Evaluation of Direct Immunofluorescence studies in diagnosis of oral lichen planus

Oral lichen planus (OLP) is a common chronic immunologic inflammatory disease of skin and mucous membrane which associates with pain or discomfort. The status of OLP as a premalignant condition has been debated for many years. In some cases that are not pathogonomic clinical variations like plaque, specially erosive or bullous form, histologic examination is necessary for definite diagnosis or rule out possible dysplasia and carcinoma. 1- Sometimes pathologic results mention to OLP without any type of lesion (erosive, atrophic) 2- In some cases diagnosis is not clear and results are "compatible with OLP". In these cases DIF is necessary after routine histologic examination. The aim of this study is evaluation of direct immunofluorescence in diagnosis of oral lichen planus. Methods & Materials: In a retrospective case series study first, an 18 paraffin embeded biopsies were analyzed. All were confirmed histopatholigcally for OLP. These biopsies were collected since 1379, till 1381. All biopsies were examined by direct Immunofluoresence for the Presence of IgA, IgM and IgG antibodies in oral tissues. Data were analysed statistically by Fisher Exact test and percentage frequency. 3 of 18 patients (16.6%) were male and 15 (83.3%) were females and their average age was 50.6 years. The common site of biopsy was in buccal mucosa (44.4%) Fluorescent globules were present in 11 patients (61.1%) that graded with base of fluoresent intensity to 3+, 2+, 1+. In 3 cases with white (keratotic) lesions 2 (66.6%) patients were DIF+ and in 11 cases with white and red lesions (keratotic, atrophic, erosive and bulluse) 8 cases (72.7%) were DIF+. DIF was positive in 61.1% of OLP patients. According to Fisher's test there was no significant differences between white (keratotic) and red (erosive …) lesions and DIF+ (P=0.67).