Association of Oral Candidiasis with Oral Lichen planus in patients using corticosteroid therapy- Meta-analysis
Main Article Content
Keywords
Oral Lichen planus, Candida, Corticosteroids, steroid therapy
Abstract
The Oral Lichen planus (OLP) is a chronic inflammatory disease that commonly affects the skin and mucous membranes. A difference of opinion among clinicians about whether oral lichen planus have been associated with oral Candidiasis. Nonetheless, in OLP patients, the oral candidiasis prevalence rate ranges from between 7.7% and 16.6%, as established through biopsy findings, whereas 37-50% has been noticed in culture findings. Oral Candidiasis has been linked to several local and systemic factors, including salivary gland dysfunction, dental prostheses, topical or inhaled corticosteroids, smoking, and the use of systemic medications. The Aim was to highlight the association of Candida in patients diagnosed with Oral Lichen planus (OLP), correlate the use of steroid therapy and enumerate the factors of using steroid therapy as implicated cause for oral Candidiasis. A search was made using search engines such as PubMed, Scopus, Cochrane database of systematic reviews, Science citation index, NIH Public access, and Clarivate analytics. The words using the research option for this field were "Oral Candidiasis" AND "Oral Lichen planus" or "Candidiasis" AND "Corticosteroids" or "Topical Corticosteroids" AND Oral Lichen planus or "Inhalation Corticosteroids" AND "Candidiasis" or "Oral Lichen planus" AND "Corticosteroids." The database search was made from 1991-2021. Additional articles were obtained regarding the literature of OLP and Oral Candidiasis, considered background material. The incidence of Oral Candidiasis and associated lichen planus following steroid therapy enlisted by various authors have been addressed. According to the results of this study, there is a positive correlation between the presence of oral Candidiasis in the oral lichen planus patients treated with corticosteroids. In conclusion the meta-analysis concluded that there is a positive correlation between the presence of candida species in Oral Lichen Planus and steroid medication.
References
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5) Coronado-Castellote L, Jimenez-Soriano Y. Clinical and microbiological diagnosis of oral candidiasis. J Clin Exp Dent. 2013;5:279-86.
6) Ellepola AN, Morrison CJ. Laboratory diagnosis of invasive candidiasis. J Microbiol. 2005;43:65-84.
7) Clark NM, Grim SA, Lynch JP. Posaconazole: use in the prophylaxis and treatment of fungal infections. Semin Respir Crit Care Med. 2015;36:767-785.
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14) Kulthanan K, Jiamton S, Varothai S, Pinkaew S, Sutthipinittharm P. Direct immunofluorescence study in patients with lichen planus. Int J Dermatol. 2007;46(12):1237-41.
15) Rotaru D, Chisnoiu R, Monica PA, Picos A, Chisnoiu A. Treatment trends in oral lichen planus and oral lichenoid lesions (Review) Experimental and therapeutic medicine 2020;20:198:1-4
16) Ismail SB, Kumar SK, Zan RB. Oral lichen planus and lichenoid reactions: etiopathogenesis, diagnosis, management, and malignant transformation. J Oral Sci. 2007;49:89-106.
17) McCullough MJ, Savage NW. Oral candidosis and the therapeutic use of antifungal agents in dentistry. Aust Dent J. 2005;50:36-9.
18) De Rossi SS, Ciarroca KN. Lichen planus, lichenoid drug reactions, and lichenoid mucositis. Dent Clin North Am. 2005;49:77-89.
19) Marable DR, Bowers LM, Stout TL, Stewart CM, Berg KM, Sankar V, DeRossi SS. Oral Candidiasis following steroid therapy for Oral Lichen planus. Oral Diseases. 2016;22(2):140-7.
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21) Lodi G, Scully C, Carrozzo M, Griffiths M, Sugerman PB, Thongprasom K. Current controversies in oral lichen planus: Report of an international consensus meeting. Part 2. Clinical management and malignant transformation. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2005;100(2):164-78.
22) Jainkittivong A, Kuvatanasuchati J, Pipattanagovit P, Sinheng W. Candida in Oral Lichenplanus patients undergoing topical steroid therapy. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2007;104(1):61-6.
23) Gonzalez-Garcia A, Diniz-Freitas M, Gandara-Vila P, Blanco-Carrion A, Garcia-Garcia A, Gandara-Rey J. Triamcinolone acetonide mouth rinse for the treatment of erosive oral lichen planus: efficacy and risk of fungal over infection. Oral Dis. 2006;12:559-65.
