 30 days and 45 days.
Conclusion: As duration of zinc intake increases, the mean serum zinc level increases and symptoms of pain (NRS) decreases.
The serum zinc level affects the change in symptoms scale.
As the mean serum Zinc level increases from base line (0 day) to 45th day of treatment, the ulceration in study subjects reduces in size and intensity.
Time bound evaluation of role of serum zinc level in clinical types of oral lichen planus and its co-relation with associated sign and symptoms Author: Akhilanand Chaurasia., Amit Chaudhary., Kaleem Ahmad and Harshita Singh
https://journalijcar.org/issues/time-bound-evaluation-role-serum-zinc-level-clinical-types-oral-lichen-planus-and-its-co
https://journalijcar.org/sites/default/files/issue-files/8318-RW-2018.pdf
2. 2019
The present case series describes the use of supplements (oral zinc acetate 50 mg) in patients having symptomatic oral lichen planus with favorable outcome in terms of size of lesion and global index score
- The patient's VAS was 10/10 during the first visit which gradually decreased to 1/10 and a 90% decrease in the size of the lesion was noticed after 8 weeks of treatment.
At follow up visit of 2 months after stopping treatment, there was no recurrence of burning sensation and complete resolution of lesion was observed.
Similar results for rest 2 patients.
- oral zinc acetate 50 mg twice daily may be an effective treatment modality in patients of oral lichen planus.
Zinc sulfate has many adverse effects such as nausea, stomach upset, and heartburn and rare adverse effects include fever, sore throat, mouth sores, weakness, and fatigue, compared with zinc acetate. Hence, in our present cases, zinc acetate was given to patients for treatment of oral lichen planus.
- Significant decrease in burning sensation, pain, and lesion size was observed. Also, there was no recurrence of lesion and no rebound effect was noticed.
- There was a significant decrease in VAS and the size of the lesion in all the three patients. No recurrence of lesions or burning sensation was observed at follow up visits till 2 months after stopping treatment. / It is noteworthy that there were reports with rebound effect of lesions with steroids. In the present case series, there was no recurrence of lesion and no rebound effect was noticed. The major limitation of this case series, was that zinc serum levels was not monitored or correlated with response.
- Further prospective studies with larger sample are recommended.
The present case series describes the use of oral zinc acetate (50 mg) in patients having symptomatic oral lichen planus with favorable outcome in terms of size of lesion and global index score.
- A 52-year-old male. The burning sensation assessed by visual analog scale (VAS) was 10/10, and the size of the lesion was assessed by global index scale.
The patient's VAS was 10/10 during the first visit which gradually decreased to 1/10 in a span of 8 weeks.
The size and number of the lesions : a 90% decrease in the size of the lesion was noticed after 8 weeks.
At follow up visit of 2 months after stopping treatment, there was no recurrence of burning sensation and complete resolution of lesion.
- A 45-year-old female patient was 80% decrease in size of the lesion during the 8 weeks follow up according to global index scale, besides that VAS decreased from 10/10 to 1/10 in a span of 8 weeks.
- A 48-year-old female patient : the size of the lesion was decreased by 90%, besides that VAS decreased from 10/10 to 1/10 in a span of 8 weeks.
Chaitanya NC, Chintada S, Kandi P, Kanikella S, Kammari A, Waghamare RS. Zinc Therapy in Treatment of Symptomatic Oral Lichen Planus. Indian Dermatol Online J. 2019 Mar-Apr;10(2):174-177. doi: 10.4103/idoj.IDOJ_230_18. PMID: 30984596; PMCID: PMC6434769.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6434769/
3. This study aimed to compare the efficacy of a combination of oral zinc acetate 50 mg tablets and the 0.1% triamcinolone acetonide Orabase with Orabase alone in the healing process of symptomatic oral lichen planus (OLP).
40 patients were randomly included in the study and were categorized into 2 groups, each comprised 20 patients.
Group A (control group) received the 0.1% triamcinolone acetonide Orabase 2 times daily.
