Severity Of Lichen Planus Research Articles

The Typical Nail Lichen Planus Severity Index: An Outcome Instrument for Typical Nail Lichen Planus.

Despite numerous treatment options for nail lichen planus (NLP), a validated method for measuring the severity of NLP and therapeutic response in clinical trials is absent. The aim of the study was to develop and validate a measurement instrument, Typical Nail Lichen Planus Severity Index (tNLPSI), for typical NLP that could be used in clinical trials. A total of 48 patients pathologically confirmed with typical NLP were enrolled in this study. Five dermatologists were trained to use the tNLPSI activity scale and the Physician's Global Assessment (PGA) scale to score samples independently to estimate inter-rater and intra-rater reliability across two sessions. In addition, tNLPSI activity scores were compared with PGA scores to assess the construct validity. The tNLPSI activity scale had excellent internal consistency and inter-rater reliability (Cronbach's alpha 0.990; ICC = 0.954; 95% CI = 0.930-0.971), and the correlations between the different graders' scores indicate good consistency (rp = 0.934-0.968). In addition, the tNLPSI activity scale demonstrated high intra-rater reliability (ICC = 0.996; 95% CI = 0.993-0.998), showing good reproducibility. And tNLPSI activity scores and PGA scores showed good construct validity (Spearman's rho = 0.941 and Spearman's rho = 0.903-0.935, respectively; p < 0.01). The tNLPSI activity scale was demonstrated to be consistent, reliable, reproducible, and feasible, making it a potential valuable tool for evaluating the treatment response in typical NLP clinical trials.

Oral mucosal changes in tight junction proteins in patients with oral lichen planus.

This study aimed to investigate the expression of tight junction, its distribution pattern in oral lichen planus samples and its potential association with the severity of oral lichen planus. Cross-sectional study designs were conducted. Transcriptome sequencing was conducted using oral mucosal tissues from 22 patients with oral lichen planus and 11 healthy controls. Immunohistochemistry and quantitative reverse transcription PCR were performed to verify the expression of claudin-1, claudin-4, occludin and zonula occludens-1 in oral mucosal tissues from another 30 patients with oral lichen planus and 26 healthy controls. The relationship between tight junction protein expression and oral lichen planus severity was explored using correlation analysis. 5603 and 2475 differentially expressed genes were upregulated and downregulated respectively, in oral lichen planus tissues. KEGG analysis showed that tight junctions including CLDN1, CLDN4, OCLN and TJP1 were downregulated in oral lichen planus. Claudin-1, claudin-4, occludin and zonula occludens-1 expression was verified to be significantly lower in oral lichen planus. Furthermore, correlation analyses showed that decreased occludin expression was positively related to oral lichen planus severity. Decreased expression of TJ barrier proteins may be associated with the development of oral lichen planus.

Analysis of oral lichen planus severity on micro-RNA linked with malignant transformation risks.

The present study evaluated the oral tissue expression of micro-RNA (miRNAs) linked to the potential malignant evolution of oral lichen planus (OLP). Furthermore, the correlation between OLP severity and miRNAs expression was assessed, and possible predictors of miRNAs in OLP patients were identified. The present study enrolled 41 patients with OLP (median age 58 years) and 42 healthy controls (median age 59 years). In each patient, miRNA levels (miR-7a-3p,-7a2-3p,-7a-5p,-21-3p,-21-5p,-100-3p,-100-5p,-125b-2-3p,-125b-5p,-200b-3p,-200b-5p) were assessed and analyzed through reverse transcription polymerase chain reaction. Clinical parameters and the eventual presence of OLP symptoms, signs, and disease severity scores in each patient were reported using an anamnestic questionnaire. In comparison with healthy controls, OLP patients showed significantly higher miR-7a-3p,-7a-2-3p,-21-3p, miR-21-5p and miR-100-5p levels (p < 0.05) and significantly lower miR-125b-2-3p,-125b-5p,-200b-3p, and -200b-5p levels (p < 0.05). Furthermore, OLP symptoms and signs and disease severity scores were significantly correlated and were also predictors of all analyzed miRNAs (p < 0.05). In comparison with healthy subjects, OLP patients exhibited unbalanced oral miRNAs expression linked to the risk of potential malignant evolution of OLP. Furthermore, some miRNAs were correlated with OLP extent and were significant predictors of OLP symptoms, signs, and disease severity scores.