24) Eisen D. The therapy of Oral lichen planus. Crit Rev Oral Biol Med. 1993;4:141-58.
25) Richard DPN, Batsiou M, Bjermer L, Bosnic-Antic ES, ChryStyn H. Incidence of oral thrush in patients with COPD prescribed inhaled corticosteroids: Effect of drug, dose, and device. Respir Med. 2016;120:54-63.
26) Kennedy WA, Laurier C, Gautrin D. Occurrence and risk factors of oral Candidiasis treated with oral antifungals in seniors using inhaled steroids J Clin Epidemiol 2000;53(7):696-701.
27) Bryant L, Bang C, Chew C, Baik SH, Wiseman D. Adequacy of inhaler technique used by people with asthma or chronic obstructive pulmonary disease. J Prim Health Care. 2013;5(3):191-98.
28) Knight L, Fletcher J. Growth of Candida albicans in saliva: stimulation by glucose associated with antibiotics, corticosteroids, and diabetes mellitus J Infect Dis. 1971;123(4):371-77.
29) Fardet L, Petersen I, Nazareth I. Common Infections in patients prescribed systemic glucocorticoids in primary care: A population-based cohort study. PLOS Medicine. 2016; DOI:10.1371/journal.pmed.1002024.
30) Hatchuel DA, Peters E, Lemmer J, Hille JJ, McGaw WT. Candidal infection in oral lichen planus. Oral Surg Oral Med Oral Pathol. 1990;70:172-5.
31) Zeng X, Xiong C, Wang Z, Jiang L, Hou X, Shen J, et al. Genotypic profiles and virulence attributes of Candida albicans isolates from patients with oral lichen planus. APMIS. 2008;116:284-91.
32) Mehdipour M, Zenouz AT, Hekmatfar S, Adibpour M, Bahramian A, Khorshidi R. Prevalence of candida species in erosive oral lichen planus. J Dent Res Dent Clin Dent Prospect. 2010;4:14-16.
33) Masaki M, Sato T, Sugawara Y, Sasano T, Takahashi N. Detection and identification of non-Candida albicans species in human oral lichen planus. Microbiol Immunol. 2011;55(1):66-70.
34) Shivanandappa SG, Ali I, Sabarigirinathan CS, Mushannavar L. Candida in Oral Lichen Planus. J Indian Acad Oral Med Radiol. 2012;24:182-5.
35) Artico G, Freitas RS, Santos Filho AM, Benard G, Romiti R, Migliari DA. Prevalence of Candida spp., Xerostomia, and hyposalivation in oral lichen planus--a controlled study. Oral Dis. 2014;20: 36-41.
36) Werneck JT, de-Oliveira CT, Stibich CA, Almeida LC, Dias EP, Silva J. An Oral lichen planus: study of 21 cases. A Bras Dermatol. 2015;90(3):321-6.
37) Arora S, Verma M, Gupta SR, Urs AB, Dhakad MS, Kaur R. Phenotypic variability and therapeutic implications of Candida species in patients with oral lichen planus. Biotech Histochemis. 2016;91(4):237-41.
38) Hong He, Xia X, Yang H, Peng Q, Zheng J. A pilot study: a possible implication of Candida as an etiologically endogenous pathogen for oral lichen planus. BMC Oral Health. 2020; 20(1):72. DOI: 10.1186/s12903-020-1042-8
39) Miranda FB, Werneck JT, Dias EP, Milagres A, Gonçalves LS, Silva J. A Clinical behaviour of Oral Lichen planus in association with Candidiasis. Med Mycol. 2020;7(1):1-5.
40) Al Hashimi I, Schifter M, Lockhart PB. Oral Lichen planus and lichenoid lesions: diagnostic and therapeutic considerations. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2007;103 Suppl 25:1-12.
41) Kragelund C, Kieffer-Kristensen L, Reibel J. Oral candidosis in lichen planus: the diagnostic approach is of major therapeutic importance. Clin Oral Investig. 2013;17:957-65.
42) Lundstrom IMC, Anneroth GB, Holmberg K. Candida in patients with Oral Lichenplanus. Int. J Oral Surg. 1984;13:226-38.
43) Pfaller MA. Antifungal drug resistance: mechanisms, epidemiology, and consequences for treatment. Am J Med. 2012;125:3-13.
44) Lockhart SR, Joly S, Vargas K, Swails-Wenger J, Enger L, Soll DR. Natural defences against candida colonization breakdown in the oral cavities of the elderly. J Dent Res. 1999;78:857-68.
