Oral Lichen Planus in a Patient with Ectodermal Dysplasia and Undifferentiated Connective Tissue Disease
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Published:
Dec 24, 2018
Keywords:
Oral lichen planus, ectodermal dysplasia, undifferentiated connective tissue disease
Main Article Content
Abstract
Oral lichen planus is a common mucocutaneous disorder presented in oral medicine clinic. Although, mostly affected mucosa and occasionally skin, sometimes this lesion probably lead to the diagnosis of systemic disease which manifest similarly in oral cavity. This case report presented the female patient who had been diagnosed with ectodermal dysplasia, presented with mucosal lesion clinically consistent with oral lichen planus. Since she had several systemic abnormality, the oral manifestation from systemic disorder was suspected. Further investigations were performed, leading to the diagnosis of undifferentiated connective tissue disease and subsequent appropriate treatment.
Article Details
How to Cite
1.
Okuma N, Maipanich S, Panpradit N. Oral Lichen Planus in a Patient with Ectodermal Dysplasia and Undifferentiated Connective Tissue Disease. M Dent J [Internet]. 2018 Dec. 24 [cited 2024 Nov. 18];38(3):249-65. Available from: https://he02.tci-thaijo.org/index.php/mdentjournal/article/view/179118
Section
Review articles
References
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3. do Canto AM, de Freitas RR, Müller H, da Silva Santos PS. Oral lichen planus (OLP): clinical and complementary diagnosis. An Bras Dermatol. 2010;85:669-75.
4. Müller S. Oral lichenoid lesions: distinguishing the benign from the deadly. Mod Pathol. 2016; 30:S54-S67.
5. Deshmukh S, Prashanth S. Ectodermal dysplasia: a genetic review. Int J Clin Pediatr Dent. 2012;5:197-202.
6. Visinoni AF, Lisboa-Costa T, Pagnan NAB, Chautard-Freire-Maia EA. Ectodermal dysplasia: clinical and molecular review. Am J Med Genet A. 2009;149:1980-2002.
7. Singh CGP, Saxena LCV. Case report hypohidrotic ectodermal dysplasia. Med J Armed Forces India. 2015;71:S530-33.
8. Pagnan NAB, Visinoni AF. Update on ectodermal dysplasia clinical classification. Am J Med Genet A. 2014;164:2415-23.
9. Nguyen-Nielsen M, Skovbo S, Svaneby D, Pedersen L, Fryzek J. The prevalence of X-linked hypohidrotic ectodermal dysplasia (XLHED) in Denmark, 1995-2010. Eur J Med Genet. 2013;56: 236-42.
10. Hung SO, Patterson A. Ectodermal dysplasia associated with autoimmune disease. Br J Ophthalmol. 1984;65:367-9.
11. Keller MD, Petersen M, Ong P, Church J, Risma K, Burham J, et al. Hypohidrotic ectodermal dysplasia and immunodeficiency with coincident NEMO and EDA mutations. Front Immunol.2011;2:1-8.
12. Vaz CC, Couto M, Medeiros D, Miranda L, Costa J, Nero P. et al. Undifferentiated connective tissue disease: a seven-center cross-sectional study of 184 patients. Clin Rheumatol. 2009;28:915-21.
13. Mosca M, Neri R, Bombardieri. Undifferentiated connective tissue disease (UCTD): a review of the literature and a proposal for preliminary classification criteria. Clin Exp Rheumatol. 1999;17:615-20.
14. Chi AC, Neville BW, Krayer JW, Gonsalves WC. Oral manifestation of systemic disease. Am Fam Physician. 2010;82:1381-8.
15. Babu RSA, Chandrashekar P, Kumar KK, Reddy GS, Chandra KLP, Rao V, et al. A study on oral mucosal lesion in 3500 patients with dermatological diseases in south India. Ann Med Health Sci Res. 2014;4:S84-93.
16. Porter SR, Mercadante V, Fedele S. Oral manifestation of systemic disease. BDJ. 2017;223:683-91.
17. Glavina D, Majstorović M, Lulić-Dukić O, Jurić H. Hypohidrotic ectodermal dysplasia: dental features and carriers detection. Coll Antropol. 2001;25:303-10.