Assessment of serum levels of anti-gliadin (IgA and IgG) antibodies in patients with lichen planus: A pilot study

elevated AGA levels have been reported in several immune-mediated cutaneous conditions even in the absence of gastrointestinal disease clinical manifestations. A gluten-free diet led to improvements in some of these disorders. The link between oral lichen planus (LP) and CD was revealed, but there is currently no information available regarding the association between cutaneous LP and gluten sensitivity. This study aimed to assess the AGA (IgA and IgG) serum levels in LP patients compared to controls and to determine their correlation with LP severity. The study included 20 patients with cutaneous LP and 20 age- and sex-matched controls, both free of CD manifestations. The enzyme-linked immunosorbent assay (ELISA) technique was utilized for the evaluation of AGA (IgA and IgG) serum levels. Hepatitis C virus (HCV) antibodies in LP patients were evaluated qualitatively using a chromatographic immunoassay. In LP patients, AGA (IgA and IgG) serum levels were significantly elevated compared to controls (p = 0.015 and p=0.016, respectively). A significant positive correlation between AGA (IgG) serum levels and the age of patients (p= 0.024), duration of disease (p= 0.02), and LP severity index (p&lt; 0.0001) was found. AGA serum levels were insignificantly different between HCV-positive and HCV-negative LP patients (p= 0.054). In conclusion, the significant elevation of serum AGA levels in LP patients reflects a possible link between LP and occult CD. Serum AGA (IgG) levels can be used as a marker of LP severity..

Introducing a novel histopathological scoring system to assess disease activity and chronicity in cutaneous lichen planus: A proposal.

Lichen planus (LP) is a chronic inflammatory disorder caused by an autoimmune attack by cytotoxic T-cells. The clinical course is variable, with episodes of remission and exacerbation. A clinicopathological scoring system for cutaneous LP is not available for effectively assessing disease severity and monitoring treatment response. This study was designed with the aim of proposing an objective and reproducible scoring system, comprising histopathological features of active and chronic disease, and to correlate these scores with clinical morphology groups. This is a retrospective study of 200 cases of cutaneous LP, which were categorized into five clinical groups (I-V) at the time of biopsy. The corresponding histopathological feature was assigned a score based on feature of active and chronic disease. Individual scores were summated to calculate a histopathological index (index [AI] and chronicity index [CI]). The comparison of indices between various clinical groups was performed by Mann-Whitney U test. The median AI was lowest (1) for post-inflammatory hyperpigmentation (clinical group I) and highest (7) for the bullous group (clinical group IV). The median CI (7) was highest for the scarring group (clinical group V). The difference between median AI of clinical group I (post-inflammatory hyperpigmentation) and rest of the groups (clinical groups II, III, IV, and V) was statistically significant (p value <0.05). We present this clinico-histopathological scoring system as a reliable and facile method of assessing the activity and severity of LP.

Nail Lichen Planus Severity Index (NALSI): A Novel Severity Score for Nail Lichen Planus.