45) Krogh P, Hald B, Holmstrup P. Possible mycological etiology of oral mucosal cancer: the catalytic potential of infecting Candida albicans and other yeasts in production of N-nitrosobenzyl methylamine. Carcinogenesis. 1987;8(10):1543-8.
46) Gayathri K, Balachander N, Malathi L, Sankari Sl. Candida in potentially malignant oral disorders. J Pharm Bioallied Sci. 2015;7(5):164.
47) Simark-Mattsson C, Eklund C. Reduced immune responses to purified protein derivative and Candida albicans in oral lichen planus. J Oral Pathol Med. 2013;42:691-7.
48) Gainza-Cirauqui ML, Nieminen MT, Novak Frazer L, Aguirre-Urizar JM, Moragues MD, Rautemaa R. Production of carcinogenic acetaldehyde by Candida albicans from patients with potentially malignant oral mucosal disorders. J Oral Pathol Med. 2013;42:243-9.
49) Cribier B, Frances C, Chosidow O. Treatment of Lichen planus-An Evidence based Medicine Analysis of Efficacy. Arcaurh Dermatol. 1998;134(12):1521-1530.
50) Henriksen DP, Davidsen JR, Laursen CB, Christiansen A, Laursen CB, Damkier P, et al. Inhaled corticosteroids and systemic or topical antifungal therapy: a symmetry analysis. Ann Am Thorac Soc. 2017;14(6):1045-1047.
51) Miravitlles M, Auladell-Rispau A, Monteagudo M, Vázquez-Niebla JC, Mohammed J, Nunez A, et al. Systematic review on long-term adverse effects of inhaled corticosteroids in the treatment of COPD. Eur Respir Rev. 2021;30(160):210075. doi: 10.1183/16000617.0075-2021.
2) Akpan A, Morgan R. Oral candidiasis. Postgrad Med J. 2002;78:455-59. doi: 10.1136/pmj.78.922.455.
3) Rautemaa R, Ramage G. Oralcandidosis-clinical challenges of a biofilm disease. Crit Rev Microbiol. 2011;37:328-336.
4) Axell T, Samaranayake LP, Reichart PA, Olsen I. A proposal for Reclassification of oral candidosis. Oral Med Oral Pathol Oral Radiol Endod. 1997;84:111-112. doi:10.1016/S1079-2104 (97)90049-4.
5) Coronado-Castellote L, Jimenez-Soriano Y. Clinical and microbiological diagnosis of oral candidiasis. J Clin Exp Dent. 2013;5:279-86.
6) Ellepola AN, Morrison CJ. Laboratory diagnosis of invasive candidiasis. J Microbiol. 2005;43:65-84.
7) Clark NM, Grim SA, Lynch JP. Posaconazole: use in the prophylaxis and treatment of fungal infections. Semin Respir Crit Care Med. 2015;36:767-785.
8) Hofling JF, Anibal PC, Obando-Pereda GA, Peixoto IA, Furletti VF, Foglio MA, et al. Antimicrobial potential of some plant extracts against Candida species. Braz J Biol. 2010;70:1065-68.
9) Lavanya N, Jayanthi P, Umadevi KR, Ranganathan K. Oral lichen planus: An update on pathogenesis and treatment. J Oral Maxillofac Pathol. 2011;15(2):127-32.
10) Sugerman PB, Savage NW, Walsh LJ, Zhao ZZ, Zhou XJ, Khan A, et al. The pathogenesis of oral lichen planus. Crit Rev Oral Biol Med. 2002;13:350-65.
11) Zhou XJ, Sugarman PB, Savage NW, Walsh LJ, Seymour GJ. Intra-epithelial CD8+ T cells and basement membrane disruption in oral lichen planus. J Oral Pathol Med. 2002;31:23-7.
12) Van der Meij EH, van der Waal I. Lack of clinicopathologic correlation in the diagnosis of oral lichen planus based on the presently available diagnostic criteria and suggestions for modifications. J Oral Pathol Med. 2003;32(9):507-12.
13) Changchang L, Xiaoqiong T, Xiaoyan Z, Shuqi G, Hao W, Xiaoqiong L, et al. Global prevalence and incidence estimates of oral lichen planus: A systematic review and meta-analysis. JAMA Dermatol. 2020;156(2):172-81.
14) Kulthanan K, Jiamton S, Varothai S, Pinkaew S, Sutthipinittharm P. Direct immunofluorescence study in patients with lichen planus. Int J Dermatol. 2007;46(12):1237-41.
