Systemic Lupus Erythemathosus and Oral Lichen Planus overlap syndrome: case report

Authors

DOI:

https://doi.org/10.33448/rsd-v11i6.28978

Keywords:

Overlap Syndrome; Systemic Lupus Erythematosus; Lichen Planus; Teaching.

Abstract

The Overlap Syndrome (OS) associated with Systemic Lupus Erythematosus (SLE) and Lichen Planus (LP), a rare entity, is characterized by a clinical and immunohistopathological signs of both. We report the case of a 39-year-old female patient diagnosed with SLE, presenting with intraoral lesions whose diagnostic hypotheses were Oral Lichen Planus (OLP) and SLE. In this scenario, the present study aimed to describe the pathologies mentioned, as well as to expose the difficulties of the diagnostic process of the overlap syndrome in question, explaining the stages of the disease and the treatment performed. The work was carried out through a case study with descriptive objectives and a qualitative approach using clinical knowledge of dermatology, stomatology and rheumatology, based on bibliographic research and integrative literature review in digital databases with the analysis of complementary, histopathological and immunofluorescence exams. In the biopsy of clinically ambiguous lesions, as in the case of the patient's oral lesions, histopathological features of one or both processes can be found simultaneously or fluctuating at different times, making diagnosis difficult and complicating prognosis and treatment. Thus, it was observed that direct immunofluorescence (DIF) has become an essential tool to aid in the diagnosis of this condition. This case reinforces that OS has a challenging diagnosis and its treatment involves several professionals to manage it.

References

Agência Saúde. (2018, November 23). Lúpus: causas, sintomas, diagnóstico, tratamento e prevenção. Ministério da Saúde. https://antigo.saude.gov.br/saude-de-a-z/lupus

Alrashdan, M. S., Cirillo, N., & McCullough, M. (2016). Oral lichen planus: a literature review and update. Archives of Dermatological Research, 308(8), 539–551.

Alves, V. L. P., Carniel, A. Q., Costallat, L. T. L., & Turato, E. R. (2015). Significados do adoecer para pacientes com lúpus eritematoso sistêmico: revisão da literatura. Revista Brasileira de Reumatologia, 55(6), 522–527.

Aoki, V., Maruta, C., Santi, C. (2016). Dermatoses Bolhosas Autoimunes. V. 2. São Paulo: Editora Atheneu.

Canto, A. et al. (2010). Líquen Plano Oral (LPO): Diagnóstico Clínico e Complementar. Rev. Anais Brasileiros de Dermatologia, São Paulo.

Demirci, G. T., Altunay, I. K., Sarıkaya, S., & Sakiz, D. (2011). Lupus erythematosus and lichen planus overlap syndrome:a case report with a rapid response to topical corticosteroid therapy. Dermatology reports, 3(3), e48.

De Sousa F.A., Rosa L.E.B. (2008). Oral Lichen Planus: clinical and histopathological considerations. Brazilian Journal of Otorhinolaryngology. 74(2):284–292.

Duarte, Artur. (2012). Colagenoses e a Dermatologia. 2ª Edição. Rio de Janeiro: Editora Dilivros.

Eisen D. (1999). The evaluation of cutaneous, genital, scalp, nail, esophageal, and ocular involvement in patients with oral Lichen Planus. Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology, and Endodontics. 88(4):431–436.

Elder, D. et al. (2001). Histopatologia da Pele de Lever. 1ª Edição. São Paulo: Editora Manole.

Fava, Márcia. (2011). Diagnóstico diferencial de lesões orais de líquen plano e lúpus eritematoso por meio de imunoistoquímica e PAS = Differential diagnosis of lichen planus and lupus erythematosus oral lesions using immunohistochemistry and PAS. 2011. 82 f. Tese (Doutorado em Odontologia) - Pontifícia Universidade Católica do Rio Grande do Sul, Porto Alegre.

Ferreira Borba, E., et al (2008). Consenso de Lúpus Eritematoso Sistêmico. Rev Bras Reumatol, 4, 196–207.

Gorouhi F., Firooz A., Khatami A., et al. (2009). Interventions for cutaneous Lichen Planus. Cochrane Database of Systematic Reviews. (4)CD008038.

López-Labady, J., Villarroel Dorrego, M. (2008). Estudio comparativo de lesiones bucales producidas por Liquen Plano y Lupus Eritematoso en un grupo de pacientes venezolanos. Acta Odontológica Venezolana, 46(2), 151-154. Recuperado em 18 de novembro de 2021, de http://ve.scielo.org/scielo.php?script=sci_arttext&pid=S0001-63652008000200008&lng=es&tlng=es.

Lospinoso, D., Fernelius, C., Edhegard, K., Finger, D., & Arora, N. (2013). Lupus erythematosus/lichen planus overlap syndrome: successful treatment with acitretin. Lupus, 22(8), 851–854.

Lourenço, S.V. et al. (2007). Lupus erythematosus: clinical and histopathological study of oral manifestations and immunohistochemical profile of the inflammatory infiltrate. J Cutan Pathol, Copenhagen, v. 34, n.7, p.558-564.

Moreira, C.; Carvalho, M.A. (2001). Reumatologia – diagnóstico e tratamento. 2.ed., Rio de Janeiro: Medsi, 786 p.

Neville, B.W. et al. (2004). Patologia Oral & Maxilofacial. 2.ed., Rio de Janeiro: Guanabara Koogan. 798 p.

Nico, M. M. S., Fernandes, J. D., & Lourenço, S. V. (2011). Líquen plano oral. Anais Brasileiros de Dermatologia, 86(4), 633–643.

Orteu, C.H. et al. (2001). Systemic lupus erythematosus presenting with oral mucosal lesion: easily missed? Br J Dermatol, Oxford, v.144, n.6, p.1219-1223.

Powers, D.B. (2008). Systemic lupus erythematosus and discoid lupus erythematosus. Oral Maxillofac Surg Clin North Am, Philadelphia, v.20, n.4, p.651-662.

Regezi, J.A.; Sciubba, J.J.; Jordan, R.C. (2008). Oral Pathology: Clinical and Pathologic Correlations. 5.ed., St. Louis: Saunders Elsevier, 418 p.

Ribeiro, B., Lyra De Albuquerque, A., Amorim Barroso, K., Sérgio, H., Gonçalves De Carvalho, Sueli, M., & Soares, M. (2010). Marcadores Biológicos e Etiopatogenia do Líquen plano bucal Oral lichen Planus: Etiopathogenesis and Bioma- rkers. Odontol. Clín.-Cient, 9(1), 19–23.

Sil, A., Chakraborty, S., Panigrahi, A., & Mondal, S. (2020). Blaschkoid lichen planus occurring in childhood systemic lupus erythematosus. Pediatric Dermatology, 37(3), 579–581.

Published

26/04/2022

How to Cite

LIRA, R. M. .; OLIVEIRA, C. R. R. de; KOTOVICZ, L. B. de M. .; OMENA, A. M. A. de; ABREU, E. M. V. de; FERREIRA, S. M. S. . Systemic Lupus Erythemathosus and Oral Lichen Planus overlap syndrome: case report. Research, Society and Development, [S. l.], v. 11, n. 6, p. e23911628978, 2022. DOI: 10.33448/rsd-v11i6.28978. Disponível em: https://rsdjournal.org/index.php/rsd/article/view/28978. Acesso em: 20 apr. 2024.

Issue

Section

Health Sciences