Clinical challenge Rigorous data on treatment options in nail lichen planus (LP) is lacking and even the existing studies do not offer robust scientific evidence.[1] This is primarily due to lack of a comprehensive severity scoring tool for enabling consistent, comparative and thorough evaluation. It is unlike nail psoriasis, where nail psoriasis severity index (NAPSI) is a commonly used objective, validated tool for assessing nail disease severity and response to treatment.[2] We propose a nail severity score for nail LP which takes into account the peculiarities of this disease e.g., only few features being responsive to therapy; presence of scarring and irreversible changes; and extensive involvement of the nail unit including nail folds. Solution The nail lichen planus severity index (NALSI) is to be scored in four quadrants per nail, like NAPSI where two imaginary lines, perpendicular to each other are drawn. We score nail matrix, nail bed, and nail fold features per quadrant. A score of 0 or 1 is assigned based on the absence or presence of nail matrix disease features [longitudinal ridging/fissuring, longitudinal melanonychia, thinning/thickening of the nail plate, trachyonychia, red/mottled lunula]; nail bed features [diffuse/longitudinal erythema, discoloration (yellow, black, or dyschromia), onycholysis and/or subungual hyperkeratosis, bullous/erosive lesions]; or nail fold features [pigmentation, swelling, LP lesions, and ragged cuticle] [Figure 1; Table 1]. Thus, a maximum score of 3 per quadrant and 12 per nail is possible. In addition, irreversible changes [dorsal pterygium, atrophy, anonychia, or disappearing nail bed] are recorded separately with the English alphabet ‘I’ (for irreversible) being added to the final score [Figure 2]. Thus, the worst possible score would be 12-I per nail and nails without the “I” score could be chosen for comparing treatment efficacy. NALSI can be an objective and simple scoring system estimating the extent of involvement and location of diseases within the nail unit, and is subject to change with both the progression of disease or its resolution with or without treatment.Figure 1: Clinical picture of nail lichen planus showing the Nail Lichen planus Severity Index (NALSI) scoring. Each small box in each of the four quadrants is scored as 1 (if any one of the nail matrix/nail bed/nail fold feature is present) or 0 (if no nail matrix/nail bed/nail fold feature is present). The score for this nail is 10Table 1: Parameters to be Recorded in Nail Lichen Planus Severity Index (NALSI) ScoringFigure 2: Clinical picture of nail lichen planus showing the Nail Lichen planus Severity Index (NALSI) scoring. Each small box in each of the four quadrants is scored as 1 (if any one of the nail matrix/nail bed/nail fold feature is present) or 0 (if no nail matrix/nail bed/nail fold feature is present). The score for this nail is 8-IFinancial support and sponsorship Nil. Conflicts of interest There are no conflicts of interest.

AYURVEDIC APPROACH ON LICHEN PLANUS WITH SPECIAL REFERENCE TO KITIBHA KUSHTHA: A CASE STUDY

Skin disease makes as a great impact as other serious medical conditions when assessed by effects on health-related quality of life. There has been widespread acknowledgment that skin diseases can affect physical, social, and psychological aspects of patient’s everyday lives, as well as their partners, family, and friends, one such disease is Lichen planus. Lichen planus is a pruritic, benign, papulo-squamous, inflammatory dermatosis of unknown aetiology that affects either or all the skin, mucous membrane, hair, and nails. In its classical form, it presents with violaceous, scaly, flat topped, polygonal and papules. In classical texts of Ayurveda, the diagnosis is considered as Kitibha Kushtha. Kitibha Kushtha is vata and kapha dosha dominant condition in class of Kshudra Kushtha which has lakshanas like Shyava, Kina-khara sparsha, Parusha. Here, an effort was made to treat a thirty-eightyears old female diagnosed with Kitibha Kushtha vis-a-vis Lichen planus by classical Ayurveda regimens. She was administered with Shodhana therapies (bio-cleansing procedures) and then followed by intake of Thuvaraka rasayana and Shamana Aushadhis. The total duration of the treatment was 44 days, and the Study subject assessed before treatment and after treatment for improvement using Lichen planus Severity Index. All the symptoms observed in the beginning were found considerably reduced, and the severity also found mild.

Estimation of neutrophil activation marker in lichen planus patients.

Lichen planus disease is a chronic inflammatory disorder of mucosal and cutaneous tissues, and its etiology and pathogenesis are unclear. Cytokines have a significant role in the beginning, the maintenance of inflammatory and intercellular crosstalk. We assessed serum levels of neutrophil activation marker (calprotectin) in patients with cutaneous lichen planus with different subtypes and made a comparison with healthy individuals. Peripheral blood samples of 30 cases with lichen planus were compared with 30healthy individuals. Serum samples were prepared from LP patients, using a commercial ELISA kit, and calprotectin level was measured in each serum sample. The serum level of calprotectin was significantly raised in LP cases compared with control (141.34±17.47ng/ml versus 40.03±1.54ng/ml respectively; p<0.001). No correlation was recorded among of serum of calprotectin and patients' ages, sex, disease period, and the existence or strength of pruritus. But a strong positive correlation was present between the coexistence of oral lesions and the number of locations. Calprotectin can be used as a marker of Lichen planus severity and progression. Calprotectin may play a role in the pathogenesis of LP.

Does signal transducer and activator of transcription-3 have a role in lichen planus?