15) Rotaru D, Chisnoiu R, Monica PA, Picos A, Chisnoiu A. Treatment trends in oral lichen planus and oral lichenoid lesions (Review) Experimental and therapeutic medicine 2020;20:198:1-4
16) Ismail SB, Kumar SK, Zan RB. Oral lichen planus and lichenoid reactions: etiopathogenesis, diagnosis, management, and malignant transformation. J Oral Sci. 2007;49:89-106.
17) McCullough MJ, Savage NW. Oral candidosis and the therapeutic use of antifungal agents in dentistry. Aust Dent J. 2005;50:36-9.
18) De Rossi SS, Ciarroca KN. Lichen planus, lichenoid drug reactions, and lichenoid mucositis. Dent Clin North Am. 2005;49:77-89.
19) Marable DR, Bowers LM, Stout TL, Stewart CM, Berg KM, Sankar V, DeRossi SS. Oral Candidiasis following steroid therapy for Oral Lichen planus. Oral Diseases. 2016;22(2):140-7.
20) Muzyka BC, Glick M. A review of Oral fungal infections and appropriate therapy. J Am Dent Assoc. 1995;126:63-72.
21) Lodi G, Scully C, Carrozzo M, Griffiths M, Sugerman PB, Thongprasom K. Current controversies in oral lichen planus: Report of an international consensus meeting. Part 2. Clinical management and malignant transformation. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2005;100(2):164-78.
22) Jainkittivong A, Kuvatanasuchati J, Pipattanagovit P, Sinheng W. Candida in Oral Lichenplanus patients undergoing topical steroid therapy. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2007;104(1):61-6.
23) Gonzalez-Garcia A, Diniz-Freitas M, Gandara-Vila P, Blanco-Carrion A, Garcia-Garcia A, Gandara-Rey J. Triamcinolone acetonide mouth rinse for the treatment of erosive oral lichen planus: efficacy and risk of fungal over infection. Oral Dis. 2006;12:559-65.
24) Eisen D. The therapy of Oral lichen planus. Crit Rev Oral Biol Med. 1993;4:141-58.
25) Richard DPN, Batsiou M, Bjermer L, Bosnic-Antic ES, ChryStyn H. Incidence of oral thrush in patients with COPD prescribed inhaled corticosteroids: Effect of drug, dose, and device. Respir Med. 2016;120:54-63.
26) Kennedy WA, Laurier C, Gautrin D. Occurrence and risk factors of oral Candidiasis treated with oral antifungals in seniors using inhaled steroids J Clin Epidemiol 2000;53(7):696-701.
27) Bryant L, Bang C, Chew C, Baik SH, Wiseman D. Adequacy of inhaler technique used by people with asthma or chronic obstructive pulmonary disease. J Prim Health Care. 2013;5(3):191-98.
28) Knight L, Fletcher J. Growth of Candida albicans in saliva: stimulation by glucose associated with antibiotics, corticosteroids, and diabetes mellitus J Infect Dis. 1971;123(4):371-77.
29) Fardet L, Petersen I, Nazareth I. Common Infections in patients prescribed systemic glucocorticoids in primary care: A population-based cohort study. PLOS Medicine. 2016; DOI:10.1371/journal.pmed.1002024.
30) Hatchuel DA, Peters E, Lemmer J, Hille JJ, McGaw WT. Candidal infection in oral lichen planus. Oral Surg Oral Med Oral Pathol. 1990;70:172-5.
31) Zeng X, Xiong C, Wang Z, Jiang L, Hou X, Shen J, et al. Genotypic profiles and virulence attributes of Candida albicans isolates from patients with oral lichen planus. APMIS. 2008;116:284-91.
32) Mehdipour M, Zenouz AT, Hekmatfar S, Adibpour M, Bahramian A, Khorshidi R. Prevalence of candida species in erosive oral lichen planus. J Dent Res Dent Clin Dent Prospect. 2010;4:14-16.
33) Masaki M, Sato T, Sugawara Y, Sasano T, Takahashi N. Detection and identification of non-Candida albicans species in human oral lichen planus. Microbiol Immunol. 2011;55(1):66-70.
34) Shivanandappa SG, Ali I, Sabarigirinathan CS, Mushannavar L. Candida in Oral Lichen Planus. J Indian Acad Oral Med Radiol. 2012;24:182-5.
35) Artico G, Freitas RS, Santos Filho AM, Benard G, Romiti R, Migliari DA. Prevalence of Candida spp., Xerostomia, and hyposalivation in oral lichen planus--a controlled study. Oral Dis. 2014;20: 36-41.
