Erosive oral lichen planus and salivary cortisol

Patients with oral lichen planus (OLP) often relate the onset and aggravation of oral symptoms to increased levels of stress. Under normal conditions, stress induces increased cortisol secretion that counteracts inflammatory reactions. The objective of the present study was to assess whether patients with OLP have an impaired capacity to elevate their cortisol concentrations as a response to stress. Saliva samples were collected for cortisol analysis from 10 OLP patients once every 15 min during a 2-h test period. In order to induce stress during a part of this test period, the patients were confronted with a computerised device specifically developed for the induction of transient stress. A visual analogue scale (VAS) and a mood adjective check list (MACL) were used to estimate the degree of permanent stress. A control group of patients was matched for age and sex. The OLP patients did not present with different stress scores when a psychometric test (MACL) was used. No statistically significant correlation between cortisol concentration and stress level was observed. Thus, no support for an impaired capacity of OLP patients to suppress an immune response through cortisol induction in conjunction with experimental stress was revealed.