Direct Immunofluorescence Positivity Rates as a Potential Identification Marker Between Oral Lichen Planus and Oral...

Area of Science:

• Oral pathology
• Immunodermatology
• Diagnostic accuracy

Background:

• Oral lichen planus (OLP) and oral lichenoid lesions (OLL) require accurate differentiation for appropriate patient management.
• Direct immunofluorescence (DIF) is a diagnostic tool with potential in distinguishing these conditions.

Purpose of the Study:

• To evaluate the diagnostic role of direct immunofluorescence (DIF) in differentiating oral lichen planus (OLP) from oral lichenoid lesions (OLL) using a meta-analysis approach.

Main Methods:

• An extensive literature search was conducted across major scientific databases up to October 2025.
• Five relevant studies involving 465 participants were included after quality assessment.
• Meta-analyses were performed using RevMan 5.4 and Stata 18.0 software.

Main Results:

• Significant differences in DIF positivity rates for fibrin (Fib), IgA, and IgM were observed between OLP and OLL.
• Area under the curve (AUC) values for Fib and IgA suggested moderate diagnostic efficacy.
• Pooled analysis confirmed higher positive rates of Fib, IgA, and IgM in OLP compared to OLL.

Conclusions:

• Fibrin, IgA, and IgM show potential as biomarkers to aid in the differential diagnosis of OLP.
• Relying on a single antibody's positivity is insufficient for definitive OLP/OLL distinction.
• Further investigation into immunofluorescence patterns is necessary to refine diagnostic criteria.