ObjectiveThe aim was to evaluate the role of signal transducer and activator of transcription 3 (STAT3) in lichen planus (LP).BackgroundLP is a chronic mucocutaneous T-cell-mediated inflammatory disease. STAT3 is responsible for signal transmission to the nucleus from many receptors and nonreceptor-associated kinases.Materials and methodsA prospective case–control study was conducted on 20 cases with LP and 20 age-matched, sex-matched, and localization-matched apparently healthy participants. All sections were immunohistochemically stained for STAT3.ResultsThere were significant differences between the studied groups regarding STAT3 positivity in both dermis and epidermis (P = 0.043 for both), as well as STAT3 intensity of expression in epidermis and dermis (P = 0.008 and 0.001, respectively). There were significant associations between moderate and strong STAT3 expression and generalized lesions, presence of precipitating factors, presence of dermal melanophages, and presence of moderate spongiosis (P = 0.01, 0.005, 0.05, and 0.04, respectively).ConclusionOverexpression of STAT3 in LP could play a role in pathogenesis and severity of LP. Anti-STAT3 target therapy might be suggested to ameliorate LP.

Evaluation of Angiopoietin 2 Serum Level in Lichen Planus and Psoriasis Patients

Background: Psoriasis and lichen planus (LP) are common chronic inflammatory skin diseases. The exact pathogenesis of these diseases until now is not fully determined. Angiogenesis is tightly regulated by a balance between pro- and anti-angiogenic mediators. Objective: To assess the relation of Ang-2 serum level with angiogenesis and inflammation that occurs in psoriasis and lichen planus. Patients and Methods: Thirty adult patients were included in this study. They were divided into 2 groups, 15 patients each, of psoriasis and lichen planus (8 patients with combined cutaneous and oral LP and 7 patients with cutaneous LP only). In addition to fifteen healthy subjects taken as control. The activity of the diseases was estimated at the time of examination using specific activity index for each disease. The serum level of angiopoietin 2 had been estimated by ELISA. Results: It was found that these diseases had significantly higher serum levels of angiopoietin 2 than the control group. The serum levels of angiopoietin 2 were higher in psoriasis compared to lichen planus, but the difference between psoriasis and lichen planus was not statistically significant. There was significant positive correlation between serum levels of angiopoietin 2 and the clinical severity of psoriasis. On the other hand, there was no correlation between serum level of angiopoietin 2 and the clinical severity of lichen planus. Conclusion: An important evidence on the importance of angiopoietin 2 serum level in pathogenesis of lichen planus as well as psoriasis. It elevated in serum of psoriasis and lichen planus patients that reflects its role in angiogenesis and inflammation that are important events in the development of these diseases.

Evaluation of Angiopoietin 2 Serum Level in Lichen Planus and Psoriasis Patients

Background: Psoriasis and lichen planus (LP) are common chronic inflammatory skin diseases. The exact pathogenesis of these diseases until now is not fully determined. Angiogenesis is tightly regulated by a balance between pro- and anti-angiogenic mediators. Objective: To assess the relation of Ang-2 serum level with angiogenesis and inflammation that occurs in psoriasis and lichen planus. Patients and Methods: Thirty adult patients were included in this study. They were divided into 2 groups, 15 patients each, of psoriasis and lichen planus (8 patients with combined cutaneous and oral LP and 7 patients with cutaneous LP only). In addition to fifteen healthy subjects taken as control. The activity of the diseases was estimated at the time of examination using specific activity index for each disease. The serum level of angiopoietin 2 had been estimated by ELISA. Results: It was found that these diseases had significantly higher serum levels of angiopoietin 2 than the control group. The serum levels of angiopoietin 2 were higher in psoriasis compared to lichen planus, but the difference between psoriasis and lichen planus was not statistically significant. There was significant positive correlation between serum levels of angiopoietin 2 and the clinical severity of psoriasis. On the other hand, there was no correlation between serum level of angiopoietin 2 and the clinical severity of lichen planus. Conclusion: An important evidence on the importance of angiopoietin 2 serum level in pathogenesis of lichen planus as well as psoriasis. It elevated in serum of psoriasis and lichen planus patients that reflects its role in angiogenesis and inflammation that are important events in the development of these diseases.