Group B (case group) received 50 mg zinc acetate tablets plus Ora-base 2 times daily for 8 weeks. Orabase was discontinued after 1 week of application in the case group, whereas zinc acetate tablets were continued throughout the treatment period.
Conclusions: Oral zinc therapy was found to be an adjunct in reducing burning sensation and lesion size in symptomatic OLP.
- - -
Group A patients had received 0.1% triamcinolone acetonide Orabase twice daily application after food.
Group B patients had provided with oral zinc 50 mg tablets + 0.1% triamcinolone acetonide Orabase twice daily after food for 8 weeks. Steroid Orabase was discontinued after 1-week application, whereas oral zinc 50 mg was continued for all over the treatment period.
The follow-up period for both the groups was 6 months.
Thongprasom et al., 1992, had given scoring for the clinical assessment of the lesion for both objective and subjective findings which include scores
0 for no lesion,
1 for mild white striae with no erythematous area,
2 for white striae with atrophic area <1 cm2,
3 for white striae with atrophic area more than 1 cm2,
4 for white striae with erosive area <1 cm2, and
5 for white striae with erosive area more than 1 cm2 for the objective findings of the lesion,
whereas score 0 for not cured lesions and 1 for cured lesions with no inflammation or erythematous areas, no white striae or very mild striae, and no other symptoms.[11,12]
The scores obtained by the visual analog scale for burning sensation and Thongprasom scale for clinical assessment of size of the lesion of both case and control groups were subjected to statistical analysis.
- - -
A comparative study between oral zinc therapy with or without steroid application in symptomatic oral lichen planus: a randomized controlled trial Pundarikakshaiah Deveneni Suvarna Chintada Nallan C.S.K. Chaitanya Kavya Alluri Sourab Abhyankar Jaya Surya Kondapaneni DOI:https://doi.org/10.1016/j.oooo.2019.07.057
https://europepmc.org/article/MED/32002387
oral Lichen planus (7)
1. 2014
evaluated the serum zinc level in 22 patients with erosive lichen planus and 22 patients with non erosive lichen planus and 44 healthy individuals and concluded that serum zinc levels were reduced in patients with lichen planus (and the lower, the worse the disease severity).
22 patients with erosive oral lichen planus, 22 patients with non erosive OLP and 44 healthy individuals as the control group.
Results: The mean serum zinc levels in the erosive and non erosive lichen planus groups and control groups were 8.3 (1.15), 11.15 (0.92) and 15.74 (1.75) μg/dl respectively. The difference was statistically significant (p< 0.05).
Conclusion: The serum zinc levels were decreased in patients with erosive oral lichen planus. This finding may probably indicate the promising role of zinc in development of oral lichen planus.
Gholizadeh N, Mehdipour M, Najafi Sh, Bahramian A, Garjani Sh, Khoeini Poorfar H. Evaluation of the serum zinc level in erosive and non-erosive oral lichen planus. J Dent (Shiraz). 2014 Jun;15(2):52-6. PMID: 24883340; PMCID: PMC4033083.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4033083/
2.-3.-4. 2016
- 52 patients with OLP(36 women and 16 men) were enrolled and 48 self-admitted healthy people.
Results: The mean±SD of serum zinc in case group was6.4±1.02 and in control group was 12.1±1.5 µg/dl, respectively. There were significant difference between two groups.P<0.01
Conclusion: Results of this study showed that plasma levels of zinc in OLP patients were lower than those in healthy subjects.
Azizi A, Alaee A. Comparison of serum zinc in lichen planus patients and healthy subjects. J Res Dent Sci 2016; 12 (4) :182-185 URL: http://jrds.ir/article-1-733-en.html
https://jrds.ir/browse.php?a_id=733&sid=1&slc_lang=en
- 14.0% (8/57) of patients with OLP were zinc deficient
Serum zinc levels in 368 patients with oral mucosal diseases: A preliminary study
https://pubmed.ncbi.nlm.nih.gov/27031065/
- With increasing severity of the clinical course is observed a significant decrease in the level of zinc.