36) Werneck JT, de-Oliveira CT, Stibich CA, Almeida LC, Dias EP, Silva J. An Oral lichen planus: study of 21 cases. A Bras Dermatol. 2015;90(3):321-6.
37) Arora S, Verma M, Gupta SR, Urs AB, Dhakad MS, Kaur R. Phenotypic variability and therapeutic implications of Candida species in patients with oral lichen planus. Biotech Histochemis. 2016;91(4):237-41.
38) Hong He, Xia X, Yang H, Peng Q, Zheng J. A pilot study: a possible implication of Candida as an etiologically endogenous pathogen for oral lichen planus. BMC Oral Health. 2020; 20(1):72. DOI: 10.1186/s12903-020-1042-8
39) Miranda FB, Werneck JT, Dias EP, Milagres A, Gonçalves LS, Silva J. A Clinical behaviour of Oral Lichen planus in association with Candidiasis. Med Mycol. 2020;7(1):1-5.
40) Al Hashimi I, Schifter M, Lockhart PB. Oral Lichen planus and lichenoid lesions: diagnostic and therapeutic considerations. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2007;103 Suppl 25:1-12.
41) Kragelund C, Kieffer-Kristensen L, Reibel J. Oral candidosis in lichen planus: the diagnostic approach is of major therapeutic importance. Clin Oral Investig. 2013;17:957-65.
42) Lundstrom IMC, Anneroth GB, Holmberg K. Candida in patients with Oral Lichenplanus. Int. J Oral Surg. 1984;13:226-38.
43) Pfaller MA. Antifungal drug resistance: mechanisms, epidemiology, and consequences for treatment. Am J Med. 2012;125:3-13.
44) Lockhart SR, Joly S, Vargas K, Swails-Wenger J, Enger L, Soll DR. Natural defences against candida colonization breakdown in the oral cavities of the elderly. J Dent Res. 1999;78:857-68.
45) Krogh P, Hald B, Holmstrup P. Possible mycological etiology of oral mucosal cancer: the catalytic potential of infecting Candida albicans and other yeasts in production of N-nitrosobenzyl methylamine. Carcinogenesis. 1987;8(10):1543-8.
46) Gayathri K, Balachander N, Malathi L, Sankari Sl. Candida in potentially malignant oral disorders. J Pharm Bioallied Sci. 2015;7(5):164.
47) Simark-Mattsson C, Eklund C. Reduced immune responses to purified protein derivative and Candida albicans in oral lichen planus. J Oral Pathol Med. 2013;42:691-7.
48) Gainza-Cirauqui ML, Nieminen MT, Novak Frazer L, Aguirre-Urizar JM, Moragues MD, Rautemaa R. Production of carcinogenic acetaldehyde by Candida albicans from patients with potentially malignant oral mucosal disorders. J Oral Pathol Med. 2013;42:243-9.
49) Cribier B, Frances C, Chosidow O. Treatment of Lichen planus-An Evidence based Medicine Analysis of Efficacy. Arcaurh Dermatol. 1998;134(12):1521-1530.
50) Henriksen DP, Davidsen JR, Laursen CB, Christiansen A, Laursen CB, Damkier P, et al. Inhaled corticosteroids and systemic or topical antifungal therapy: a symmetry analysis. Ann Am Thorac Soc. 2017;14(6):1045-1047.
51) Miravitlles M, Auladell-Rispau A, Monteagudo M, Vázquez-Niebla JC, Mohammed J, Nunez A, et al. Systematic review on long-term adverse effects of inhaled corticosteroids in the treatment of COPD. Eur Respir Rev. 2021;30(160):210075. doi: 10.1183/16000617.0075-2021.
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Feb 4, 2023
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Alqahtani, S. S., & Faris M. Alabeedi. (2023). Association of Oral Candidiasis with Oral Lichen planus in patients using corticosteroid therapy- Meta-analysis. Journal of Population Therapeutics and Clinical Pharmacology, 30(1). https://doi.org/10.47750/jptcp.2023.1020
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All articles published in JPTCP are licensed under Copyright Creative Commons Attribution-NonCommercial 4.0 International License.
How to Cite
Alqahtani, S. S., & Faris M. Alabeedi. (2023). Association of Oral Candidiasis with Oral Lichen planus in patients using corticosteroid therapy- Meta-analysis. Journal of Population Therapeutics and Clinical Pharmacology, 30(1). https://doi.org/10.47750/jptcp.2023.1020