Advances in Clinical and Experimental Medicine
2018, vol. 27, nr 12, December, p. 1729–1736
Publication type: original article
Application of fractal dimension analysis and photodynamic diagnosis in the case of differentiation between lichen planus and leukoplakia: A preliminary study
1 Department of Oral Surgery, Faculty of Dentistry, Wroclaw Medical University, Poland
2 Department of Pathology, Faculty of Medicine, Wroclaw Medical University, Poland
Background. Photodynamic therapy (PDT) is a noninvasive method for the treatment of premalignant lesions, such as leukoplakia and lichen planus (LP). These lesions are very irregular. In the case of such irregular lesions, fractal dimension analysis (FDA) is very helpful. Photodynamic diagnosis (PDD) enables the visualization of irregular lesion shapes more precisely than a classical white-light examination.
Objectives. In our study, we tried to distinguish oral leukoplakia and LP, using FDA in a classical examination with white light and PDD. Lesions treated using PDT were histopathologically verified.
Material and Methods. We enrolled 35 patients in our study. Fractalyse software v. 2.4 (University of Franche-Comté, Besançon, France) was used to count fractal dimensions (FDs). Photodynamic therapy and PDD were mediated with 20% delta-aminolevulinic acid (5-ALA).
Results. Fractal dimensions of leukoplakia foci of the tongue in a white-light examination were significantly lower than in PDD. In the case of LP, a significant difference of FDs was observed between lesions in the cheek and in the alveolar ridge region. Differences in FDs were observed between leukoplakia foci of the alveolar ridge, tongue and palate. A complete response of leukoplakia foci to PDT was observed in 10 out of 34 lesions, partial remission occurred in 20 lesions and a total lack of response was noted in 4 lesions. Generally, LP was completely treated in 7 out of 14 cases, a partial response was observed in 5 lesions and a failure of PDT treatment was noted in 2 cases.
Conclusion. Fractal dimension analysis may be a useful method in the comparison of complicated shapes of such lesions as LP or leukoplakia, but our study did not confirm that this method may be used to distinguish LP and leukoplakia without a histopathological examination. Photodynamic therapy is an effective treatment method in the case of LP and leukoplakia of the oral cavity.
photodynamic therapy, lichen planus, leukoplakia, fractal dimension analysis, photodynamic diagnosis
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