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Oral lichen planus (OLP) is an immunologically T cell-mediated disease caused by an unknown stimulus. Despite intensive investigation its pathogenesis still remains unknown. A few possible associations between OLP and certain diseases such as thyroid and malignant diseases as well as specific medication intake have been proposed in the literature with inconsistent findings. We aimed to investigate the profile of 163 Australian and 163 Croatian OLP patients with special regard to their systemic diseases, medication intake (with special regard to the drugs that metabolize through Cytochrome P450), OLP type and localization, as well as involvement of other body surfaces with lichen. We did not find any statistical significance with regard to the OLP presence and thyroid and malignant diseases. As expected, the reticular type of OLP was most prevalent, as well as involvement of the both buccal mucosas. There was no significant association with other oral diseases such as labial herpes. Simultaneous involvement of other body surfaces in patients with OLP does not seem to be prevalent. None of the medical conditions which were investigated had significant correlation with OLP neither in Australian nor in Croatian patients with OLP. Furthermore, the use of drugs which metabolize through Cytochrome P450 (CYP450) was not significantly correlated with OLP in either studied population. Therefore, we conclude that patients with OLP are not to be routinely screened for any systemic conditions.

"Non-Aromatic Very rich in Steranes" (NAVS) naphthalan is a purified natural oil derivative, abundant in steranes (geogenic "steroids"). The purpose of this study was to evaluate the effectiveness of NAVS in the treatment of oral lichen planus (OLP) and recurrent aphthous stomatitis (RAS). We used NAVS oil in adhesive paste in 11 patients with clinically and histologically proven OLP (open label), and in 7 patients with RAS (double blind randomized; topical betamethasone in adhesive paste used as control). The severity of the OLP lesions was objectively scored. The number and diameter of RAS lesions were assessed on days 0, 3, and 5. The intensity of pain and discomfort was determined using visual analogue scale (VAS) and "Oral health impact profile" (OHIP-14) before and after therapy. OLP cumulative activity scores on days 0 and 28 were 101.5 and 48.5, respectively (t=5.99; P=0.0001). Using NAVS for 28 days resulted in 52.2% overall clinical improvement. Cumulative OHIP-14 scores on days 0 and 28 were 210 and 142, respectively (t=5.65; P=0.0002). Out of a total of 7 patients with RAS, 4 of them were treated with NAVS and 3 with topical corticosteroids. There were no statistically significant differences in improvement rate between the two groups (lesion number (day 3 P=0.29; day 5 P=0.32); lesion diameter (day 3 P=0.64; day 5 P=0.74)). NAVS successfully reduced the clinical signs and symptoms of OLP, and reduced the number, diameter, and symptoms in patients with RAS, statistically comparable with corticosteroids.

We report a case of propolis allergy in an 18-year-old female patient. Medical history revealed self-prescribed topical use of propolis spray as a medication for gingival swelling caused by orthodontic molar bands. After 24 hours, the patient developed lip edema and erythema of the perioral skin accompanied by burning pain in her lips. Discrete erosions were present in the corners of her lips. Erythema of the right infraorbital region was also observed. The patient was prescribed betamethasone propionate cream two times daily. Complete recovery was observed after 10 days. Propolis allergy was confirmed by a patch test. We believe that the use of propolis for the treatment of oral diseases should be avoided due to sparse evidence of its efficacy and numerous cases of allergic reactions.

Orofacial granulomatosis (OFG) is an uncommon disease, usually presenting as recurrent or persistent swelling of the soft tissues in the orofacial region, predominantly lips (cheilitis granulomatosa). The cause of this illness is unknown. OFG may also be part of the triad of Melkersson-Rosenthal syndrome (MRS) and some consider it a monosymptomatic form of MRS. We describe a case of a Croatian male patient with recurrent swelling limited to the upper lip for the past 6 years. After establishing the diagnosis, we performed intralesional triamcinolone injections (16 mg, twice on a weekly schedule), resulting in complete remission. OFG differential diagnosis and treatment modalities are discussed.