山东大学：《口腔组织病理学》课程教学资源（课件讲稿）第十三章 口腔黏膜病 扁平苔鲜

少水子 1901 ONG UN SHANDONG UNIVERSITY 扁平苔藓 LICHED LLGDNUS Department of Oral Pathology, Shandong University

Department of Oral Pathology, Shandong University 扁平苔藓

Lichen planus 扁平苔藓( lichen Planus,LP) common cutaneomucosal diseases Wilson first report(1869) about 44% skin lichen planus associated With oral mucosa lesion Some patients the lesion only involves oral mucosa Department of Oral Pathology, Shandong University

Department of Oral Pathology, Shandong University 2 Lichen planus 扁平苔藓 (lichen Planus，LP) common cutaneomucosal diseases Wilson first report (1869) About 44% skin lichen planus associated with oral mucosa lesion Some patients the lesion only involves oral mucosa

Etiology】 Genetic predisposition H ypersensitivity to Infective agents dental materials Systemic diseases Tobacco smoking Graft-versus-host Tobacco and /or betel seases chewing Drug reactions Ⅴ itamin deficiedcies Psychiatric disorders Department of Oral Pathology, Shandong University

Department of Oral Pathology, Shandong University 3 【 Etiology 】 Genetic predisposition Infective agents Systemic diseases Graft-versus-host diseases Drug reactions  Hypersensitivity to dental materials  Tobacco smoking  Tobacco and /or betel chewing  Vitamin deficiedcies  Psychiatric disorders

Etiology】 近年的研究表明,免疫调节异常与本 病的发生密切相关,特别是T细胞介导的 免疫反应对本病的发病起了重要作用。 随着疾病的进展,不仅辅助性T细 胞增多,而且抑制性T细胞也增多,但B 细胞与自然杀伤细胞很少出现。 Department of Oral Pathology, Shandong University

Department of Oral Pathology, Shandong University 近年的研究表明，免疫调节异常与本 病的发生密切相关，特别是T细胞介导的 免疫反应对本病的发病起了重要作用。 随着疾病的进展，不仅辅助性T细 胞增多, 而且抑制性T细胞也增多，但B 细胞与自然杀伤细胞很少出现。 【 Etiology 】 4

Etiology】 这表明由于T细胞被激活,产生了多 种细胞因子(如IL-4、ⅡL-6、TNF-等) 促进了T细胞介导的免疫反应过程。 T细胞功能缺陷或降低,是本病的 项客观检测标志。 Department of Oral Pathology, Shandong University

Department of Oral Pathology, Shandong University 这表明由于T细胞被激活，产生了多 种细胞因子(如IL-4、IL-6、TNF-α等)， 促进了T细胞介导的免疫反应过程。 T细胞功能缺陷或降低，是本病的一 项客观检测标志。 【 Etiology 】 5

(Clinical features) a The prevalence about 0.5 per cent Females account for at least 65 of patients Patients usually over 40 years old (40-49 Untreated disease can persist for 10 or more years Department of Oral Pathology, Shandong University

Department of Oral Pathology, Shandong University 6 【Clinical features】  The prevalence about 0.5 per cent  Females account for at least 65% of patients  Patients usually over 40 years old (40-49)  Untreated disease can persist for 10 or more years

(Clinical features) Common sites are ■ Buccal mucosa a Dorsum of tongue Gingiva p Palate Lesions usually bilateral and often symmetrical Cutaneous lesions only occasionally associated a Usually good response to corticosteroids Department of Oral Pathology, Shandong University

Department of Oral Pathology, Shandong University 7 【Clinical features】 Common sites are:  Buccal mucosa  Dorsum of tongue  Gingiva  Lip  Palate Lesions usually bilateral and often symmetrical Cutaneous lesions only occasionally associated Usually good response to corticosteroids

(Clinical features) Clinical ty pe Reticular lace-like striae Atrophy diffuse red lesion resembling erythoplakia Plaque-like --white plaque resembling leukoplakia Papular --smal white papules that may coalesce Erosive extensive areas of shallow ulceration Bullous --subepithellal bulla Department of Oral Pathology, Shandong University

Department of Oral Pathology, Shandong University 8 【Clinical features】 Clinical type: Reticular --lace-like striae Atrophy --diffuse red lesion resembling erythoplakia Plaque-like --white plaque resembling leukoplakia Papular --smal white papules that may coalesce Erosive --extensive areas of shallow ulceration Bullous --subepithelial bullea

Department of Oral Pathology, Shandong University

Department of Oral Pathology, Shandong University 9

327 Department of Oral Pathology, Shandong University 10

Department of Oral Pathology, Shandong University 10