18. Chokshi A, Chokshi K, Chokshi R, Mhambrey S. Ectodermal dysplasia: a review. Int J Oral Health Med Res.2015;2:101-4.
19. Hinchcliff M, Varga J. Systemic sclerosis/scleroderma: a treatable multisystem disease. Am Fam Physician. 2008;78:961-8.
20. Reiseter S, Gunnarsson R, Corander J, Haydon J, Lund MB, AalØkken TM, et al. Disease evolution in mixed connective tissue disease: results from a long-term nationwide prospective cohort study. Arthritis Res Ther. 2017;19:284-92.
21. Olson MA, Rogers RS, Bruce AJ. Oral lichen planus. Clin Dermatol.2016;34:495-504.
22. McParland H, Warnakulasuriya S. Oral lichenoid contact lesion to mercury and dental amalgam-a review. J Biomed Biotechnol [Internet]. 2012 [cited 2018 July 1]:1-8. Available from: https://www.semanticscholar.org/paper/Oral-Lichenoid-Contact-Lesions-to-Mercury-and-McParland-Warnakulasuriya/69799bd0ffa892e39a2a775f3c50d11ef06afdd3.
23. Thanyavuthi A, Boonchai W, Kasemsarn P. Amalgam contact allergy in oral lichenoid lesions. ACDS. 2016;27:215-21.
24. Suter VGA, Warnakulasuriya S. The role of patch testing in the management of oral lichenoid reaction. J Oral Pathol Med. 2016;45:48-57.
25. Lynch M, Ryan A, Galvin S, Flint S, Healy CM, O’Rourke N, et al. Patch testing in oral lichenoid lesions on uncertain etiology. ACDS. 2015;26:89-93.
26. Lourenço SV, de Carvalho FRG, Boggio P, Sotto MN, Vilela MAC, Rivitti EA, et al. Lupus erythematosus: clinical and histopathology study of oral manifestation and immunohistochemical profile of the inflammatory infiltration. J Cutan Pathol. 2007;34:558-64.
27. LÓpez-Labady J, Villarroel-Dorrego M, González N, Pérez R, de Henning MM. Oral manifestation of systemic and cutaneous lupus erythematosus in a Venezuelan population. J Oral Pathol Med. 2007;36:524-7.
28. Osailan S, Pramanik R, Shirodaria S, Challacombe SJ, Proctor GB. Investigating the relationship between hyposalivation and mucosal wetness. Oral Dis. 2011;17:109-14.
29. Jager DHJ, Bots CP, Forouzanfar T, Brand HS. Clinical oral dryness score: evaluation of a new screening method for oral dryness. Odontology [Internet]. 2018 [cited 2018 July 1]:1-6. Available from: https://doi.org/10.1007/s10266-018-0339-4.
30. Mehta U, Brunworth J, Fete TJ, Sindwani R, Louis S. Head and neck manifestations and quality of life of patients with ectodermal dysplasia. OTO Open. 2007;136:843-7.
31. Yildirim M, Yorgancilar E, Gun R, Topcu I. Ectodermal dysplasia: otolaryngologic evaluation of 23 cases. Ear Nose Throat J. 2012;91:28-33.
32. Seraj B, Nahvi A. Hydrotic or hypohydrotic ectodermal dysplasia: diagnostic dilemmas. Int J Curr Microbiol App Sci. 2015;4:778-83.
33. Saltnes SS, Jensen JL, Sæves R, Nordgarden H, Geirdal AØ. Association between ectodermal dysplasia, psychological distress and quality of life in a group of adults with oligodontia. Acta Odontol Scand. 2017;75:564-72.
34. Shirasuna K. Oral lichen planus: malignant potential and diagnosis. Oral Science International. 2014;11:1-7.
35. Jordan RC, Daniels TE, Greenspan JS, Regezi JA. Advanced diagnostic methods in oral and maxillofacial pathology. Part II: immunohistochemical and immunofluorescent methods. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2002;93:56-74.
36. Lo Rosso L, Fedele S, Guiglia R, et al. Diagnostic pathways and clinical significance of desquamative gingivitis. J Periodontol. 2008;79:4-24.
37. Nithya SJ, Sankarnarayanan R, Hemalatha VT, Sarumathi T. Immunoflurescence in oral lesions. J Oral Maxillofac Pathol. 2017;21:402-6.
