Incidence of Oral Lichen Planus in Perimenopausal Women: A Cross-sectional Study in Western Uttar Pradesh Population

Ravi Prakash Sasankoti Mohan, Akanksha Gupta, Nagaraju Kamarthi, Sangeeta Malik, Sumit Goel, Swati Gupta, Ravi Prakash Sasankoti Mohan, Akanksha Gupta, Nagaraju Kamarthi, Sangeeta Malik, Sumit Goel, Swati Gupta

Abstract

Background: Hormonal fluctuations during menopause lead to endocrine changes in women, especially in their sex steroid hormone production. Studies have documented the role of estrogen and progesterone (Pg) on autoimmune disorders such as multiple sclerosis, systemic lupus erythematosus, and rheumatoid arthritis. Lichen planus (LP), an autoimmune disorder, seen frequently in perimenopausal women, may also get affected by sex steroid hormones, but no direct relationship has been established yet.

Aim: The aim of this study is to find the incidence of oral LP (OLP) in perimenopausal women and evaluate the factors associated with it.

Materials and methods: This cross-sectional study was conducted over a period of 1 year. All the perimenopausal women (44.69 ± 3.79 years) who came to the dental outpatient department were evaluated for the presence of LP and various factors associated with it. Depression Anxiety Stress Scale-21 questionnaire was used for psychometric evaluation of perimenopausal women.

Results: According to our study, incidence of LP in postmenopausal women was 10.91%, which is higher than incidence of LP in general population, i.e., 0.5% to 2.0%. Incidence of LP increased with the severity of depression in perimenopausal women (P = 0.000).

Conclusion: The incidence of OLP is higher in perimenopausal women than in general population and increases significantly with increase in the severity of depression. LP in perimenopausal women can be mediated by declined level of estrogen and Pg directly or indirectly through causing depression that can trigger LP.

Keywords: Autoimmunity; depression; estrogen; lichen planus; perimenopausal women; progesterone.

Conflict of interest statement

There are no conflicts of interest.

References

    1. Grover CM, More VP, Singh N, Grover S. Crosstalk between hormones and oral health in the mid-life of women: A comprehensive review. J Int Soc Prev Community Dent. 2014;4(Suppl 1):S5–10.
    1. Ahuja M. Age of menopause and determinants of menopause age: A PAN India survey by IMS. J Midlife Health. 2016;7:126–31.
    1. Santoro N, Randolph JF., Jr Reproductive hormones and the menopause transition. Obstet Gynecol Clin North Am. 2011;38:455–66.
    1. Prior JC. Progesterone for symptomatic perimenopause treatment - Progesterone politics, physiology and potential for perimenopause. Facts Views Vis Obgyn. 2011;3:109–20.
    1. Gupta A, Mohan RP, Gupta S, Malik SS, Goel S, Kamarthi N. Roles of serum uric acid, prolactin levels, and psychosocial factors in oral lichen planus. J Oral Sci. 2017;59:139–46.
    1. Ismail SB, Kumar SK, Zain RB. Oral lichen planus and lichenoid reactions: Etiopathogenesis, diagnosis, management and malignant transformation. J Oral Sci. 2007;49:89–106.
    1. Khan D, Ansar Ahmed S. The immune system is a natural target for estrogen action: Opposing effects of estrogen in two prototypical autoimmune diseases. Front Immunol. 2016;6:635.
    1. Hughes GC. Progesterone and autoimmune disease. Autoimmun Rev. 2012;11:A502–14.
    1. White HD, Crassi KM, Givan AL, Stern JE, Gonzalez JL, Memoli VA, et al. CD3+ CD8+ CTL activity within the human female reproductive tract: Influence of stage of the menstrual cycle and menopause. J Immunol. 1997;158:3017–27.
    1. Schmidt PJ, Rubinow DR. Sex hormones and mood in the perimenopause. Ann N Y Acad Sci. 2009;1179:70–85.
    1. Manolache L, Seceleanu-Petrescu D, Benea V. Lichen planus patients and stressful events. J Eur Acad Dermatol Venereol. 2008;22:437–41.
    1. Tawil M, Sediki N, Hassan H. Psychobiological aspects of patients with lichen planus. Curr Psychiatry. 2009;16:370–80.
    1. Kalkur C, Sattur AP, Guttal KS. Role of depression, anxiety and stress in patients with oral lichen planus: A pilot study. Indian J Dermatol. 2015;60:445–9.
    1. Soares CN, Almeida OP, Joffe H, Cohen LS. Efficacy of estradiol for the treatment of depressive disorders in perimenopausal women: A double-blind, randomized, placebo-controlled trial. Arch Gen Psychiatry. 2001;58:529–34.
    1. Sandhu SV, Sandhu JS, Bansal H, Dua V. Oral lichen planus and stress: An appraisal. Contemp Clin Dent. 2014;5:352–6.
    1. Srivastava K. Urbanization and mental health. Ind Psychiatry J. 2009;18:75–6.
    1. Munde AD, Karle RR, Wankhede PK, Shaikh SS, Kulkurni M. Demographic and clinical profile of oral lichen planus: A retrospective study. Contemp Clin Dent. 2013;4:181–5.
    1. Lamey PJ, Gibson J, Barclay SC, Miller S. Grinspan's syndrome: A drug-induced phenomenon? Oral Surg Oral Med Oral Pathol. 1990;70:184–5.
    1. Lavaee F, Majd M. Evaluation of the association between oral lichen planus and hypothyroidism: A retrospective comparative study. J Dent (Shiraz) 2016;17:38–42.
    1. Unnikrishnan AG, Kalra S, Sahay RK, Bantwal G, John M, Tewari N. Prevalence of hypothyroidism in adults: An epidemiological study in eight cities of India. Indian J Endocrinol Metab. 2013;17:647–52.
    1. Sànchez-Pérez J, De Castro M, Buezo GF, Fernandez-Herrera J, Borque MJ, García-Díez A. Lichen planus and hepatitis C virus: Prevalence and clinical presentation of patients with lichen planus and hepatitis C virus infection. Br J Dermatol. 1996;134:715–9.

Source: PubMed

Sponzoři a spolupracovníci

Zdravotní podmínky

Drogové intervence

3
Předplatit