Diode laser treatment is effective for plaque-like lichen planus of the tongue: a case report
| Autor: | Serena Cernuschi, Marialuisa Valente, Stefano Sivolella, Mario Berengo |
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| Rok vydání: | 2011 |
| Předmět: |
Pathology
medicine.medical_specialty Mucocutaneous zone Population terapia laser Dermatology lichen della mucosa orale Tongue Diseases Tongue medicine Humans Medical history Local anesthesia Oral mucosa education Direct fluorescent antibody Leukoplakia education.field_of_study business.industry Lichen Planus Middle Aged medicine.disease medicine.anatomical_structure Surgery Female Lasers Semiconductor business |
| Zdroj: | Lasers in medical science. 27(2) |
| ISSN: | 1435-604X |
| Popis: | IntroductionLichen planus is a chronic mucocutaneous disease thatoften affects the oral mucosa and tongue, without involvingthe skin. It affects 1–2% of the general population. Its causeis unknown in most cases. It is classifiable by severalclinical features. The atrophic and erosive forms may bepainful. The reticular and plaque-like forms are the mostcommon, affecting almost 60% of patients. The mostfrequently affected site is the tongue [1]. The diagnosisrelies on clinical and histological evidence in associationwith direct immunofluorescence. OLP treatment dependson the related symptoms. Numerous drugs have been usedwith variable results, but topical corticosteroids remain themainstay of therapy [2]. The use of laser therapies in theoral cavity has also gained acceptance for the treatment ofpremalignant oral lesions, such as leukoplakia. Many typesof laser are now available. Mona Soliman [3] and Cafaro[4] reported using the diode laser on OLP. Here, the authorsdescribe a case of OLP characterized by raised, plaque-like,keratotic lesions on the dorsum of the tongue that provedrefractory to conventional therapy, but were effectivelytreated with the diode laser with no clinical evidence ofrecurrence 18.6 months after starting the laser treatment.Case descriptionA 49-year-old woman came to our attention with atrophic,white plaque-like oral lesions, particularly on the tongue,which had persisted for 10 years.She reported soreness and a burning sensation on thetonguebuttheproblemsheconsideredmostimportantwasthecosmetic effect. Her medical history was positive for arthritis.She was taking COX-2 selective inhibitors (Etoricoxib,Tauxib, Sigma Tau, Rome, Italy) as necessary and localcorticosteroid infiltration treatments once or twice a year. Theorallesionshaddevelopedbeforeshestartedbeingtreatedforarthritis.Examination of the oral cavity revealed mild marginalgingivitis, severe plaque and tartar accumulation, whitekeratotic lines (Wickham’s striae) interlacing with erythema-tousareasandmultifocalerosivelesions,locatedbilaterallyonthe posterior buccal mucosa, Wickham’s striae on the ventraland lateral portions of the tongue, and atrophic and plaque-like lesions ranging from flat to raised areas on the dorsum ofthe tongue (Fig. 1). In particular, the dorsal surface of thetongue showed four areas of depapillation and a whitepapular patch measuring approximately 1.0 × 0.7 cm. Therewere no lesions on the floor of the mouth. Furtherexamination revealed no cutaneous lesions. The symptomsof tongue discomfort were periodical events. Routinehematological investigations and biochemistry yielded nega-tive results.Two incisional biopsies, approximately 5 mm in diam-eter, were obtained under local anesthesia, one from the |
| Databáze: | OpenAIRE |
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