Possible link between Hashimoto's thyroiditis and oral lichen planus: a novel association found

Clin Oral Investig. 2013 Jan;17(1):333-6. doi: 10.1007/s00784-012-0767-4. Epub 2012 Jun 15.

Abstract

Objectives: Hashimoto's thyroiditis as well as lichen planus has been associated to a number of disorders, generally of auto-immune origin. A novel possible association between oral lichen planus (OLP) and Hashimoto's thyroiditis (HT) is here proposed on the basis of a cross-sectional survey.

Materials and methods: One hundred and five unrelated OLP patients were considered. Diagnosis of HT was based on positive serum anti-TPO, anti-Tg, TSH levels and the typical ultrasound pattern of the thyroid gland.

Results: In the present survey, the prevalence of HT in the OLP group was 14.3 % whereas the prevalence of HT-related hypothyroidism in the general population was reported to be equal to 1 %. By Fisher's exact test, it was revealed that the difference between our data and historical prevalence of HT was found statistically significant.

Conclusion: Actually, there is no definitive hypothesis that could explain the coexistence of OLP and HT. However, considering the onset timing of HT followed by OLP in 93.3 % of our series, we suspected a causal or predisposing role for HT. Specifically, we believe that in HT patients, circulating thyroid antibodies could contribute to trigger an organ-specific auto-immune response also in the oral mucosa or skin, leading to the development of LP lesions.

Clinical relevance: Because of the large number of cases of asymptomatic chronic auto-immune thyroiditis, it would be useful that women over 40 years of age affected by OLP were screened for thyroid dysfunction, particularly HT.

MeSH terms

  • Adult
  • Autoantibodies / analysis
  • Autoantigens / analysis
  • Cross-Sectional Studies
  • Female
  • Hashimoto Disease / epidemiology*
  • Humans
  • Iodide Peroxidase / analysis
  • Iron-Binding Proteins / analysis
  • Italy / epidemiology
  • Lichen Planus, Oral / epidemiology*
  • Middle Aged
  • Prevalence
  • Thyroid Nodule / epidemiology
  • Thyrotropin / analysis
  • Thyroxine / analysis
  • Triiodothyronine / analysis

Substances

  • Autoantibodies
  • Autoantigens
  • Iron-Binding Proteins
  • Triiodothyronine
  • Thyrotropin
  • TPO protein, human
  • Iodide Peroxidase
  • Thyroxine