THE ROLE OFB1 INTEGRINS AND LAMININ IN THE PATHOGENESIS OF ORAL LICHEN PLANUS

Abstract

Oral lichen planus (OLP) is a common chronic mucocutaneous disease. The prevalence ofOLP is 1.9% in the general population .OLP is mainly seen on the buccal mucosa. Various forms of OLP appear clinically: reticular, papular, plaque like, atrophic, erosive and bullous lesions that can occur separately or simultaneously. In papular fonn there is 0.5 to lmm withish elevated lesions, or papules while atrophic fonn describes inflamed areas of the oral mucosa covered by thinned red epithelium, plaque like, atrophic forms are very frequently accompanied by reticular lesions, the diagnosis of OLP is often confirmed by identifying an area of reticular pattern which consists of whitish lines (Wickham's striae) that produce either a lace like lesion or annular iesions. Atrophic and erosive forms usually cause symptoms of pain and discomfort. The most frequently described therapy for OLP has been the administration of topical or systemic corticosteroids. Because of the severity and nature ofL.P, high doses of corticosteroids are usually needed for prolonged periods for disease control. Because of the frequent occurrence or•corticosteroids side effects, inadequate control, or both, supplementation with other drugs often is required. The use of systemic levamisole plus low-dose prednisolone in oral lichen planus showed excellent objective and subjective therapeutic effects, levamisole has been shown to be effective and relatively safe in comparison with high-dose prednisolone, obviously, the role of levamisole in achieving longer term remission and speeding clinical efficacy is positive, this is one of the major advantages of levamisole over prednisone. Histopathologically, OLP shows focal hyperkeratosis, irregular acanthosis, basal cell liquefaction degeneration, and a dense bank like infiltrate of T lymphocytes, changes believed to represent an aberrant cell-mediated immune response directed against basal keratinocytes.