Immunofluorescence in diagnosing Oral Lichen Planus.

Geertman, S.J. (2015) Immunofluorescence in diagnosing Oral Lichen Planus. thesis, Dentistry.

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Abstract

Background: Oral Lichen Planus (OLP) can be diagnosed based on several clinical criteria, which are highly variable. In the Dutch ‘Guideline Lichen Planus’ histopathology is the golden standard for additional research. The WHO criteria of 1978 have never been validated. Direct immunofluorescence (DIF) tests are used in the University Medical Centre Groningen (UMCG) to diagnose OLP. Objectives: To determine whether the Dutch ‘Guideline Lichen Planus’ (Dutch criteria) is followed by the department of Oral and Maxillofacial Surgery in the UMCG. To assess the additional value of direct immunofluorescence (DIF) in the process of diagnosing OLP. Methods: We included 358 patients from the medical database of the UMCG, who had a biopsy between June 2002 and January 2015 and where OLP was in the differential diagnosis. The patients, treated at the Department of Oral and Maxillofacial Surgery were scored on several clinical, histopathological and DIF features. The UMCG diagnostic work-up was compared with the ‘Dutch criteria’, ‘WHO criteria’ and the ‘Modified WHO criteria’. The additional diagnostic value of DIF was examined. Results: The ‘Dutch criteria’ are followed in 23.3% of the patients diagnosed with OLP by the clinicians in the UMCG. When DIF is used additionally to histopathology for differentiating OLP from OLL, 3.26 times more patients are diagnosed with OLP. The use of Levothyroxine was found in 11.5% of the patients with OLP or OLL. Conclusion: The Dutch ‘Guideline Lichen Planus’ is not always fully followed by the clinicians in the UMCG. The addition of DIF to the original ‘Dutch criteria’ would diagnose OLP in more patients. When the diagnostic work-up used in the UMCG is compared with abovementioned diagnostic criteria, there is a dramatic shift in the diagnosis of OLP to OLL. An additional finding was a high percentage of patients with OLP or OLL using suppletion of thyroid hormone.

Item Type:	Thesis (Thesis)
Supervisor name:	Witjes, Dr. M.J.H. and Schepman, Dr. K.P. and Delli, Drs. K.
Faculty:	Medical Sciences
Date Deposited:	25 Jun 2020 10:44
Last Modified:	25 Jun 2020 10:44
URI:	https://umcg.studenttheses.ub.rug.nl/id/eprint/561

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