Assessment of CLA+T-cell subpopulations in the blood of patients with chronic dermatoses

Background. CLA+T-cell are an important component of skin-associated lymphoid tissue, and thus determine the pathogenesis of many immuno-mediated dermatoses.&#x0D; Aims. Determine the relative number of CLA+T-cell subpopulations in the peripheral blood of patients with psoriasis, lichen planus and atopic dermatitis, as well as assess their impact on the severity of dermatoses.&#x0D; Materials and methods. We examined 82 patients with psoriasis aged 19 to 62 years, 54 patients with lichen planus (LP) aged 18 to 54 years, 44 patients with atopic dermatitis (AD) aged 18 to 44 years, as well as 20 practically healthy individuals aged 18 to 52 years who were admitted to the clinic for the removal of benign skin neoplasms.&#x0D; All patients underwent a standard clinical examination with the determination of indicators that characterize the severity of dermatosis: PASI (Psoriasis Area and Severity Index) for patients with psoriasis, IPSLP (index of prevalence and severity of lichen planus) for patients with lichen planus and SCORAD (Scoring of Atopic Dermatitis) for patients with atopic dermatitis. Defining subpopulations CLA+T-lymphocytes were carried out on a flow cytometer Cytomics FC500 by Beckman Coulter using appropriate combinations of direct monoclonal antibodies and isotopic controls. The groups were compared using the nonparametric Mann Whitney test, and the differences were considered significant at p0,05. To analyze the relationship between the severity of dermatosis and the relative content of subpopulations CLA+T-cells used Spearman's rank correlation coefficient.&#x0D; Results. In patients with psoriasis, a significant increase in the percentage of the total number of T-lymphocytes positive for CLA (CLA+CD3+) and T-helpers positive for CLA (CLA+CD4+) (p=0,002 and 8,5104, respectively), in patients with PL and AD only CLA+CD4+ lymphocytes (p=0,028 and 0,003, respectively). In the progressive period of psoriasis, a direct moderate correlation was found between the circulating subpopulation of cytotoxic T lymphocytes positive for CLA (CLA+CD8+) and the PASI index (rs=0,47; p0,001), in the acute period of AD between the CLA+CD3+ subpopulations and CLA+CD4+ cells and the SCORAD index (rs=0,53; p 0,001 and rs=0,57; p0,001, respectively). In PL, the severity of the course of dermatosis was not accompanied by any significant changes in the CLA-positive T-cell subpopulations.&#x0D; Conclusion. The results of the study confirmed the important role of CLA+T cell subpopulations in the development of chronic dermatoses. In all groups (psoriasis, LP and AD), an increase in the relative number of CLA+CD4+ T-helpers was noted compared with the control group. The relationship between the severity of psoriasis and the relative number of CLA+CD8+ cytotoxic T-lymphocytes, and the severity of AD with CLA+CD3+ and CLA+CD4+ T-helpers is also shown.

A new index to assess the severity of Lichen planus in clinical practice

Purpose.Development and validation of the severity index of lichen planus (LP).&#x0D; Materials and methods.At the first stage, by means of theoretical substantiation, the main parameters and signs were identified that affect the severity of the disease and the quality of life of patients, which culminated in the derivation of the final index formula, which was called the lichen area and severity index (LPASI). At the second stage, LPASI was validated during the examination of 45 LP patients who were treated in the clinic of skin and venereal diseases of the Military Medical Academy in 20182019. Determination of LPASI was carried out by five dermatovenerologists independently of each other twice with an interval of one week.&#x0D; The analysis of the results was carried out using STATISTICA 10.0 programs and SPSS Statistics 17.0. The Spearman Brown and Pearson correlation coefficients were used to evaluate the intra-expert and inter-expert reliability of the index, and the Cronbach's alpha coefficient was calculated to assess the internal consistency of the scale.&#x0D; Results.The final formula for calculating LPASI is as follows: 0.2A+2B+5С+D, where A is the area of skin lesions in percentage, B is the severity of clinical manifestations on the skin, C is the severity of clinical manifestations on the oral mucosa and D is the severity of subjective sensations. The index can range from 0 to 82.&#x0D; The LPASI values for the whole group (n=45) were characterized by a normal distribution of the trait (p0.05), the minimum and maximum values varied from 7.2 to 42 points, the median was 22 points, the interquartile span from 14 to 27 points. The values of the Spearman Brown and Pearson coefficients were equal to 0.91 (95% CI 0.890.99) and 0,87 (95% CI 0.860.93), which indicates the reproducibility of the results and the reliability of the index. In this case, a high consistency between the selected features within the scale (Cronbach's alpha criterion 0.93) was established.&#x0D; Conclusion.Objectification of the severity of the disease using LPASI should become an integral part of the clinical examination of patients. The use of LPASI will allow to control the effectiveness of prescribed therapy, as well as to compare the results of scientific research.

