Effectiveness of corticosteroid therapy in oral lichen planus

Abstract

Introduction. Lichen planus is an acquired, chronic, immune-mediated disease, manifesting as polygonal, purple, pruritic, planar papules or on the skin and other lesions on the mucosal membranes, such as in the oral cavity. Lichen planus is reported in less than 1% of the population. The incidence may increase in December and January. No significant geographical variation and no racial or sex predispositions have been observed. Children are rarely affected; most patients affected by lichen planus lie in the range of 30 – 60 years. Lichen planus is thought to be an immunologically-mediated disorder. It seems to be a CD8 cell-mediated response against antigens in the basal cell layer and the dermo-epidermal junction (mainly keratinocytes). The cause of this response is unknown, and exposure to certain viruses (e.g., hepatitis C and hepatitis B) or medications have been considered. The immune-mediated damage to keratinocytes releases melanin into the dermis, leading to hyperpigmentation. The main pathology of the lesion is primarily found at the interface of the squamous epithelium and papillary dermis (interface dermatitis). At this junction, microscopically, a dense lymphocyte infiltration is seen. The damaged basal keratinocytes often atrophy or become necrotic; they appear like the mature cells of the stratum spinosum (squamatisation). This, in turn, causes saw toothing (angulated contour) of the interface. In the dermis, anucleate, necrotic basal cells (colloid or Civatte bodies) are seen. In addition to these changes, other features of lichen planus include epidermal hyperplasia, hypergranulosis, and hyperkeratosis. Aim. To prove the effectiveness of corticosteroid therapy in patients with oral lichen planus Materials and method: 5 cases of lichen planus were studied, these cases were treated earlier in community institution “zaporozhye regional dermatovenerolgy clinical hospital” in zaporozhye regional council during 2018-2019. Standard methods of diagnosis and treatment are used according to the national regime.