Upper gastrointestinal findings and detection of Helicobacter pylori in patients with oral lichen planus

Abstract

Lichen planus (LP) is a mucocutaneous disease of unknown aetiology, which may involve the gastrointestinal (GI) mucosa. The association of Helicobacter pylori with LP has been a subject of debate. To investigate upper GI findings and the presence of H. pylori in GI mucosa and oral LP (OLP). Oral biopsies from 20 patients with erosive OLP and 20 with non-erosive OLP were investigated for the presence of H. pylori by histopathological examination and PCR. Upper GI endoscopy and GI mucosal biopsies were examined for LP lesions and/or H. pylori. The endoscopic findings of both groups were oesophagitis, antral gastritis and duodenitis. No LP or LP-like changes were found in the upper GI mucosa. H. pylori was found by histopathological examination in the gastric mucosa of 18 patients (45%), with equal distribution in both the control and study groups. Positive PCR results were obtained from biopsy specimens of oral lesions in all patients with erosive OLP and presence of H. pylori in the stomach (9 patients), but in none of the patients with non-erosive OLP (P = 0.001). We did not find any difference in symptoms, endoscopic findings and histopathological results between patients with erosive and non-erosive OLP. However, the concomitant presence of erosive OLP, of H. pylori nucleic acid in erosive OLP and the H. pylori organisms in gastric mucosa implies a possible pathogenic connection between this bacterium and erosive OLP.