38. Buajeeb W, Okuma N, Thanakun S, Laothumthut T. Direct immonoflurescence in oral lichen planus. J Clin Diagn Res. 2015;9:ZC34-7.
39. Anuradha CH, Malathi N, Anandan S, Magesh KT. Current concepts of immunofluorescence in oral mucocutaneous diseases. J Oral Maxillofac Pathol. 2011;15:261-6.
40. Thornhill MH, Sankar V, Xu XJ, Barrett AW, High AS, Odell EW, Speight PM, Farthing PM. The role of histopathological characteristics in distinguishing amalgam-associated oral lichenoid reactions and oral lichen planus. J Oral Pathol 2006;35:233-40.
41. Thornhill MA, Pemberton MN, Simmons RK, Theaker ED. Amalgam-contact hypersensitivity lesion and oral lichen planus. Oral Surg Oral Med Oral Pathol Oral Radiol Endod.2003;95:291-9.
42. Şahin EB, Çetinözman F, Avcu N, Karaduman A. Evaluation of patients with oral lichenoid lesions by dental patch testing and results of removal of the dental restoration material. Turkderm-Arch Turk Dermatol Venerology. 2016;50:1-7.
43. Aberle T, Bourn RL, Chen H, Roberts VC, Guthridge JM, Bean K, et al. Use of SLICC criteria in a large, diverse lupus registry enables SLE classification of a subset of ACR-designated subjects with incomplete lupus. Lupus Sci Med [Internet]. 2017 [cited 2018 July 1];4:1-7. Available from: https://www.ncbi.nlm.nih.gov/pmc/journals/2614
44. Egner W. The use of laboratory tests in the diagnosis of SLE. J Clin Pathol. 2000;53:424-32.
45. Ippolito A, Wallace DJ, Gladman D, Fortin PR, Urowitz M, Werth V, et al. Autoantibodies in systemic lupus erythematosus; comparison of historical and current assessment of seropositivity. Lupus. 2011;20:250-5.
46. Balachandran A, Mathew AJ. SLICC classification criteria for SLE. Evidence Based Medicine – SLICC criteria for SLE. 2015:37-46.
47. Hudson M, Fritzler MJ. Diagnostic criteria of systemic sclerosis. J Autoimmun. 2014;48-49:38-41.
48. Adnan ZA. Diagnosis and treatment of scleroderma. Acta Med Indones-Indones J Intern Med.2008;40:109-12.
49. Mosca M, Tani C, Baldini C, Bombardieri S. Undifferentiated connective tissue diseases (UCTD). Autoimmun Rev. 2006;6:1-4.
50. Marable DR, Bowers LM, Stout TL, Stewart CM, Berg KM, Sankar V, et al. Oral candidiasis following steroid therapy for oral lichen planus. Oral Dis. 2016;22:140-7.
51. Ellepola ANB, Samaranayake LP. Inhalational and topical steroids, and oral candidosis: a mini review. Oral Dis. 2001;7:211-6.
52. Nadig SD, Ashwathappa DT, Manjunath M, Krishna S, Annaji AG, Shivaprakash PK. A relationship between salivary flow rates and Candida counts inpatients with xerostomia. J Oral Maxillofac Pathol. 2017;21:316.
53. Conti V, Esposito A, Cagliuso M, Fantauzzi A, Pastori D, Mezzaroma I, et al. Undifferentiated connective tissue disease – an unsolved problem: revision of literature and case studies. Int J Immonopathol Pharmacol. 2009; 23:271-8.
54. Birtane M, Yavuz S, Taştekin N. Laboratory evaluation in rheumatic diseases. World J Methodol. 2017;7:1-8.
55. Au J, Patel D, Campbell JH. Oral lichen planus. Oral Maxillofac Surg Clin North Am. 2013;25:93-100.
56. Usatine RP, Tinitigan M. Diagnosis and treatment of lichen planus. Am Fam Physician. 2011;84:53-60.
57. Patil S, Khandelwal S, Sinha N, Kaswan S, Rahman F, Tipu S. Treatment modalities of oral lichen planus: an update. J Oral Diag. 2016;01:47-52.
58. Lodi G, Tarozzi M, Sardella A, Demarosi F, Canegallo L, Di Benedetto D, et al. Miconazole as adjuvant therapy for oral lichen planus: a double-blind randomized controlled trial. Br J Dermatol. 2007;156:1136-41.
