Evaluation of mast cells, eosinophils, blood capillaries in oral lichen planus and oral lichenoid mucositis

BACKGROUND Lichen planus (LP) is a chronic T cell mediated autoimmune disorder affecting the skin and mucosa of the oral cavity. Mainstays of treatment are corticosteroids which are mostly used topically, and severe cases require systemic management. Recalcitrant or severe cases may require steroid sparing immune-modulators. Mast cells are predominant in the active phase of LP and antihistamines reduce mast cell numbers. The purpose of this study was to evaluate the effectiveness of antihistamines in oral lichen planus. METHODS This study was conducted from June 2019 to March 2020 in oral medicine department. A total of 54 patients were included in which group – 1 (n = 27) patients were treated with both systemic antihistamine with topical steroids, group – 2 (n = 27) patients were treated with topical steroids only. The Challacombe scale was used to assess the severity of disease at baseline, 15 days and 30 days. RESULTS Results showed that patients were in the age group of 51 - 60 years (27.8 %), female predilection (63 %), erosive OLP (50 %) and reticular OLP (38.8 %) was most commonly reported. Mean difference and standard deviation at first review and second review for group 1 was 9.85 ± 2.349, 8.14 ± 2.685; group 2 was 4.74 ± 2.297, 4.37 ± 2.436 respectively with a statistically significant value (< 0.05). In between the reviews, group - 1 showed a rapid reduction in severity of disease when compared to group - 2. CONCLUSIONS A combined therapy of topical steroids and systemic antihistamines was more effective in active reduction of disease and are easily available with no adverse effects reported. KEY WORDS Antihistamines; Challacombe Scale; Mast Cells; Oral Lichen Planus

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Role of Mast Cells in Oral Lichen Planus and Oral Lichenoid Reactions

Autoimmune Diseases ◽

10.1155/2018/7936564 ◽

2018 ◽

Vol 2018 ◽

pp. 1-5

Author(s):

Suganya Ramalingam ◽

Narasimhan Malathi ◽

Harikrishnan Thamizhchelvan ◽

Narasimhan Sangeetha ◽

Sharada T Rajan

Keyword(s):

Mast Cells ◽

Lichen Planus ◽

Immune Cells ◽

Oral Lichen Planus ◽

Consistent Finding ◽

Cell Densities ◽

Lichenoid Reactions ◽

Oral Lichen ◽

Chemical Mediators

Introduction. Oral lichen planus (OLP) is a chronic T cell mediated disease of oral mucosa, skin, and its appendages with a prevalence of 0.5 to 2.6% worldwide. Oral lichenoid reactions (OLR) are a group of lesions with diverse aetiologies but have clinical and histological features similar to OLP, thereby posing a great challenge in differentiating both lesions. Mast cells are multifunctional immune cells that play a major role in the pathogenesis of lichen planus by release of certain chemical mediators. Increased mast cell densities with significant percentage of degranulation have been observed as a consistent finding in pathogenesis of oral lichen planus. Aim. The current study was aimed at quantifying the mast cells in histopathological sections of OLP and OLR thereby aiding a means of distinguishing these lesions. Materials and Methods. The study group involved 21 cases of oral lichen planus, 21 cases of oral lichenoid reactions, and 10 control specimens of normal buccal mucosa. All the cases were stained with Toluidine Blue and routine haematoxylin and eosin and the mast cells were quantified. Statistical Analysis Used. The results were analyzed using the Kruskal–Wallis test and an intergroup analysis was performed using Mann–Whitney U test. Conclusion. The number of mast cells showed an increased value in oral lichen planus when compared to oral lichenoid reaction and thus an estimation of mast cells count could aid in distinguishing OLP from OLR histopathologically.

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