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

Résumé fourni par la source

Oral lichen planus (OLP) and oral lichenoid reactions (OLR) including oral lichenoid contact lesion (OLCL) and oral lichenoid drug reaction (OLDR), are clinically and histopathologically similar conditions. Mast cells play a major role in immune responses and have been implicated in the pathogenesis of OLP. This study investigated mast cell counts in OLP, OLCL and OLDR using toluidine blue staining and its association with demographic, clinical and direct immunofluorescence findings. 60 samples (30 OLP, 18 OLDR, 12 OLCL) cases were examined for mast cells using toluidine blue staining. The mean mast cell counts were obtained from five subepithelial fields at 100x magnification and analyzed using Chi square and Kruskal-Wallis tests. OLDR showed significantly elevated mean mast cell counts (p=0.015), followed by OLCL and OLP. Significant associations were found between mean mast cell counts and presence of clinical symptoms in OLP (p=0.013) and number of involved sites in OLCL (p=0.045). Buccal mucosa was the most common affected site, and reticular form was the most frequently encountered clinical presentation in all lesion types. This study demonstrated significant differences in mast cell counts among OLP, OLCL, and OLDR, with the highest mast cell density observed in OLDR, supporting a contributory role of mast cells in the pathogenesis of oral lichenoid reactions. The observed associations with clinical features further suggest that mast cells may influence disease activity and clinical expression. Toluidine blue staining is a practical and reproducible adjunctive method for mast cell assessment and may aid in distinguishing clinically and histologically overlapping OLP and OLR lesions in routine diagnostic practice.

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