Abstract
BackgroundTo examine if patients with oral lichen planus, oral lichenoid lesions and generalised stomatitis and concomitant contact allergy have more frequent and severe xerostomia, lower unstimulated and chewing-stimulated saliva and citric-acid-stimulated parotid saliva flow rates, and higher salivary concentration of total protein and sIgA than cases without contact allergy and healthy controls.MethodsForty-nine patients (42 women, aged 61.0 ± 10.3 years) and 29 healthy age- and gender-matched subjects underwent a standardised questionnaire on general and oral health, assessment of xerostomia, clinical examination, sialometry, mucosal biopsy and contact allergy testing.ResultsNineteen patients had oral lichen planus, 19 patients had oral lichenoid lesions and 11 patients had generalised stomatitis. 38.8% had contact allergy. Xerostomia was significantly more common and severe in patients (46.9%) than in healthy controls, whereas the saliva flow rates did not differ. The patients had higher sIgA levels in unstimulated and chewing-stimulated saliva than the healthy controls. The total protein concentration in saliva was lower in the unstimulated saliva samples whereas it was higher in the chewing stimulated saliva samples from patients when compared to healthy controls. The differences were not significant and they were irrespective of the presence of contact allergy.ConclusionXerostomia is prevalent in patients with oral lichen planus, lichenoid lesions and generalised stomatitis, but not associated with salivary gland hypofunction, numbers of systemic diseases or medications, contact allergy, age, or gender. Salivary sIgA levels were higher in patients than in healthy controls, but did not differ between patient groups. The total salivary protein concentration was lower in unstimulated saliva samples and higher in chewing-stimulated saliva samples in patients than in healthy controls, but did not differ between patient groups. Our findings do not aid in the discrimination between OLP and OLL and these conditions with or without contact allergic reactions.
Highlights
To examine if patients with oral lichen planus, oral lichenoid lesions and generalised stomatitis and concomitant contact allergy have more frequent and severe xerostomia, lower unstimulated and chewingstimulated saliva and citric-acid-stimulated parotid saliva flow rates, and higher salivary concentration of total protein and Secretory immunoglobin A (sIgA) than cases without contact allergy and healthy controls
We have previously shown that only 15% of the 45% Oral lichen planus (OLP) patients who complained about xerostomia, had hyposalivation, and this could be related to a daily intake of cardiovascular medications including antihypertensives known to cause xerostomia and/or hyposalivation [18, 27, 28]
We found no significant differences in Unstimulated whole saliva (UWS), Chewing stimulated whole saliva (SWS) and stimulated parotid saliva (SPS) flow rates between the patients with and without concomitant allergies and the healthy control subjects, there was a tendency towards lower UWS flow rates in patients with OLP/oral lichenoid lesions (OLL) and a concomitant contact allergy
Summary
To examine if patients with oral lichen planus, oral lichenoid lesions and generalised stomatitis and concomitant contact allergy have more frequent and severe xerostomia, lower unstimulated and chewingstimulated saliva and citric-acid-stimulated parotid saliva flow rates, and higher salivary concentration of total protein and sIgA than cases without contact allergy and healthy controls. OLP and OLL may occur in conditions that are associated with xerostomia and salivary gland hypofunction, including Sjögren’s syndrome, hepatitis C infection, type 1 diabetes, and graft-versus-host disease [21,22,23,24,25,26] Patients with these conditions often display immune-mediated sialoadenitis which may affect the function of the salivary glands. It is still debatable whether the complaints of dry mouth and other sicca symptoms should be ascribed the OLP/OLL alone or whether they reflect a pathogenic association to systemic autoimmune diseases in which xerostomia and salivary gland dysfunction are common clinical manifestations. Another study on 100 patients with OLP found no associations between OLP and low unstimulated and citric acid stimulated whole saliva flow rates [30]
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