Assessment of neopterin level and severity in lichen planus patients treated with narrow-band ultraviolet B.

Neopterin is a cellular immunity biochemical marker. Serum and saliva neopterin levels have been reported to increase in lichen Planus. Nonetheless, analysis has not yet been made for the direct link between narrow band ultraviolet B and severity of Lichen planus. We aimed to assess serum neopterin levels in patients who receive narrow band ultraviolet B therapy treatment with lichen planus, paired with the severity of the disease. The study consisted of 35 lichen planus patients and 30 healthy individuals. A 35 patient group received narrow band ultraviolet B therapy. An enzyme-related immunosorbent assay procedure was used in serum neopterin analysis before and post-therapy. The correlation between the level and severity of the patient group was statistically significant (P = .001). In patients with severe disease, serum neopterin levels were significantly increased. Also, in the severe lichen planus group, the serum neopterin level was statistically higher than that of the mild or moderate groups (P = .001).Also, a significant decrease was seen following therapy according to serum neopterin level. Serum neopterin levels are a useful marker for the assessment of the severity and effectiveness of narrow band ultraviolet therapy. Thus, our findings may provide a new approach with the management of disease and follow-up strategies in patients with lichen planus.

Lichen Planus Severity Index: A new, valid scoring system to assess the severity of cutaneous lichen planus.

Lichen planus is a chronic autoimmune inflammatory disorder. At present, there is a lack of any specific scoring system to judge the severity of cutaneous lichen planus. Hence, a study was undertaken to establish and validate a system to define the severity of cutaneous lichen planus, i.e. Lichen Planus Severity Index. Skin outpatient department, Krishna Institute of Medical Sciences, Karad. The formulation model was Psoriasis Area Severity Index (PASI) and the validation model was Onychomycosis Severity Index (OSI). The consensus group included two dermatologists and two dermatology residents with special interest in lichen planus and a statistician. Results of the consensus group were compared with a preliminary reproducibility group of two dermatologists and four dermatology residents. Later, reliability assessment was carried out by two groups: 1. Twenty-one dermatologists scored 20 photographs of four patients of lichen planus after being trained to use Lichen Planus Severity Index. 2. Six doctors (three experts and three randomly selected physicians) evaluated ten real-world patients of lichen planus in skin outpatient department. The physicians were blind to the scores assigned by experts. There are five morphological types of lesions seen in lichen planus, namely, erythematous papule, violaceous papule, violaceous plaque, hyperpigmented hypertrophic papule and plaque and postinflammatory hyperpigmentation. Total involved body surface area is determined and a body surface area factor is assigned. Area involvement factor for each of these morphological lesions is calculated and multiplied with the respective multiplication factor. Sum of all the products gives the lesion severity score. Product of lesion severity score with the body surface area factor gives the final Lichen Planus Severity Score. There was no significant difference between the scores of consensus group and preliminary reproducibility group. Both assessment groups showed high reliability. (Group 1: Cronbach alpha = 0.92, ICC = 0.85; Group 2: Cronbach's alpha = 0.99, ICC = 0.92). The correlation between Lichen Planus Severity Index and the standard Physician Global Assessment score was found to be positive (correlation coefficient = 0.73). : The system is tedious and requires a steep learning curve. Possible uses of Lichen Planus Severity Index are yet to be explored and validated. Lichen Planus Severity Index is a new reproducible tool to grade the severity of lichen planus.

Serotonin Expression in Lichen Planus Lesions and Its Relationship with Depression/Anxiety

