Differential Lymphocyte Infiltration Shapes Corticosteroid Efficacy in Oral Lichen Planus

Oral lichen planus (OLP) is a chronic, immune-mediated disorder affecting 2%-4% of the population. Corticosteroids are commonly used for treatment, but responses vary, likely due to differences in lymphocyte profiles. This study evaluated the impact of CD20+ B cells and CD38+ plasma cells on corticosteroid efficacy in OLP patients.

This retrospective study included 101 patients with symptomatic, diffuse, and severe OLP. Immunohistochemical staining identified CD3+ T cells, CD20+ B cells, and CD38+ plasma cells in tissue lesions. All patients received prednisone, and outcomes were assessed using Reticulation/Erosion/Ulceration (REU) and Visual Analog Scale (VAS) scores. Statistical analyses compared treatment responses based on lymphocyte profiles.

All patients showed CD3-positive T cell infiltration. Patients in the CD20- group showed significantly greater reductions in REU and VAS scores than the CD20+ group, indicating that B cell infiltration may reduce corticosteroid efficacy. Conversely, CD38+ patients exhibited greater score reductions than CD38- patients, suggesting that plasma cells may enhance responsiveness to treatment. The CD38+/CD20- group exhibited the most favorable response; the CD38-/CD20+ group had the least.

Infiltration by B cells and plasma cells influences corticosteroid response in OLP. B cells are associated with reduced efficacy, while plasma cells correlate with improved treatment outcomes.