The Role of Mineral Elements in The Pathogenesis of Lichen Planus of The Oral Mucosa. Sergey Vasilevich Chuykin*, Gyuzel Maratovna Akmalova, Oleg Sergeyevich Chuykin, Natalia Vyacheslavovna Makusheva, and Galina Grigoryevna Akatyeva
https://www.rjpbcs.com/pdf/2016_7(6)/[89].pdf
5. 2018
40 patients with OLP and 40 healthy control subjects.
Mean Zn concentration was lower in patients with erosive lichen planus compared to the non-erosive group and the healthy controls. However, only the difference between erosive lichen planus patients and healthy participants was significant.
Plasma level of trace elements in patients with oral lichen planus, Fahimeh Rezazadeh, MD 1 Mahshid Sokhakian
http://www.iranjd.ir/article_98352_aa5abe7c46e2e467df0cf3b69745d4a5.pdf
6. 2019
In this study serum Cu and Zn levels can be used as early diagnostic markers for the malignant transformation of OPMDs such as lichen planus.
Garg R, Gupta VV, Dicksit DD. Analysis of serum zinc and copper levels in patients with oral potentially malignant disorders: A cross-sectional study. J Int Oral Health 2019;11:208-12
https://www.jioh.org/article.asp?issn=0976-7428;year=2019;volume=11;issue=4;spage=208;epage=212;aulast=Garg
7. 2020
reduced levels of zinc have been reported in OLP patients
Gholizadeh N, Sheykhbahaei N. Micronutrients Profile in Oral Lichen Planus: a Review Literature. Biol Trace Elem Res. 2021 Mar;199(3):912-924. doi: 10.1007/s12011-020-02221-9. Epub 2020 Jun 12. PMID: 32533293.
https://pubmed.ncbi.nlm.nih.gov/32533293/
ΑΝΤΙΜΕΤΩΠΙΣΗ : 2 κλινικές δοκιμές (100 ασθενείς) + 3 case reports
oral Lichen planus
1. 2018
The present study aims at evaluation of serum Zn level in study case and controls.
30 patients with erosive oral lichen planus, non erosive lichen planus and 30 healthy individuals as the control group.
In a patient with clinically and histopathologically confirmed case of oral lichen planus 20mg Zinc is given once a daily from baseline, 15 days, 30 days and 45 days.
Conclusion: As duration of zinc intake increases, the mean serum zinc level increases and symptoms of pain (NRS) decreases.
The serum zinc level affects the change in symptoms scale.
As the mean serum Zinc level increases from base line (0 day) to 45th day of treatment, the ulceration in study subjects reduces in size and intensity.
Time bound evaluation of role of serum zinc level in clinical types of oral lichen planus and its co-relation with associated sign and symptoms Author: Akhilanand Chaurasia., Amit Chaudhary., Kaleem Ahmad and Harshita Singh
https://journalijcar.org/issues/time-bound-evaluation-role-serum-zinc-level-clinical-types-oral-lichen-planus-and-its-co
https://journalijcar.org/sites/default/files/issue-files/8318-RW-2018.pdf
2. 2019
The present case series describes the use of supplements (oral zinc acetate 50 mg) in patients having symptomatic oral lichen planus with favorable outcome in terms of size of lesion and global index score
- The patient's VAS was 10/10 during the first visit which gradually decreased to 1/10 and a 90% decrease in the size of the lesion was noticed after 8 weeks of treatment.
At follow up visit of 2 months after stopping treatment, there was no recurrence of burning sensation and complete resolution of lesion was observed.
Similar results for rest 2 patients.
- oral zinc acetate 50 mg twice daily may be an effective treatment modality in patients of oral lichen planus.
Zinc sulfate has many adverse effects such as nausea, stomach upset, and heartburn and rare adverse effects include fever, sore throat, mouth sores, weakness, and fatigue, compared with zinc acetate. Hence, in our present cases, zinc acetate was given to patients for treatment of oral lichen planus.
- Significant decrease in burning sensation, pain, and lesion size was observed. Also, there was no recurrence of lesion and no rebound effect was noticed.
