title: Can deram be a cause of oral lichen planus?
abstract: OBJECTIVE
  To study the relationship between oral lichen planus LP and the habit of chewing deram.
  
  
  METHODS
  A clinically based controlled observational study including a total of 176 women who used to chew deram and 200 women who never used deram, who consulted the Dermatology Department of Basrah Teaching Hospital, and a private clinic, Barsah, Iraq during the period from February 2005 to July 2007.
  
  
  RESULTS
  The study showed that the incidence of oral LP is greater among 176 deram chewers (23.3%) in comparison with 200 women who never use deram (1.5%), particularly among those with frequent (51.2%) and prolonged (65.8%) chewing of deram. Oral lesions, were mostly asymptomatic (80.5%) and predominantly of reticulate pattern (87.9%). Avoidance of deram chewing induced marked or complete improvement of the oral lesions in 56.3% of cases even without treatment within a 3 month follow up period. Pathological examination showed features similar to classical LP.
  
  
  CONCLUSIONS
  Deram chewing should be considered as a possible cause of oral LP, particularly among frequent and prolonged chewers.
authors.affiliation: Department of Dermatology, Basrah Medical College, Basrah, Iraq. khalil_hamdi2003@yahoo.com
authors.forename: Khalil I
authors.initials: KI
authors.lastname: Al-Hamdi
mesh_terms: D000284:Administration, Oral; D000293:Adolescent; D000328:Adult; D016022:Case-Control Studies; D015331:Cohort Studies; D003358:Cosmetics / Q000008:administration & dosage; D005260:Female; D006801:Humans; D007493:Iraq; D031324:Juglans; D017676:Lichen Planus, Oral / Q000453:epidemiology* / Q000473:pathology; D008409:Mastication; D008875:Middle Aged; D028321:Plant Preparations / Q000008:administration & dosage*; D012307:Risk Factors
chemical_list: D003358:Cosmetics; D028321:Plant Preparations