59. Epstein JB, Jensen SB. Management of hyposalivation and xerostomia: criteria for treatment strategies. Compendium. 2015;36:2-6.
60. Villa A, Connell CL, Abati S. Diagnosis and management of xerostomia and hyposalivation. Ther Clin Risk Manag. 2015;11:45-51.
61. Eisen D, Carozzo M, Began Sebastein J-V, Thongprasom K. Mucosal diseases series number V, oral lichen planus: clinical features and management. Oral Dis. 2005;11:338-49.
2. Cheng YSL, Gould A, Kurago Z, Fantasia J, Muller S. Diagnosis of oral lichen planus: a position pater of the American Academy of Oral and Maxillofacial Pathology. Oral Surg Oral Med Oral Pathol Oral Radiol. 2016;122:332-54.
3. do Canto AM, de Freitas RR, Müller H, da Silva Santos PS. Oral lichen planus (OLP): clinical and complementary diagnosis. An Bras Dermatol. 2010;85:669-75.
4. Müller S. Oral lichenoid lesions: distinguishing the benign from the deadly. Mod Pathol. 2016; 30:S54-S67.
5. Deshmukh S, Prashanth S. Ectodermal dysplasia: a genetic review. Int J Clin Pediatr Dent. 2012;5:197-202.
6. Visinoni AF, Lisboa-Costa T, Pagnan NAB, Chautard-Freire-Maia EA. Ectodermal dysplasia: clinical and molecular review. Am J Med Genet A. 2009;149:1980-2002.
7. Singh CGP, Saxena LCV. Case report hypohidrotic ectodermal dysplasia. Med J Armed Forces India. 2015;71:S530-33.
8. Pagnan NAB, Visinoni AF. Update on ectodermal dysplasia clinical classification. Am J Med Genet A. 2014;164:2415-23.
9. Nguyen-Nielsen M, Skovbo S, Svaneby D, Pedersen L, Fryzek J. The prevalence of X-linked hypohidrotic ectodermal dysplasia (XLHED) in Denmark, 1995-2010. Eur J Med Genet. 2013;56: 236-42.
10. Hung SO, Patterson A. Ectodermal dysplasia associated with autoimmune disease. Br J Ophthalmol. 1984;65:367-9.
11. Keller MD, Petersen M, Ong P, Church J, Risma K, Burham J, et al. Hypohidrotic ectodermal dysplasia and immunodeficiency with coincident NEMO and EDA mutations. Front Immunol.2011;2:1-8.
12. Vaz CC, Couto M, Medeiros D, Miranda L, Costa J, Nero P. et al. Undifferentiated connective tissue disease: a seven-center cross-sectional study of 184 patients. Clin Rheumatol. 2009;28:915-21.
13. Mosca M, Neri R, Bombardieri. Undifferentiated connective tissue disease (UCTD): a review of the literature and a proposal for preliminary classification criteria. Clin Exp Rheumatol. 1999;17:615-20.
14. Chi AC, Neville BW, Krayer JW, Gonsalves WC. Oral manifestation of systemic disease. Am Fam Physician. 2010;82:1381-8.
15. Babu RSA, Chandrashekar P, Kumar KK, Reddy GS, Chandra KLP, Rao V, et al. A study on oral mucosal lesion in 3500 patients with dermatological diseases in south India. Ann Med Health Sci Res. 2014;4:S84-93.
16. Porter SR, Mercadante V, Fedele S. Oral manifestation of systemic disease. BDJ. 2017;223:683-91.
17. Glavina D, Majstorović M, Lulić-Dukić O, Jurić H. Hypohidrotic ectodermal dysplasia: dental features and carriers detection. Coll Antropol. 2001;25:303-10.
18. Chokshi A, Chokshi K, Chokshi R, Mhambrey S. Ectodermal dysplasia: a review. Int J Oral Health Med Res.2015;2:101-4.
19. Hinchcliff M, Varga J. Systemic sclerosis/scleroderma: a treatable multisystem disease. Am Fam Physician. 2008;78:961-8.
20. Reiseter S, Gunnarsson R, Corander J, Haydon J, Lund MB, AalØkken TM, et al. Disease evolution in mixed connective tissue disease: results from a long-term nationwide prospective cohort study. Arthritis Res Ther. 2017;19:284-92.
