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OPTIMIZATION OF COMPREHENSIVE THERAPY FOR
EXUDATIVE-HYPEREMIC AND EROSIVE-ULCERATIVE
VARIANTS OF ORAL LICHEN PLANUS
Sabirov Shukhrat Solijonovich
Bukhara State Medical Institute
Abstract.
This study explores optimized treatment strategies for the exudative-
hyperemic and erosive-ulcerative variants of oral lichen planus (OLP), a chronic
inflammatory disorder of the oral mucosa known for its persistent course, therapeutic
resistance, and potential for malignant transformation. The research evaluates the
distribution of clinical forms of OLP across different age groups and highlights the
condition’s correlation with systemic illnesses and detrimental lifestyle factors such as
smoking. Findings indicate that a tailored, multidisciplinary treatment approach
significantly alleviates clinical symptoms, enhances mucosal healing, and contributes
to a better quality of life for patients affected by OLP.
Keywords:
oral mucosa, oral lichen planus, exudative-hyperemic variant,
erosive-ulcerative variant, integrated therapy, systemic comorbidities, risk factors.
Oral lichen planus (OLP) is one of the most prevalent diseases affecting the oral
mucosa (SMF), distinguished by its unknown etiopathogenesis, the presence of severe
forms, a wide range of symptoms, potential for malignant transformation, and frequent
resistance to therapy. These characteristics underscore its significant medical and
social importance. [1] Among the different forms of OLP is the erosive-ulcerative form
o damage to the mucous membrane of the oral cavity and the red border of the lips ,
the disturbance of eating due to pain , which leads to a decrease in the quality of life of
patients.[2] Factors provoking the development of OLP develop as a result of a
violation of the microbiocenosis of the oral cavity , a decrease in local and general
immunity, stress, an increase in related somatic diseases, and the reception of certain
drugs. Solving the problem of effective treatment of SMF OLP remains an urgent
problem in dental practice .[3]
Erythematous flatulence on the mucous membrane of the oral cavity (OLP) is one
of the common, difficult to treat diseases, the etiology and pathogenesis of which have
not been fully determined. According to scientific sources, OLP is important among
inflammatory diseases of the oral mucosa, because it is characterized by pain,
inconsistency and the possibility of transition to a poor quality form [4]. The severe
course of OLP and its resistance to treatment prompt doctors and researchers to study
this disease in depth [5].
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There are different forms of OLP, among which exudative-hyperemic and
erosive-ulcerative forms are of particular importance. These forms present with
obvious signs on the oral mucosa and are painful for patients, affecting eating, speaking
and daily activities (Silverman, 2005). The fact that severe forms of the disease in rare
cases have the risk of transition to low-quality tumors indicates the need to study OLP
as one of the important medical problems [6].
Recent studies confirm the role of various factors, including genetic,
immunological, and psychogenic factors in the development of OLP. Stress conditions
and related somatic diseases are among the factors that stimulate the development of
OLP [7]. Therefore, it is important to use integrated approaches to increase the
effectiveness of treatment of OLP.
Various studies show that in the pathogenesis of OLP, the decrease of local and
general immunity, the disturbance of the microbiocenosis in the oral cavity, and the
effect of certain drugs are significant [8]. Accordingly, there is a need to improve
therapeutic methods for effective treatment of various forms of the disease.
The relevance of the research is determined by the fact that the complexity of the
pathogenetic mechanisms associated with OLP in the mucous membrane of the oral
cavity creates difficulties in the complete elimination of this disease. Therefore, the
issue of increasing the effectiveness of complex treatment of exudative-hyperemic and
erosive-ulcer forms of OLP in the mucous membrane of the oral cavity and improving
the quality of life of patients remains an important problem in dental practice.
The purpose of the study:
improvement of complex therapy aimed at increasing
the effectiveness of treatment of exudative-hyperemic and erosive-ulcer forms of
erysipelas on the mucous membrane of the oral cavity.
Research material and method.
122 people from 18 to 80 years old who were
diagnosed with red squamous cell carcinoma of the oral mucosa (exudative-hyperemic
and erosive-ulcer forms) were included in the study. the average age was 56.28±3.78
years. The average age of men (n=32) was 58.09±5.12 years, and the average age of
women (n=90) was 54.47±2.44 years. The age of patients suffering from different
forms of erysipelas was comparatively evaluated in SMF. The analysis showed that the
average age of patients with the exudative-hyperemic form of SMF OLP was found to
be significantly lower than that of patients with the erosive-ulcerative form of scarlet
fever: 50.54±2.38 years in the exudative-hyperemic form, 50.54±2.38 years in the
erosive-ulcerative form and 62.02±5.18 years old (p<0.05) indicators were analyzed.
The WHO showed the indicators of the distribution of patients by gender . The
exudative-hyperemic form was recorded in 13 (21.67%) men and 47 (78.33%) women,
and the erosive-ulcerative form was recorded in 19 (30.65%) men and 43 (69.35%)
women. (p>0.05).
Research results
. During the study, in the exudative-hyperemic and erosive-
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ulcerative forms of SMF OLP, a case of somatic diseases meeting one by one at the
same time was observed. Gastrointestinal tract (GIT) diseases (chronic gastritis,
cholecystopancreatitis, liver diseases, colitis), cardiovascular system (CHD) pathology
(ischemic
heart
disease,
atherosclerosis),
and
nervous
system
diseases
(encephalopathy, cerebral circulation disorders) the number of patients was found to
be high. At the same time, it should be noted that the reliable superiority of the erosive-
ulcerated form of the red flat iron in the oral cavity in patients with diseases of the
cardiovascular system has gained great importance. (p<0.05). In addition, there are
other groups and types of somatic diseases, endocrine system diseases (diabetes,
hypothyroidism and obesity) and urogenital system (STT) diseases (nephrotic
syndrome, kidney stone disease, pyelonephritis, endometriosis in women, chronic
prostatitis and prostate gland in men) adenoma) in patients with oral cavity red flat iron
erosive-ulcerative type was observed much more than exudative-hyperemic type
(p<0.05).