BackgroundPsychological factors such as stress, depression, and anxiety have been documented to contribute to the development of lesions in lichen planus (LP).ObjectiveTo evaluate the relationship between serotonin expression in LP lesions and depression/anxiety.MethodsForty patients (22 females, 18 males) with LP and 20 healthy control subjects were included in this study. The severity of LP was assessed with the palmar method (using the measurement of affected body surface area [BSA]). The depression and anxiety scores were measured with Beck's depression inventory (BDI) and Beck's anxiety inventory (BAI). The expression of serotonin was determined via immunohistochemistry in LP lesions and in the control group skin using a monoclonal antibody to serotonin.ResultsThe skin biopsies of the LP patients had significantly higher levels of serotonin than those of the control subjects (p<0.001). In the LP patients, and there was a positive correlation between serotonin expression and LP severity (p=0.022). Based on the results from the BDI and BAI, there was a significant relationship between the severity of depression/anxiety and intensity of serotonin expression (p<0.001).ConclusionData from this study suggest that serotonin may have a possible role in the pathogenesis of LP. Further, the relationship between serotonin expression in acute cutaneous lesions and the depression/anxiety scores indicates that serotonin may be a mediator for the association of LP and depression/anxiety simultaneously. There is a need for more specific studies showing the expression of serotonin in the lichen planus to demonstrate the cause or effect.

Psychopathological profile and quality of life of patients with oral lichen planus.

ObjectivesOral lichen planus (OLP) is a chronic, multifocal, sometimes painful, inflammatory disease of the oral mucosa. OLP can predispose development of psycho-emotional disorders. Until now, the relationship between the severity of lichen planus and the psychological profile of patients (psychological well-being, perceived stress and pain coping strategies) has never been studied.Material and MethodsStudy was conducted on 42 OLP patients. Number of sites involved, severity and activity score of OLP were evaluated. Psychological tests were used to evaluate patients’ psycho-emotional condition. The mean duration time of symptomatic OLP was 43 months.ResultsWe detected that the longer the duration of subjective symptoms, the poorer the quality of life and the higher the level of perceived stress (PSS). Also, the higher the PSS results, the greater the anxiety and depression on Hospital Anxiety and Depression Scale (HADS). Likewise, higher level of depression in HADS was strongly correlated with worse quality of life. (p≤0.05).ConclusionsIn this study, we detected a relationship between duration of the disease, level of perceived stress and quality of life. The longer the disease lasts, the higher it tends to catastrophize. This may influence development or increase of the anxiety and depression and may decrease patients’ quality of life.

Increased cyclooxygenase 2 expression in association with oral lichen planus severity

Background/purposeAlthough some studies have shown induction of cyclooxygenase 2 (COX-2) in oral lichen planus (OLP), an association between COX-2 upregulation and OLP clinical severity has not been investigated. Therefore, we aimed to compare COX-2 expression in OLP with that in normal oral tissues, and to determine correlations between COX-2 expression and both clinical criteria and visual analog scale (VAS) scores. Materials and methodsCOX-2 expression was studied in 25 OLP and 13 normal oral tissues by immunohistochemistry. Both clinical criteria and VAS scores were used to evaluate the clinical severity of OLP. The differences in COX-2 expression between OLP and normal tissues, and the correlations between COX-2 expression and clinical severity were determined by the nonparametric statistical tests. ResultsCOX-2 expression was significantly increased in OLP epithelium when compared with normal epithelium (P < 0.001), and intense COX-2 staining in inflammatory infiltrates was observed in the OLP lamina propria. COX-2 expression in OLP epithelium and inflammatory infiltrates was significantly correlated with the clinical criteria score (r = 0.428, P = 0.007, and r = 0.681, P < 0.001, respectively), whereas a significant correlation with the VAS score was observed only in OLP inflammatory infiltrates (r = 0.605, P < 0.001). ConclusionEnhanced COX-2 expression in both OLP epithelium and inflammatory infiltrates correlates well with the clinical severity. An association between VAS score and COX-2 expression in OLP inflammatory infiltrates suggests an important role of additional COX-2 expression from inflammation in causing pain in OLP patients.

OI0414 Two scoring systems comparison: evaluation of lichen planus severity

OI0414 Two scoring systems comparison: evaluation of lichen planus severity

Measurement of Serum Monoamine Oxidase in Lichen Planus Patients and Its Clinical Significance

To study the role of serum Monoamine oxidase (MAO) in Lichen planus(LP). 82 cases of Lichen planus patients and 35 healthy controls were selected in the investigation. The total serum MAO levels were measured. The levels of serum MAO in Lichen planus patients were significantly higher than those in healthy controls (P<0.01). The severity of Lichen planus was not correlated with serum MAO levels (r =0.4873, t=0.73, p>0.05). According to the findings, there might be a coincidence of MAO and lichen planus. However, further studies are required to clarify the immunological mechanisms which are responsible for MAO synthesis during immunoreaction.