Role of Mast Cells in Oral Lichen Planus and Oral Lichenoid Reactions

Suganya Ramalingam, Narasimhan Malathi, Harikrishnan Thamizhchelvan, Narasimhan Sangeetha, Sharada T Rajan, Suganya Ramalingam, Narasimhan Malathi, Harikrishnan Thamizhchelvan, Narasimhan Sangeetha, Sharada T Rajan

Abstract

Introduction: Oral lichen planus (OLP) is a chronic T cell mediated disease of oral mucosa, skin, and its appendages with a prevalence of 0.5 to 2.6% worldwide. Oral lichenoid reactions (OLR) are a group of lesions with diverse aetiologies but have clinical and histological features similar to OLP, thereby posing a great challenge in differentiating both lesions. Mast cells are multifunctional immune cells that play a major role in the pathogenesis of lichen planus by release of certain chemical mediators. Increased mast cell densities with significant percentage of degranulation have been observed as a consistent finding in pathogenesis of oral lichen planus.

Aim: The current study was aimed at quantifying the mast cells in histopathological sections of OLP and OLR thereby aiding a means of distinguishing these lesions.

Materials and methods: The study group involved 21 cases of oral lichen planus, 21 cases of oral lichenoid reactions, and 10 control specimens of normal buccal mucosa. All the cases were stained with Toluidine Blue and routine haematoxylin and eosin and the mast cells were quantified.

Statistical analysis used: The results were analyzed using the Kruskal-Wallis test and an intergroup analysis was performed using Mann-Whitney U test.

Conclusion: The number of mast cells showed an increased value in oral lichen planus when compared to oral lichenoid reaction and thus an estimation of mast cells count could aid in distinguishing OLP from OLR histopathologically.

Figures

Figure 1
Figure 1
Photomicrograph of the section shows normal buccal mucosa (H&E 10x).
Figure 2
Figure 2
Photomicrograph of the section shows parakeratotic stratified squamous epithelium with juxtaepithelial band of inflammatory infiltration in oral lichen planus (H&E 10x). The arrows refer to juxtaepithelial band of inflammatory infiltration in oral lichen planus.
Figure 3
Figure 3
Photomicrograph of the section shows parakeratotic stratified squamous epithelium with basal cell degeneration. The arrows refer to inflammatory infiltration extending deep into reticular zone of lamina propria in oral lichenoid reaction (H&E 20x).
Figure 4
Figure 4
Photomicrograph of the section shows normal buccal mucosa (Toluidine Blue 10x). The arrows refer to mast cells.
Figure 5
Figure 5
Photomicrograph of the section shows intact mast cells in oral lichen planus (Toluidine Blue 40x). The arrows refer to intact mast cells in oral lichen planus.
Figure 6
Figure 6
Photomicrograph of the section shows intact mast cells in oral lichenoid reaction (H&E 40x). The arrow refers to intact mast cells.
Figure 7
Figure 7
Mast cells distribution between study group.

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