CC BY 4.0 · Eur J Dent 2024; 18(02): 510-516
DOI: 10.1055/s-0043-1772247
Original Article

The Correlation between Oral Lichen Planus and Thyroid Pathologies: A Retrospective Study in a Sample of Italian Population

1   Department of Neurosciences, Reproductive and Odontostomatological Sciences, Maxillofacial Surgery Unit, University Federico II, Naples, Italy
,
2   Department of Experimental and Clinical Medicine, Maxillofacial Surgery Unit, “Magna Graecia” University, Catanzaro, Italy
,
2   Department of Experimental and Clinical Medicine, Maxillofacial Surgery Unit, “Magna Graecia” University, Catanzaro, Italy
,
2   Department of Experimental and Clinical Medicine, Maxillofacial Surgery Unit, “Magna Graecia” University, Catanzaro, Italy
,
2   Department of Experimental and Clinical Medicine, Maxillofacial Surgery Unit, “Magna Graecia” University, Catanzaro, Italy
› Author Affiliations

Abstract

Objectives The association between oral lichen planus and thyroid disorders, especially hypothyroidism and Hashimoto's thyroiditis, has been discussed in current literature with conflicting outcomes.

Materials and Methods The study retrospectively evaluated the thyroid status in patients diagnosed with oral lichen planus and oral lichenoid lesions. A case–control approach was used to prove that thyroid disorders were statistically significant risk factors for oral lichen planus and oral lichenoid lesions.

Statistical Analysis To evaluate these associations, odds ratios (ORs) were used. ORs precision and statistical significance were estimated using a 95% confidence interval (CI) and p-value, respectively.

Results A total of 307 patients were involved in the study: 158 females and 149 males. OR, 95% CIs, and p-values were analyzed. Patients with thyroid diseases showed an increased risk of developing oral lichen planus (OR: 4.29, 95% CI: 1.85–9.96, p-value: 0.0007) and oral lichenoid lesions (OR: 2.76, 95% CI: 1.24–6.13, p-value: 0.0129). This association was maintained in patients with oral lichen planus, while also considering hypothyroidism (OR: 3.74, 95% CI: 1.46–9.58, p-value: 0.0059) and Hashimoto's thyroiditis (OR: 4.57, 95% CI: 1.58–13.23, p-value: 0.005) alone. The correlation of hypertension, diabetes, dyslipidemia, and smoking status with oral lichen planus and oral lichenoid lesions was also evaluated but no statistical significance was found.

Conclusion Even if further investigations are needed, the association between oral lichen planus and oral lichenoid lesions with thyroid pathologies should be taken into consideration by endocrinologists due to the potential malignancy of these disorders.

Ethics Approval Statement

The study protocol of the current study was reviewed and approved by the Research Ethics Committee of the “Magna Graecia” University of Catanzaro.


Patient Consent Statement

The treatment of patients was in line with the Declaration of Helsinki 2013 and each patient signed informed consent.




Publication History

Article published online:
20 September 2023

© 2023. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/)

Thieme Medical and Scientific Publishers Pvt. Ltd.
A-12, 2nd Floor, Sector 2, Noida-201301 UP, India