Local exogenous risk factors for the occurrence of OLP were identified during
oral cavity examination: the presence of sharp edges of teeth and roots, the
unsatisfactory condition of fillings in 57% of patients, the presence of metal prostheses
made of dissimilar metals in 27%, the use of colored plastics for prosthetics were
identified in 8% of patients. KPU index of tooth caries intensity was 18.85±0.9. In the
analysis of the KPU index in patients, patients with OLP before treatment had an index
of "K" equal to 3.77±0.6, 20% of which was equal to "P" equal to 5.63±0.6,
corresponding to 30%, "U" equal to 9 ,37±1.04, corresponding to 50%. After treatment,
the "K" indicator was 97±0.38, the "P" indicator was 8.0±0.71, the "U" indicator was
9.8±1.03, respectively 5% of the KPU index value, It was 43% and 52% (Fig. 1).
Picture. 1. Indicators of KPU index before and after treatment in patients
with OLP.
0
1
2
3
4
5
6
7
8
9
Until treatment
After treatment
Constant "U"
Constant "P"
Constant "K"
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Pre-treatment and post-treatment indices of oral mucosal cavity and dental status
in patients with OLP (Table 1).
Table 1
Pre-treatment and post-treatment indices of oral cavity cavity
and dental status in patients with OLP
Index
Until treatment
From treatment after
R
OHI-S (score)
3.14±0.12
1.61±0.11
r < 0.001
RMA (%)
36.44±3.95
13.98±1.61
r < 0.001
N. According to Kotzschke
changed blood leave index (bally)
1.82±0.13
1.17±0.1
r < 0.05
During the initial anamnestic examination, the average value of the OHI-S
hygienic index in the buccal mucosa of patients with OLP was 3.14±0.12 points, which
is significantly higher than the value of this index in the control group by 1.01±0.02
points (r<0.001 ). OHI-S hygienic index was 4.12±0.15 points in patients with erosive
and bullous form of OLP, 2 times higher than the value of this indicator in patients
with papulose and flat (typical) form of scarlet fever - 2.23±0.14 score, , the differences
are statistically significant (p<0.001).
After a course of complex etiopathogenetic treatment, the OHI-S hygiene index
significantly decreased to 1.61 ± 0.11 points (p < 0.001), inflammatory events in
periodontal tissues decreased, which was confirmed by a significant decrease. PMA
index (p<0.001) from 36.44±3.95% to 13.98±1.61% and our modified bleeding index
N. Kotzschke from 1.82±0.13 to 1.17±0.1 (p<0.05). Dynamics of changes in indices 2-
3 in the picture given .
Mouth space mucus red flat on the floor of iron come at the exit important of the
factors one tobacco smoking, patients in the diet harmful habits (bitter and salty, spicy
food consumption do) and alcohol drinks acceptance to do is considered
Red flat in SMF of iron come at the exit this predictor factors (harmful habits and
eating diet) effect study patients and healthy people between comparative by learning
exit need necessary that showed (Table 2)
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Table 2. Harmful of habits spreading and eating order
compliance to do analysis
OBSHK OLP
Exudative hyperemic
(n=60) FORM
OBSHK OLP
Erosive-wounded
form KPL (n=62)
Control group
(n=34)
Current at the time
tobacco smoking
11/18.33%#
26/41.94%*
7/20.59%
In the past smoked tobacco
28/46.67%*
39/62.90%*
9/26.47%
Current at the time alcohol
consumption
12/20.00%
17/27.42%
6/17.65%
In the past alcohol
consumption dress
19/31.67%
24/38.71%
9/26.47%
Bitter and salty foods
inclination
32/53.33%*
41/66.13%*
11/32.35%
To food rich in
carbohydrates inclination
21/35.00%#
48/77.42%*
13/38.24%
To oils rich to food
inclination
32/53.33%
35/56.45%
18/52.94%
So mouth space mucus floor red flat ironwork to pass effect showing common
and local pathological of circumstances high level meeting was determined.
* when p< 0.05 comparison in the group to indicators relatively differences
reliable
# SMF OLP when p< 0.05 erosive-ulcerative shape with sick in patients to
indicators relatively differences reliable
Comparative analysis showed that smoking, consumption of spicy and salty
foods, and a high intake of carbohydrate-rich foods are absolute predictive factors for
the development of oral lichen planus and its severe form (erosive-ulcerative type) in
the oral mucosa. The table indicates that patients with the exudative-hyperemic form
of oral lichen planus (OLP) were significantly more likely to smoke and prefer spicy
and salty foods compared to the “healthy” individuals in the control group (p<0.05).
To research attraction done patients deep analytical that's it shows that those who
are sick between bitter and salty products, foods rich in carbohydrates consumption
custom type entered. Also red flat of iron exudative-hyperemic to the shape played in
patients, tobacco smoking and carbohydrate food products less consumption done was
determined (r<0.05).
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Conclusion:
Mouth space mucus on the floor red flat of iron exudative-hyperemic
and erosive-ulcerative forms efficient treatment methods improvement the necessity of
the disease different of forms prevalence, gender and age differences, and of the disease
different risk factors with dependence was determined. Research to the results
according to complex treatment efficiency high being a mouth space mucus on the floor
inflammation symptoms reduce and of patients life quality to improve help to give
known it happened
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