- There was a significant decrease in VAS and the size of the lesion in all the three patients. No recurrence of lesions or burning sensation was observed at follow up visits till 2 months after stopping treatment. / It is noteworthy that there were reports with rebound effect of lesions with steroids. In the present case series, there was no recurrence of lesion and no rebound effect was noticed. The major limitation of this case series, was that zinc serum levels was not monitored or correlated with response.
- Further prospective studies with larger sample are recommended.
The present case series describes the use of oral zinc acetate (50 mg) in patients having symptomatic oral lichen planus with favorable outcome in terms of size of lesion and global index score.
- A 52-year-old male. The burning sensation assessed by visual analog scale (VAS) was 10/10, and the size of the lesion was assessed by global index scale.
The patient's VAS was 10/10 during the first visit which gradually decreased to 1/10 in a span of 8 weeks.
The size and number of the lesions : a 90% decrease in the size of the lesion was noticed after 8 weeks.
At follow up visit of 2 months after stopping treatment, there was no recurrence of burning sensation and complete resolution of lesion.
- A 45-year-old female patient was 80% decrease in size of the lesion during the 8 weeks follow up according to global index scale, besides that VAS decreased from 10/10 to 1/10 in a span of 8 weeks.
- A 48-year-old female patient : the size of the lesion was decreased by 90%, besides that VAS decreased from 10/10 to 1/10 in a span of 8 weeks.
Chaitanya NC, Chintada S, Kandi P, Kanikella S, Kammari A, Waghamare RS. Zinc Therapy in Treatment of Symptomatic Oral Lichen Planus. Indian Dermatol Online J. 2019 Mar-Apr;10(2):174-177. doi: 10.4103/idoj.IDOJ_230_18. PMID: 30984596; PMCID: PMC6434769.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6434769/
3. This study aimed to compare the efficacy of a combination of oral zinc acetate 50 mg tablets and the 0.1% triamcinolone acetonide Orabase with Orabase alone in the healing process of symptomatic oral lichen planus (OLP).
40 patients were randomly included in the study and were categorized into 2 groups, each comprised 20 patients.
Group A (control group) received the 0.1% triamcinolone acetonide Orabase 2 times daily.
Group B (case group) received 50 mg zinc acetate tablets plus Ora-base 2 times daily for 8 weeks. Orabase was discontinued after 1 week of application in the case group, whereas zinc acetate tablets were continued throughout the treatment period.
Conclusions: Oral zinc therapy was found to be an adjunct in reducing burning sensation and lesion size in symptomatic OLP.
- - -
Group A patients had received 0.1% triamcinolone acetonide Orabase twice daily application after food.
Group B patients had provided with oral zinc 50 mg tablets + 0.1% triamcinolone acetonide Orabase twice daily after food for 8 weeks. Steroid Orabase was discontinued after 1-week application, whereas oral zinc 50 mg was continued for all over the treatment period.
The follow-up period for both the groups was 6 months.
Thongprasom et al., 1992, had given scoring for the clinical assessment of the lesion for both objective and subjective findings which include scores
0 for no lesion,
1 for mild white striae with no erythematous area,
2 for white striae with atrophic area <1 cm2,
3 for white striae with atrophic area more than 1 cm2,
4 for white striae with erosive area <1 cm2, and
5 for white striae with erosive area more than 1 cm2 for the objective findings of the lesion,
whereas score 0 for not cured lesions and 1 for cured lesions with no inflammation or erythematous areas, no white striae or very mild striae, and no other symptoms.[11,12]
The scores obtained by the visual analog scale for burning sensation and Thongprasom scale for clinical assessment of size of the lesion of both case and control groups were subjected to statistical analysis.
- - -
A comparative study between oral zinc therapy with or without steroid application in symptomatic oral lichen planus: a randomized controlled trial Pundarikakshaiah Deveneni Suvarna Chintada Nallan C.S.K. Chaitanya Kavya Alluri Sourab Abhyankar Jaya Surya Kondapaneni DOI:https://doi.org/10.1016/j.oooo.2019.07.057
https://europepmc.org/article/MED/32002387