Direct immunofluorescence staining patterns compared between oral and cutaneous lichen planus.

Area of Science:

• Immunodermatology
• Oral Pathology

Background:

• Lichen planus (LP) is an inflammatory condition affecting skin and mucous membranes.
• Direct immunofluorescence (DIF) is a diagnostic tool for autoimmune blistering diseases and other conditions.

Purpose of the Study:

• To investigate and compare direct immunofluorescence (DIF) findings in oral and cutaneous lichen planus (LP).
• To identify differences in DIF patterns between oral and cutaneous LP.
• To determine the most reliable DIF indicator for oral LP diagnosis.

Main Methods:

• Retrospective analysis of 147 patients with diagnosed LP (87 oral, 60 cutaneous).
• Evaluation of direct immunofluorescence (DIF) findings, including immunoreactant deposition at the dermoepidermal junction (DEJ) and colloid bodies (CBs).
• Statistical comparison of DIF results between oral and cutaneous LP groups.

Main Results:

• Overall positive DIF yield was 85%, lower in oral LP (79.3%) than cutaneous LP (93.3%).
• Significantly greater immunoreactant deposition at the DEJ in oral LP compared to cutaneous LP.
• Fibrin deposition with a shaggy pattern at the DEJ was significantly more prevalent in oral LP.
• Immunoreactant deposition at colloid bodies (CBs) was more frequent in cutaneous LP.

Conclusions:

• Direct immunofluorescence (DIF) reveals distinct patterns in oral and cutaneous lichen planus (LP).
• Fibrin deposition with a shaggy pattern at the dermoepidermal junction (DEJ) is proposed as the most sensitive diagnostic marker for oral LP.
• Understanding these DIF differences aids in accurate diagnosis and differentiation of LP subtypes.