21. Olson MA, Rogers RS, Bruce AJ. Oral lichen planus. Clin Dermatol.2016;34:495-504.
22. McParland H, Warnakulasuriya S. Oral lichenoid contact lesion to mercury and dental amalgam-a review. J Biomed Biotechnol [Internet]. 2012 [cited 2018 July 1]:1-8. Available from: https://www.semanticscholar.org/paper/Oral-Lichenoid-Contact-Lesions-to-Mercury-and-McParland-Warnakulasuriya/69799bd0ffa892e39a2a775f3c50d11ef06afdd3.
23. Thanyavuthi A, Boonchai W, Kasemsarn P. Amalgam contact allergy in oral lichenoid lesions. ACDS. 2016;27:215-21.
24. Suter VGA, Warnakulasuriya S. The role of patch testing in the management of oral lichenoid reaction. J Oral Pathol Med. 2016;45:48-57.
25. Lynch M, Ryan A, Galvin S, Flint S, Healy CM, O’Rourke N, et al. Patch testing in oral lichenoid lesions on uncertain etiology. ACDS. 2015;26:89-93.
26. Lourenço SV, de Carvalho FRG, Boggio P, Sotto MN, Vilela MAC, Rivitti EA, et al. Lupus erythematosus: clinical and histopathology study of oral manifestation and immunohistochemical profile of the inflammatory infiltration. J Cutan Pathol. 2007;34:558-64.
27. LÓpez-Labady J, Villarroel-Dorrego M, González N, Pérez R, de Henning MM. Oral manifestation of systemic and cutaneous lupus erythematosus in a Venezuelan population. J Oral Pathol Med. 2007;36:524-7.
28. Osailan S, Pramanik R, Shirodaria S, Challacombe SJ, Proctor GB. Investigating the relationship between hyposalivation and mucosal wetness. Oral Dis. 2011;17:109-14.
29. Jager DHJ, Bots CP, Forouzanfar T, Brand HS. Clinical oral dryness score: evaluation of a new screening method for oral dryness. Odontology [Internet]. 2018 [cited 2018 July 1]:1-6. Available from: https://doi.org/10.1007/s10266-018-0339-4.
30. Mehta U, Brunworth J, Fete TJ, Sindwani R, Louis S. Head and neck manifestations and quality of life of patients with ectodermal dysplasia. OTO Open. 2007;136:843-7.
31. Yildirim M, Yorgancilar E, Gun R, Topcu I. Ectodermal dysplasia: otolaryngologic evaluation of 23 cases. Ear Nose Throat J. 2012;91:28-33.
32. Seraj B, Nahvi A. Hydrotic or hypohydrotic ectodermal dysplasia: diagnostic dilemmas. Int J Curr Microbiol App Sci. 2015;4:778-83.
33. Saltnes SS, Jensen JL, Sæves R, Nordgarden H, Geirdal AØ. Association between ectodermal dysplasia, psychological distress and quality of life in a group of adults with oligodontia. Acta Odontol Scand. 2017;75:564-72.
34. Shirasuna K. Oral lichen planus: malignant potential and diagnosis. Oral Science International. 2014;11:1-7.
35. Jordan RC, Daniels TE, Greenspan JS, Regezi JA. Advanced diagnostic methods in oral and maxillofacial pathology. Part II: immunohistochemical and immunofluorescent methods. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2002;93:56-74.
36. Lo Rosso L, Fedele S, Guiglia R, et al. Diagnostic pathways and clinical significance of desquamative gingivitis. J Periodontol. 2008;79:4-24.
37. Nithya SJ, Sankarnarayanan R, Hemalatha VT, Sarumathi T. Immunoflurescence in oral lesions. J Oral Maxillofac Pathol. 2017;21:402-6.
38. Buajeeb W, Okuma N, Thanakun S, Laothumthut T. Direct immonoflurescence in oral lichen planus. J Clin Diagn Res. 2015;9:ZC34-7.
39. Anuradha CH, Malathi N, Anandan S, Magesh KT. Current concepts of immunofluorescence in oral mucocutaneous diseases. J Oral Maxillofac Pathol. 2011;15:261-6.
40. Thornhill MH, Sankar V, Xu XJ, Barrett AW, High AS, Odell EW, Speight PM, Farthing PM. The role of histopathological characteristics in distinguishing amalgam-associated oral lichenoid reactions and oral lichen planus. J Oral Pathol 2006;35:233-40.