 
  • References

  • 1 Arduino PG, Karimi D, Tirone F. et al. Evidence of earlier thyroid dysfunction in newly diagnosed oral lichen planus patients: a hint for endocrinologists. Endocr Connect 2017; 6 (08) 726-730
  • 2 Novembre D, Barca I, Cordaro R, Kallaverja E, Ferragina F, Cristofaro MG. Malignant transformation of oral lichen planus. A retrospective analysis from 2003-2014: our experience. Ann Ital Chir 2020; 91: 445-450
  • 3 Achararit P, Manaspon C, Jongwannasiri C, Phattarataratip E, Osathanon T, Sappayatosok K. Artificial intelligence-based diagnosis of oral lichen planus using deep convolutional neural networks. Eur J Dent 2023; 17 (04) 1275-1282
  • 4 Conrotto D, Barattero R, Carbone M. et al. Can atrophic-erosive oral lichen planus promote cardiovascular diseases? A population-based study. Oral Dis 2018; 24 (1-2): 215-218
  • 5 Boisnic S, Frances C, Branchet MC, Szpirglas H, Le Charpentier Y. Immunohistochemical study of oral lesions of lichen planus: diagnostic and pathophysiologic aspects. Oral Surg Oral Med Oral Pathol 1990; 70 (04) 462-465
  • 6 Porter SR, Kirby A, Olsen I, Barrett W. Immunologic aspects of dermal and oral lichen planus: a review. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 1997; 83 (03) 358-366
  • 7 Kurago ZB. Etiology and pathogenesis of oral lichen planus: an overview. Oral Surg Oral Med Oral Pathol Oral Radiol 2016; 122 (01) 72-80
  • 8 Regezi DDS MS JA, Sciubba DMD JJ, Jordan DDS. FRCD FRCPath RC. Oral Pathology.; 2017 DOI: 10.1016/C2013-0-06961-7
  • 9 Alrashdan MS, Alkhader M. Psychological factors in oral mucosal and orofacial pain conditions. Eur J Dent 2017; 11 (04) 548-552
  • 10 van der Meij EH, Schepman KP, de Visscher JG. Oral medicine 9. Lichen planus en lichenoïde afwijkingen van het mondslijmvlies [Oral medicine 9. Lichen planus and lichenoid lesions of the oral mucosa]. Ned Tijdschr Tandheelkd 2013; 120 (09) 477-482
  • 11 Garcia-Pola MJ, Llorente-Pendás S, Seoane-Romero JM, Berasaluce MJ, García-Martín JM. Thyroid disease and oral lichen planus as comorbidity: a prospective case-control study. Dermatology 2016; 232 (02) 214-219
  • 12 Robledo-Sierra J, Landin-Wilhelmsen K, Nyström HF, Mattsson U, Jontell M. Clinical characteristics of patients with concomitant oral lichen planus and thyroid disease. Oral Surg Oral Med Oral Pathol Oral Radiol 2015; 120 (05) 602-608
  • 13 Siponen M, Huuskonen L, Läärä E, Salo T. Association of oral lichen planus with thyroid disease in a Finnish population: a retrospective case-control study. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2010; 110 (03) 319-324
  • 14 Lo Muzio L, Santarelli A, Campisi G, Lacaita M, Favia G. Possible link between Hashimoto's thyroiditis and oral lichen planus: a novel association found. Clin Oral Investig 2013; 17 (01) 333-336
  • 15 Lavaee F, Majd M. Evaluation of the association between oral lichen planus and hypothyroidism: a retrospective comparative study. J Dent (Shiraz) 2016; 17 (01) 38-42
  • 16 Mustafa MB, Porter SR, Smoller BR, Sitaru C. Oral mucosal manifestations of autoimmune skin diseases. Autoimmun Rev 2015; 14 (10) 930-951
  • 17 van der Meij EH, Schepman KP, van der Waal I. The possible premalignant character of oral lichen planus and oral lichenoid lesions: a prospective study. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2003; 96 (02) 164-171
  • 18 Tang Y, Shi L, Jiang B, Zhou Z, Shen X. A cross-sectional study of oral lichen planus associated with thyroid diseases in East China. Front Endocrinol (Lausanne) 2020; 10: 928
  • 19 Wu P, Luo S, Zhou T. et al. Possible mechanisms involved in the cooccurrence of oral lichen planus and Hashimoto's thyroiditis. Mediators Inflamm 2020; 2020: 6309238
  • 20 Zhou T, Li D, Chen Q, Hua H, Li C. Correlation between oral lichen planus and thyroid disease in China: a case-control study. Front Endocrinol (Lausanne) 2018; 9: 330
  • 21 Chang JYF, Chiang CP, Hsiao CK, Sun A. Significantly higher frequencies of presence of serum autoantibodies in Chinese patients with oral lichen planus. J Oral Pathol Med 2009; 38 (01) 48-54
  • 22 Lin SC, Sun A. HLA-DR and DQ antigens in Chinese patients with oral lichen planus. J Oral Pathol Med 1990; 19 (07) 298-300
  • 23 Compilato D, Paderni C, Di Fede O, Gulotta G, Campisi G. Association of oral lichen planus with thyroid disease in a Finnish population: a retrospective case-control study: “A different finding from a Mediterranean area”. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2011; 111 (01) 12-14
  • 24 Vučićević Boras V, Savage NW, Brailo V. et al. The significance of oral and systemic factors in Australian and Croatian patients with oral lichen planus. Acta Dermatovenerol Croat 2014; 22 (02) 97-102
  • 25 Kats L, Goldman Y, Kahn A, Goldman V, Gorsky M. Oral lichen planus and thyroid gland diseases: possible associations. BMC Oral Health 2019; 19 (01) 169
  • 26 Hasan S, Ahmed S, Kiran R, Panigrahi R, Thachil JM, Saeed S. Oral lichen planus and associated comorbidities: an approach to holistic health. J Family Med Prim Care 2019; 8 (11) 3504-3517
  • 27 Li D, Li J, Li C, Chen Q, Hua H. The association of thyroid disease and oral lichen planus: a literature review and meta-analysis. Front Endocrinol (Lausanne) 2017; 8: 310
  • 28 Shahbaz M, Kazmi F, Majeed HA, Manzar S, Qureshi FA, Rashid S. Oral manifestations: a reliable indicator for undiagnosed diabetes mellitus patients. Eur J Dent 2022; 17 (03) 784-789