41. Thornhill MA, Pemberton MN, Simmons RK, Theaker ED. Amalgam-contact hypersensitivity lesion and oral lichen planus. Oral Surg Oral Med Oral Pathol Oral Radiol Endod.2003;95:291-9.
42. Şahin EB, Çetinözman F, Avcu N, Karaduman A. Evaluation of patients with oral lichenoid lesions by dental patch testing and results of removal of the dental restoration material. Turkderm-Arch Turk Dermatol Venerology. 2016;50:1-7.
43. Aberle T, Bourn RL, Chen H, Roberts VC, Guthridge JM, Bean K, et al. Use of SLICC criteria in a large, diverse lupus registry enables SLE classification of a subset of ACR-designated subjects with incomplete lupus. Lupus Sci Med [Internet]. 2017 [cited 2018 July 1];4:1-7. Available from: https://www.ncbi.nlm.nih.gov/pmc/journals/2614
44. Egner W. The use of laboratory tests in the diagnosis of SLE. J Clin Pathol. 2000;53:424-32.
45. Ippolito A, Wallace DJ, Gladman D, Fortin PR, Urowitz M, Werth V, et al. Autoantibodies in systemic lupus erythematosus; comparison of historical and current assessment of seropositivity. Lupus. 2011;20:250-5.
46. Balachandran A, Mathew AJ. SLICC classification criteria for SLE. Evidence Based Medicine – SLICC criteria for SLE. 2015:37-46.
47. Hudson M, Fritzler MJ. Diagnostic criteria of systemic sclerosis. J Autoimmun. 2014;48-49:38-41.
48. Adnan ZA. Diagnosis and treatment of scleroderma. Acta Med Indones-Indones J Intern Med.2008;40:109-12.
49. Mosca M, Tani C, Baldini C, Bombardieri S. Undifferentiated connective tissue diseases (UCTD). Autoimmun Rev. 2006;6:1-4.
50. Marable DR, Bowers LM, Stout TL, Stewart CM, Berg KM, Sankar V, et al. Oral candidiasis following steroid therapy for oral lichen planus. Oral Dis. 2016;22:140-7.
51. Ellepola ANB, Samaranayake LP. Inhalational and topical steroids, and oral candidosis: a mini review. Oral Dis. 2001;7:211-6.
52. Nadig SD, Ashwathappa DT, Manjunath M, Krishna S, Annaji AG, Shivaprakash PK. A relationship between salivary flow rates and Candida counts inpatients with xerostomia. J Oral Maxillofac Pathol. 2017;21:316.
53. Conti V, Esposito A, Cagliuso M, Fantauzzi A, Pastori D, Mezzaroma I, et al. Undifferentiated connective tissue disease – an unsolved problem: revision of literature and case studies. Int J Immonopathol Pharmacol. 2009; 23:271-8.
54. Birtane M, Yavuz S, Taştekin N. Laboratory evaluation in rheumatic diseases. World J Methodol. 2017;7:1-8.
55. Au J, Patel D, Campbell JH. Oral lichen planus. Oral Maxillofac Surg Clin North Am. 2013;25:93-100.
56. Usatine RP, Tinitigan M. Diagnosis and treatment of lichen planus. Am Fam Physician. 2011;84:53-60.
57. Patil S, Khandelwal S, Sinha N, Kaswan S, Rahman F, Tipu S. Treatment modalities of oral lichen planus: an update. J Oral Diag. 2016;01:47-52.
58. Lodi G, Tarozzi M, Sardella A, Demarosi F, Canegallo L, Di Benedetto D, et al. Miconazole as adjuvant therapy for oral lichen planus: a double-blind randomized controlled trial. Br J Dermatol. 2007;156:1136-41.
59. Epstein JB, Jensen SB. Management of hyposalivation and xerostomia: criteria for treatment strategies. Compendium. 2015;36:2-6.
60. Villa A, Connell CL, Abati S. Diagnosis and management of xerostomia and hyposalivation. Ther Clin Risk Manag. 2015;11:45-51.
61. Eisen D, Carozzo M, Began Sebastein J-V, Thongprasom K. Mucosal diseases series number V, oral lichen planus: clinical features and management. Oral Dis. 2005;11:338-49.